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AlexandraE. Kendall
Analyst in Global Health
Thehuman immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) isone of the world’s most pressing global health challenges. Since thebeginning of the epidemic, more than 60 million people have been infectedwith HIV, approximately 30 million of whom have died of HIV-relatedcauses. At the end of 2010, an estimated 34 million people were living with thevirus, the vast majority of whom live in sub-Saharan Africa. Expanded access toantiretroviral therapy (ART) over the past decade, due in large part toU.S. support, has contributed to declines in deaths among people livingwith HIV. Nonetheless, new infections continue to outpace access totreatment. The second session of the 112th Congress will likely be faced withdetermining how, and to what extent, the United States should respond tothe continued challenge of global HIV/AIDS.
The United States has recognized HIV/AIDS as a key foreign policy priority.Congress has passed several pieces of legislation related to globalHIV/AIDS prevention, treatment, and care. In particular, in 2003, Congressenacted the U.S. Leadership Against HIV/AIDS, Tuberculosis, and MalariaAct of 2003 (P.L. 108-25), authorizing $15 billion to combat global HIV/AIDS, tuberculosis(TB), and malaria through the President’s Emergency Plan for AIDS Relief (PEPFAR),an initiative proposed by the George W. Bush Administration. In 2008, Congress enactedthe Tom Lantos and Henry J. Hyde United States Global Leadership AgainstHIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (P.L.110-293), authorizing $48 billion for HIV/AIDS, TB, and malaria programsfrom FY2009 through FY2013.
PEPFAR is the largest commitment in history by any nation to combat a singledisease and makes up the majority of donor funding for global HIV/AIDS.When PEPFAR was announced, health experts were debating whether theinternational community had a responsibility to provide ART in developingcountries and whether they could be safely administered in such environments. PEPFARresponded to calls from those advocating treatment for the world’s poor and demonstratedthat ART could be effectively provided in low-resource settings.
PEPFAR is coordinated by the Office of the U.S. Global AIDS Coordinator (OGAC)at the Department of State and is implemented by a range of U.S. agenciesthat include, among others, the United States Agency for InternationalDevelopment (USAID) and the Centers for Disease Control and Prevention(CDC). The United States also supports several multilateral organizations respondingto HIV/AIDS, including the Global Fund to Fight AIDS, Tuberculosis and Malaria (GlobalFund) and the United Nations Joint Program on HIV/AIDS (UNAIDS).
Due in part to the global response to HIV/AIDS, substantial progress has beenmade in combating the epidemic. New HIV infections fell by more than 25%in 33 countries between 2001 and 2009, and a total of 2.5 million deathshave been averted in low- and middle-income countries since 1995 due toantiretroviral therapy. At the same time, major challenges remain in the fightagainst HIV/AIDS. For example, with new infections outpacing availabletreatment, experts have increasingly debated how to best allocate limitedresources. This report outlines basic facts related to global HIV/AIDS,including characteristics of the epidemic and U.S. legislation, programs,funding, and partnerships related to global HIV/AIDS. It concludes with a brief descriptionof some of the major issues that might be considered by the 112th Congress inits response to the disease.
Date of Report: June 15, 2012
Number of Pages: 16
Order Number: R41645
Price: $29.95
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