AIDS is a global epidemic. The World Health Organization (WHO) estimates that 94 percent of new infections occur in developing countries. In the United States it is estimated that between 650,000 and 900,000 people are currently infected with HIV. The WHO and UNAIDS estimate that 27.9 million adults and over 1.6 million children are currently infected worldwide and there will be 10 to 15 million orphans worldwide attributable to HIV by the year 2000. Two to three million new HIV infections are expected annually, so by the year 2000, 30 to 40 million people are likely to have been infected around the globe.
The epidemic jeopardizes decades of economic and social advances in many developing nations. In some of the nations of Africa and Asia, economic advances are threatened, and in some cases, may be reversed due to HIV and AIDS. Socio-economic studies have shown a decrease in overall domestic savings and investment levels, negative effects on foreign investments, reductions in the volumes of imports and exports, and a reduction in receipts from tourism. In many countries governments will be forced to cope with increasing numbers of cases, weakened health care systems, a deleterious economic impact on the most productive segments of society, and the reduction in the number of healthy men and women able to serve in the government and the military.
Record of Accomplishment
Since it began, HIV and AIDS has been a global concern. The U.S. has worked closely with developed and developing nations to design an international response that is both vigorous and coordinated. Sentinel achievements include:
The United States is the largest contributor to international efforts to combat the pandemic of HIV and AIDS. Several Federal Agencies are working to slow the AIDS epidemic internationally. (See Appendix E.) The Department of State works with other agencies and non-governmental organizations within a framework to guide U.S. foreign policy in the global efforts against HIV and AIDS. The major areas of U.S. leadership in the global HIV arena are: mobilizing and unifying national and international efforts; preventing new infections; biomedical research; and, reducing the personal and social impact of the epidemic.
The U.S. Agency for International Development (USAID) plays a leadership role in the global HIV response through development assistance, research, and policy formulation. USAID focuses its efforts on developing prevention programs based on proven interventions. The agency addresses social, cultural, regulatory, and economic issues related to HIV/AIDS and other sexually transmitted infections and develops and tests new interventions and methods to prevent transmission and mitigate the impact of the epidemic. The Peace Corps trains a portion of its volunteers to directly address HIV-related concerns in their countries of placement. The U.S. Information Agency (USIA) supports programs that promote dissemination of U.S. policies and information related to HIV and AIDS.
In addition, several Agencies support research overseas, including the National Institutes of Health, the Centers for Disease Control and Prevention, and the Department of Defense. The DOD is conducting clinical trials of candidate HIV vaccines in Thailand and NIH, (working in collaboration with USAID), supports a range of scientific studies in developing countries. The results of the studies ultimately will be used to develop interventions to reduce behaviors that place individuals at risk for contracting HIV infection.
Future Opportunities for Progress
To accomplish the goal of providing strong continuing support for international efforts to address the HIV epidemic, the following steps will be taken:
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