U.S. Response to the Global Threat of HIV/AIDS: Basic Facts

Alexandra E. Kendall
Analyst in Global Health

The human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is one of the world’s most pressing global health challenges. Since the beginning of the epidemic, more than 60 million people have been infected with HIV, approximately 30 million of whom have died of HIV-related causes. At the end of 2010, an estimated 34 million people were living with the virus, the vast majority of whom live in sub-Saharan Africa. Expanded access to antiretroviral therapy (ART) over the past decade, due in large part to U.S. support, has contributed to declines in deaths among people living with HIV. Nonetheless, new infections continue to outpace access to treatment. The second session of the 112th Congress will likely be faced with determining how, and to what extent, the United States should respond to the continued challenge of global HIV/AIDS.

The United States has recognized HIV/AIDS as a key foreign policy priority. Congress has passed several pieces of legislation related to global HIV/AIDS prevention, treatment, and care. In particular, in 2003, Congress enacted the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (P.L. 108-25), authorizing $15 billion to combat global HIV/AIDS, tuberculosis (TB), and malaria through the President’s Emergency Plan for AIDS Relief (PEPFAR), an initiative proposed by the George W. Bush Administration. In 2008, Congress enacted the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (P.L. 110-293), authorizing $48 billion for HIV/AIDS, TB, and malaria programs from FY2009 through FY2013.

PEPFAR is the largest commitment in history by any nation to combat a single disease and makes up the majority of donor funding for global HIV/AIDS. When PEPFAR was announced, health experts were debating whether the international community had a responsibility to provide ART in developing countries and whether they could be safely administered in such environments. PEPFAR responded to calls from those advocating treatment for the world’s poor and demonstrated that ART could be effectively provided in low-resource settings.

PEPFAR is coordinated by the Office of the U.S. Global AIDS Coordinator (OGAC) at the Department of State and is implemented by a range of U.S. agencies that include, among others, the United States Agency for International Development (USAID) and the Centers for Disease Control and Prevention (CDC). The United States also supports several multilateral organizations responding to HIV/AIDS, including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and the United Nations Joint Program on HIV/AIDS (UNAIDS).

Due in part to the global response to HIV/AIDS, substantial progress has been made in combating the epidemic. New HIV infections fell by more than 25% in 33 countries between 2001 and 2009, and a total of 2.5 million deaths have been averted in low- and middle-income countries since 1995 due to antiretroviral therapy. At the same time, major challenges remain in the fight against HIV/AIDS. For example, with new infections outpacing available treatment, experts have increasingly debated how to best allocate limited resources. This report outlines basic facts related to global HIV/AIDS, including characteristics of the epidemic and U.S. legislation, programs, funding, and partnerships related to global HIV/AIDS. It concludes with a brief description of some of the major issues that might be considered by the 112th Congress in its response to the disease.


Date of Report: June 15, 2012
Number of Pages: 16
Order Number: R41645
Price: $29.95

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