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Congressional Research Service ÷ The Library of Congress AIDS in Africa Sub-Saharan Africa has been far more severely affected by AIDS than any other part of the world. The United Nations reports that 29.4 million adults and children are infected with the HIV virus in the region, which has about 10% of the worldŐs population but more than 70% of the worldwide total of infected people. The overall rate of infection among adults in sub-Saharan Africa is 8.8%; compared with 1.2% worldwide. Twelve countries, mostly in east and southern Africa, have HIV infection rates of more than 10%, and the rate has reached 38.8% in Botswana. As of 2001, an estimated 21.5 million Africans had died of AIDS, including 2.2 million who died in that year. AIDS has surpassed malaria as the leading cause of death in Africa, and it kills many times more Africans than war. In Africa, 58% of those infected are women.
Experts relate the severity of the African AIDS epidemic to the regionŐs poverty. Health systems are ill-equipped for prevention, diagnosis, and treatment. Poverty forces many men to become migrant workers in urban areas, where they may have multiple sex partners. Poverty leads many women to become commercial sex workers, vastly increasing their risk of infection.
AIDSŐ severe social and economic consequences are depriving Africa of skilled workers and teachers while reducing life expectancy by decades in some countries. An estimated 11 million AIDS orphans are currently living in Africa, facing increased risk of malnutrition and reduced prospects for education. AIDS is being blamed for declines in agricultural production in some countries, and is regarded as a major contributor to the famine threatening southern Africa.
Donor governments, non-governmental organizations, and African governments have responded primarily by attempting to reduce the number of new HIV infections, and by trying ameliorate the damage done by AIDS to families, societies, and economies. The adequacy of this response is the subject of much debate. Spending from all sources on HIV/- AIDS in sub-Saharan Africa was estimated at $500 million for FY2000, while U.N. experts believe the region could effectively absorb $4.6 billion to combat the pandemic.
Treatment of AIDS sufferers with medicines that can result in long-term survival is reportedly available to fewer than 30,000 Africans. Advocates of expanded treatment argue that in view of recent drug price reductions, treatment is an affordable means of reducing AIDS damage to African economies, reinforcing prevention programs, and keeping parents alive. Skeptics argue that treatment is still too expensive to be an option for most Africans and would require costly improvements in health infrastructure.
U.S. concern over AIDS in Africa grew during the 1980s, as the severity of the epidemic became apparent. Legislation enacted in the 106th and the 107th Congresses increased funding for worldwide HIV/AIDS programs. H.R. 1298, which was signed into law (P.L. 108-25) on May 27, 2003, would authorize $15 billion over five years for international AIDS programs. President Bush has launched an International Mother and Child HIV Transmission Initiative that will benefit 8 African countries, and 12 are slated for added support under the global aids initiative announced in the January 28, 2003 State of the Union message. Nonetheless, activists and others urge that more be done in view of the scale of the African pandemic.
