LegiStorm

Summary:

Sub-Saharan Africa ("Africa" hereafter) has been more severely affected by AIDS than any other world region. In 2007, the United Nations reports, there were about 22.5 million HIV-positive persons in Africa, which has nearly 12% of the world's population but about 68% of the global total of infected persons. The adult rate of infection in Africa in late 2005 was 6.1%, compared with 1% worldwide, but had dropped to 5% by 2007, compared to .8% worldwide. Nine southern African countries have infection rates above 10%. In 2007, 35% of all people living globally with HIV lived in Southern Africa, where 32% of all global new HIV infections and AIDS deaths occurred. About 90% of infected children globally live in Africa, where about 61% of infected adults are women. As many as 30 million Africans may have died of AIDS since 1982, including 1.6 million who died in 2007, accounting for about 76% of global AIDS deaths in 2007. AIDS has surpassed malaria as the leading cause of death in Africa. It kills many more Africans than does war. Experts attribute the severity of Africa's AIDS epidemic to poverty, lack of female empowerment, high rates of male worker migration, and other factors. Many national health systems are ill-equipped for prevention, diagnosis, and treatment. AIDS causes severe socioeconomic consequences, e.g., declines in economic productivity due to sharp drops in life expectancy and the loss of skilled workers. It also devastates family structures. There are about 11.4 million African AIDS orphans, many of whom lack access to adequate nutrition and social services. Private organizations and the governments of donor and African nations have responded by supporting diverse efforts to prevent and reduce the rate of new infections and by trying to abate damage done by AIDS to families, societies, and economies. The adequacy of this response is much debated. An estimated 1.3 million Africa AIDS patients receiving antiretroviral (ARV) drug treatment in late-2005, up from 150,000 in mid-2004. An estimated 4.8 million Africans needed such therapy in late 2005. U.S. and other initiatives are reportedly sharply expanding access to treatment. Advocates see this goal as an affordable means of reducing the impact of the pandemic. Skeptics question whether drug access can continue to be rapidly scaled up in the absence of costly general health infrastructure improvements. U.S. concern over AIDS in Africa grew in the 1980s, as the epidemic's severity became apparent. Congress has steadily increased funding for global AIDS programs. P.L. 108-25, signed into law on May 27, 2003, authorized $15 billion over five years for international AIDS programs under the President's Emergency Plan for AIDS Relief (PEPFAR). Twelve of 15 PEPFAR "focus countries" are in Africa. Under the FY2008 budget request, these 12 countries would receive $3.421 billion under the State Department's Global HIV/AIDS Initiative. Many activists have praised the extent of such aid, but some urge that more funding or different programs be provided. Congress is likely to re-authorize PEPFAR, which expires after FY2008, or create a successor program. Other bills in the 110th Congress that focus on AIDS in Africa include S. 805 (Durbin), H.R. 3812 (Lee), H.R. 1713 (Lee), S. 2415 (Clinton), and S.Con.Res. 31 Global AIDS appropriations are discussed in other CRS reports cited within this report, which will be updated periodically.