Introduction

In the 25 years since they were first identified, Acquired Immunodeficiency Syndrome (AIDS) and the Human Immunodeficiency Virus (HIV), the virus which causes AIDS, has spread relentlessly.¹ HIV/AIDS is a global pandemic that has claimed the lives of 25 million people to date. In 2006 alone, 2.9 million lost their lives to HIV/AIDS. It is the greatest global health crisis of our time.²

HIV/AIDS impacts entire communities, overburdening social, political, and economic systems, especially within the developing world. HIV infection rates among young people 15 to 24 years old are increasing at a rapid pace. Half of all new HIV infections, almost 6,000 per day, occur among this demographic. In 2003, an estimated 10.3 million, almost one-third of the people living with HIV/AIDS worldwide were young people.³

While the pandemic affects countries all over the world, it has hit sub-Saharan Africa the hardest. There, where a little more than one-tenth of the world’s population lives, 24.7 million HIV-positive people -- 63 percent of all people living with HIV -- reside. AIDS is the leading cause of death throughout the region, having claimed the lives of 2.1 million adults and children in 2006 alone.⁴

To address this mounting crisis, the American people took the lead in the fight against global HIV/AIDS in 2003 with President George W. Bush’s announcement of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR/Emergency Plan). PEPFAR is a 5-year, $15 billion commitment to fight HIV/AIDS around the world. It includes a special emphasis on 15 focus countries in Africa, the Caribbean, and Asia that together account for approximately one-half of the world’s HIV infections.⁵

The United States financial commitment is accompanied by ambitious goals, including support for prevention of 7 million new infections; support for treatment for 2 million HIV-infected people; and support for care for 10 million people infected and affected by HIV/AIDS, including orphans and vulnerable children. To reach these goals, the Emergency Plan is implementing the most comprehensive prevention, treatment, and care strategy in the world. As of March 31, 2006, PEPFAR supported antiretroviral treatment for 561,000 men, women, and children through bilateral programs.