AIDS in Africa
Publication Date: February 2008
Publisher: Library of Congress. Congressional Research Service
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Sub-Saharan Africa ("Africa" hereafter) has been more severely affected by AIDS than any other part of the world. In 2006, the United Nations reports, there were in the range of 24.7 million HIV-positive persons in the region, which has just over 11% of the world's population but about 64% of the worldwide total of infected persons. The overall adult rate of infection in Africa in late 2005 was 6.1%, compared with 1% worldwide. Nine southern African countries have infection rates above 10%. Ten African countries with the largest infected populations account for over 50% of infected adults worldwide. By the end of 2005, an estimated 28.9 million or more Africans had died of AIDS since 1982, including 2.1 million in 2006, which comprised about 72% of global AIDS death in 2006. AIDS has surpassed malaria as the leading cause of death in Africa, and it kills many times more Africans than war. In Africa, about 59% of infected adults are women.
Experts attribute the severity of Africa's AIDS epidemic to the region's poverty, women's relative lack of empowerment, high rates of male worker migration, and other factors. Health systems are ill-equipped for prevention, diagnosis, and treatment. AIDS' severe social and economic consequences are depriving Africa of skilled workers and teachers, and reducing life expectancy by decades in some countries. There are an estimated 12.3 million African AIDS orphans. They face increased risk of malnutrition and reduced prospects for education. AIDS is blamed for declines in farm production in some countries and is seen as a major contributor to hunger and famine.
Private organizations and the governments of donor and African nations have responded by supporting diverse efforts to prevent and reduce the number 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 810,000 Africa AIDS patients were being treated with antiretroviral drugs in late-2005, up from 150,000 in mid-2004. An estimated total of 4.7 million persons were in need of such therapy. U.S. and other initiatives are expected to sharply expand access to treatment in the near future. Advocates see this goal as an affordable means of reducing the impact of the pandemic. Skeptics question whether drugs can be made widely accessible without costly health infrastructure improvements.
U.S. concern over AIDS in Africa grew in the 1980s, as the epidemic's severity became apparent. Legislation enacted in the 106th and the 107th Congresses increased funding for worldwide AIDS programs. P.L. 108-25, signed into law on May 27, 2003, authorized $15 billion over five years for international AIDS programs. President Bush announced his Emergency Plan for AIDS Relief (PEPFAR) in his 2003 State of the Union message. Twelve of 15 PEPFAR "focus countries" are in Africa. Under the FY2007 budget request, the 12 countries would receive a 61% boost in AIDS-related aid, to $1.99 billion, under the State Department's Global HIV/AIDS Initiative account. Nonetheless, activists and others urge that more be done, given the scale of the African pandemic. This CRS report replaces CRS Issue Brief IB10050, AIDS in Africa, by Nicolas Cook. It will be updated as circumstances warrant.