Sub-Saharan Africa has been more severely affected by AIDS than any other part of the world. The United Nations reports that 25.4 million adults and children are infected with the HIV virus in the region, which has about 10% of the world's population but nearly 64% of the world-wide total of infected people. The overall rate of infection among adults in sub-Saharan Africa is 7.4%, compared with 1.1% world-wide. Ten countries in southern Africa have infection rates above 10% and account for 30% of infected adults world-wide. By the end of 2004, an estimated 25.3 million Africans will have died of AIDS, including a 2004 estimate of 2.3 million deaths. AIDS has surpassed malaria as the leading cause of death in Africa, and it kills many times more Africans than war. In Africa, 57% of those infected are women. Experts relate the severity of the African AIDS epidemic to the region's poverty, the relative lack of empowerment among women, high numbers of men living as migrant workers, and other factors. Health systems are ill-equipped for prevention, diagnosis, and treatment. AIDS' severe social and economic consequences are depriving Africa of skilled workers and teachers while reducing life expectancy by decades in some countries. An estimated 12.3 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 hunger and famine. Donor governments, non-governmental organisations, and African governments have responded through prevention programs intended to reduce the number of new infections and by trying to ameliorate the damage done by AIDS to families, societies, and economies. The adequacy of this response is the subject of much debate. An estimated 310,000 Africa AIDS patients were being treated with antiretroviral drugs at the end of 2004, up from 150,000 six months earlier. However, an estimated 4 million are in need of the therapy. US and other initiatives are expected to sharply expand the availability of treatment in the near future. Advocates see expanded treatment as an affordable means of reducing the impact of the pandemic. Sceptics question whether treatment can be widely provided without costly improvements in health infrastructure. US 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 world-wide HIV/AIDS programs. H.R. 1298, signed into law (P.L. 108-25) on May 27, 2003, authorised $15 billion over five years for international AIDS programs. President Bush announced his Emergency Plan for AIDS Relief (PEPFAR) in the 2003 State of the Union message. Twelve of the 15 focus countries are in sub-Saharan Africa. Under the FY2006 budget request, they would receive a 54% boost in aid, to $1.2 billion, through the State Department's Global HIV/AIDS Initiative. Nonetheless, activists and others urge that more be done in view of the scale of the African pandemic. This new books presents a nutshell analysis of this desperate situation.
