Trends in U.S. Global AIDS Spending: FY2000-FY2007

Publication Date: December 2006

Publisher: Library of Congress. Congressional Research Service

Author(s):

Research Area: Health

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Abstract:

According to the Joint United Nations Program on HIV/AIDS (UNAIDS), since AIDS was identified in 1981, about 65 million people have been infected with HIV, and more than 25 million people have died from AIDS. At the end of 2005, some 40 million people were living with HIV/AIDS worldwide, more than 4 million of whom were newly infected; almost 3 million died of AIDS-related illnesses in 2005. More than 2 million of those living with HIV/AIDS at the end of 2005 were children, and some 570,000 of those who died of AIDS that year were under 15 years old.

UNAIDS estimates that in each day of 2005, some 1,500 children worldwide became infected with HIV, due in large part to inadequate access to drugs that prevent the transmission of HIV from mother to child. Only 9% of pregnant women in low- and middle-income countries were offered services to prevent HIV transmission to their newborns. UNAIDS asserts that an effective fight against the global spread of HIV/AIDS would cost $15 billion in 2006, $18 billion in 2007, and $22 billion in 2008. In FY2006, Congress provided almost $3.4 billion for international HIV/AIDS, tuberculosis (TB), and malaria programs, which included U.S. contributions to international partnerships, such as the Global Fund to Fight AIDS, TB, and Malaria (Global Fund). Most recent statistics indicate that in 2005, some $8.3 billion was spent on HIV/AIDS globally, though UNAIDS estimated that $11.6 billion was needed. About $4.3 billion of those funds were provided by donor governments. The Kaiser Family Foundation asserts that in 2005, the United States provided the largest percent of HIV/AIDS assistance in the world, comprising some 49% of all donor spending.

Although the United States is the leading provider of international HIV/AIDS assistance, some argue that it needs to give more, particularly to the Global Fund. Critics of increased AIDS spending, however, question whether the most affected region -- sub-Saharan Africa -- can absorb increased revenue flows. Some also contend that additional HIV/AIDS allocations will yield limited results, as poor health care systems and health worker shortages complicate efforts to scale up HIV/AIDS spending. While this report describes how HIV/AIDS, TB, and malaria are interlinked and exacerbate efforts to control each disease, it primarily addresses funding issues related to U.S. global HIV/AIDS initiatives. It provides background information on the key U.S. agencies that implement global HIV/AIDS programs; analyzes U.S. spending on HIV/AIDS by U.S. agency and department; and presents some issues Congress might encounter in the 110th Congress. This report will be updated to reflect the final decision on FY2007 appropriations.