More than 36 million people in the world today are living with HIV/AIDS. Of those, some 95% live in the Global South; sub-Saharan Africa alone is home to over 25 million, or about 70% of the world’s cases. Some twelve million African children are counted as AIDS orphans. Fifty-five percent of the HIV-positive people in sub-Saharan Africa are women; six out of seven children who are HIV-positive are girls. An estimated seventeen million Africans have died from AIDS-related causes.
In the midst of these tragic figures, there are hopeful signs. African leadership – political, NGO, and faith-based – have increasingly directed attention to the pandemic. Senegal and Uganda have been notable in the effectiveness of their prevention campaigns. Advocacy efforts from within and outside of Africa have led to dramatic declines in costs of AIDS medications. And in Congress, an array of legislation has been put forward to address various aspects of the pandemic, reflecting a growing concern and commitment within the United States to share responsibility for confronting this tragic disease. This document seeks to describe and analyze these latter efforts.
Key to AIDS initiatives is money: How much, for what purpose, and how administered.
How much: The figures most widely accepted in recent months have been a total of $7-10 billion annually to confront AIDS globally. A June 22, 2001, report in Science magazine concluded that the world’s poorest countries will need $9.2 billion annually – $4.4 billion for treatment, and $4.8 billion for prevention. Sub-Saharan Africa, the report suggests, will need half of that. Current spending only totals about $1.8 billion. Advocates argue that, given the place of the US in the world economy, our proportion should be in the range of 22-29%.
The U.S. has appropriated $285 million for global HIV/AIDS through USAID for this fiscal year. It has also appropriated $100 million for the global fund, but the fund is not expected to be operative until January 2002. President Bush budgeted for $329 million for global HIV/AIDS programs for FY2002, and has since pledged an “initial” $200 million for the global fund. Many Africa advocates in the US, including the Washington Office on Africa, have called for a minimum US appropriation of $2.75 to $3 billion divided equally between total AIDS-specific funding, new funds for global health issues, and new Africa-specific development aid.
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