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Summary:
Sub-Saharan Africa has been far more severely affected by AIDS than any other part of the world. The United Nations reports that 28.1 million adults and children are infected with the HIV virus in the region, which has about 10% of the world's population but more than 70% of the worldwide total of infected people. The overall rate of infection among adults in sub-Saharan Africa is about 8.4%; it is 1.2% worldwide. Sixteen countries, mostly in east and southern Africa, have HIV infection rates of more than 10%, and the rate has reached 35.8% in Botswana. An estimated 19.3 million Africans have died of AIDS, including 2.3 million who died in 2001. AIDS has surpassed malaria as the leading cause of death in Africa, and it kills many times more Africans than war. In Africa, HIV is spread primarily by heterosexual contact, and subSaharan Africa is the only region where women are infected at a higher rate than men. Experts relate the severity of the African AIDS epidemic to the region's poverty. Heal t h 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. AIDS' severe social and economic consequences are depriving Africa of skilled workers and teachers while reducing life expectancy by decades in some countries. The cumulative total of African children orphaned by AIDS since the epidemic began is 12.1 million. Currently 6.5 million AIDS orphans are 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. 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 has not been widely used in Africa. Advocates of 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 donors to fund costly improvements in Africa's health infrastructure. U.S. concern over AIDS in Africa grew during the 1980s, as the severity of the epidemic became apparent. According to the U.S. Agency for International Development, the United States has been the global leader in the international response to AIDS since 1986. Legislation enacted in the 106th and the 107th Congresses increased funding for worldwide HIV/AIDS programs, and the Administration has requested a further increase for FY2003. The United States has also pledged $500 million to the new Global Fund to Fight AIDS, Tuberculosis, and Malaria. Nonetheless, critics find the U.S. response inadequate in view of the scale of the African pandemic.
