In the speech, he also called on the Congress to support his May 2007 call to double U.S. international funding for AIDS, to $30 billion over five years, starting in 2009.
International AIDS issues are further covered in CRS Report RL33485, U.S. International HIV/AIDS, Tuberculosis, and Malaria Spending: FY2004-FY2008 , by [author name scrubbed]; CRS Report RL34192, PEPFAR: Policy Issues from FY2004 through FY2008 , by [author name scrubbed]; CRS Report RL33396, The Global Fund to Fight AIDS, Tuberculosis, and Malaria: Progress Report and Issues for Congress , by [author name scrubbed]; and CRS Report RL31712, The Global Fund to Fight AIDS, Tuberculosis, and Malaria: Background , by [author name scrubbed]. Characteristics of the African Epidemic2

		Overview

Sub-Saharan Africa ("Africa" hereafter) has been far more severely affected by HIV/AIDS than any other world region. Africa has nearly 12% of the world's population but about 68% of the global total of infected persons. In 2007, about 1.6 million adults and children were estimated to have died of AIDS, comprising about 76% of global AIDS deaths in 2007, down from a 2006 estimate of about 2.1 million deaths, when African AIDS deaths made up about 72% of global AIDS deaths. Aggregate estimates of deaths caused by AIDS suggest that many as 30 million Africans may have died of AIDS since 1982, at the start of the epidemic, including those who perished in 2007. It causes more deaths than malaria in African adults, and kills many times more people than Africa's armed conflicts. 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. Recent prevalence declines are attributable to a combination of deaths of infected persons; declines in new infections due to behavioral change and increased access to testing; the scaling up of access to drug therapy; and, in some cases, improved social services and access to better nutrition. Highest Rates

Southern Africa, where nine countries have adult infection rates above 10% ( Table 1 ) , is the most severely affected region. They comprised about 59% of infected adults in Africa and about 76% of HIV-positive females globally in late 2005; women comprised a slightly higher proportion of all AIDS infections in Africa, 61%, by 2007. Nonetheless, roughly 2.24 million African children under age 15 were living with AIDS in 2007, down slightly from an estimated 2.3 million in late 2005. There were an estimated 11.4 million orphans due to AIDS in Africa in 2007. P.L. In the most severely affected countries, sharp drops in life expectancy are occurring, reversing major gains achieved in recent decades. Responses to the AIDS Epidemic

Donor governments, non-governmental organizations (NGOs) working in Africa, and African governments have responded to the AIDS epidemic primarily by attempting to reduce the number of new HIV infections through prevention programs, and to some degree, by trying to ameliorate the damage done by AIDS to families, societies, and economies. Initiatives to expand ARV availability continued, and treatment became a major focus of Global Fund and the President's Emergency Plan for AIDS Relief (PEPFAR) programs (see below). 108 - 25 , the United States Leadership Against Global HIV/AIDS, Tuberculosis, and Malaria Act of 2003, signed into law by President Bush on May 27, 2003. U.S. Assistance

Under the President's FY2008 budget request, the 12 focus countries in Africa would receive $3.421 billion under the GHAI account. Legislation in the 110th Congress

Apart from appropriations legislation that would fund global HIV/AIDS assistance programs, legislation introduced in the 110 th Congress that focus on AIDS in Africa include:
S. 805 (Durbin) and H.R. H.R. 1713 (Lee) and S. 2415 (Clinton), both entitled Protection Against Transmission of HIV for Women and Youth Act of 2007. S.Con.Res.
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.