Global Policy

The Global HIV/AIDS Epidemic

OVERVIEW

Globally, HIV/AIDS has killed more than 25 million people, and another 39.5 million are estimated to be living with HIV throughout the world. In 2006, three million people died of AIDS-related causes and 4.3 million were infected with HIV. Ninety-five percent of people living with HIV/AIDS live in low- and middle-income countries.

Countries in sub-Saharan Africa have been hardest hit, followed by the Caribbean. Parts of Eastern Europe and Asia are reporting burgeoning HIV/AIDS rates. For more information on the impact of HIV/AIDS on this region – and on women and young people -- refer to the Kaiser Family Foundation Global AIDS Fact Sheet, November 2006.

THE GLOBAL RESPONSE TO HIV/AIDS

The international community has significantly increased support to global HIV/AIDS initiatives, but resources continue to fall short of meeting projected need. Most people at risk for HIV do not have access to prevention, care or treatment. UNAIDS estimates that spending on HIV/AIDS rose from US$300 million in 1996 to $8.3 billion in 2005. However, the need is much higher. UNAIDS also estimates that $15 billion will be needed to effectively respond to the HIV/AIDS epidemic in low- and middle-income countries, rising to $22 billion by 2008. The shortfall in resources limits the ability of countries most affected by the AIDS crisis to scale up effective prevention and treatment programs. Prevention programs reach fewer than one in five persons who need them and only 24% of people with HIV/AIDS who require antiretroviral therapy can get the medications they need.

The U.S. is a key supporter of global HIV/AIDS programming – contributing the highest dollar amount to prevention, care and treatment programs. U.S assistance is channeled largely through two programs: The President’s Emergency Plan for AIDS Relief (PEPFAR) and The Global Fund to Fight AIDS, Tuberculosis and Malaria.

PEPFAR

As the U.S. government’s five-year global initiative to address HIV/AIDS, TB and malaria in developing countries, PEPFAR targets the bulk of its funding to treatment in the 15 countries that are among those most affected by HIV/AIDS . Bilateral assistance is channeled to 108 additional countries. U.S. funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria also comes under the PEPFAR umbrella. PEPFAR was authorized by the U.S. Congress under the United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003 (Public Law No. 197-25). The Act must be reauthorized in 2008.

The achievements of PEPFAR have been significant. PEPFAR has supported antiretroviral treatment for 822,000 people in the 15 focus countries; 61 percent are women. In addition, PEPFAR supported HIV testing and counseling to more than 18.7 million people; prevention of mother-to-child HIV services for women during more than six million pregnancies; and care to 4.5 million orphans and people living with HIV and AIDS.

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Created in 2002, the Global Fund has played a leading role in fighting AIDS, TB and malaria around the world. It has grown into an organization with $6.8 billion committed to programs in 136 countries and now provides 20 percent of the world’s AIDS financing and two-thirds of all donor funding for TB and malaria each. As a result of its work, 770,000 people are receiving life-saving AIDS medication, two million people have been treated for TB and 18 million bed nets have been distributed to prevent children from getting malaria. The Global Fund is also working with bilateral programs to confront extremely drug-resistant TB that threatens to undermine not only basic TB control but also AIDS treatment as well.

Global HIV/AIDS Funding Requirements in 2007

Congress increased U. S. funding for global AIDS, tuberculosis and malaria programs by some $1.3 billion in 2007. APLA, with other AIDS service organizations and non-governmental organizations, successfully advocated for the increase, and is doing the same during current deliberations on 2008 appropriations.

Advocates are asking for $7.6 billion for 2008 alone and state that PEPFAR will need closer to $50 billion over the next five years to meet the global need. APLA and many other organizations are also advocating to lift restrictions on prevention funding in PEPFAR. Currently a third of all prevention funds must be spent on abstinence-only sex education. Many say this mandate limits PEPFAR’s effectiveness by imposing ideological restrictions on direct prevention programs.

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