Investing in Health

Purpose

HIV/AIDS, tuberculosis, and malaria caused approximately 5.7 million deaths worldwide in 2000, roughly 40 percent of all deaths from infectious diseases and a huge economic and social burden in developing countries. The United States is committed to the Millennium Declaration goal: "To have, [by 2015], halted, and begun to reverse, the spread of HIV/AIDS, the scourge of malaria and other major diseases that afflict humanity."

The United States is part of global partnerships such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria ("Global Fund"), Stop TB, and Roll Back Malaria, each of which includes governmental and non-governmental partners. The United States complements these commitments with country-level partnerships demonstrating national impact and enhanced capacity for long-term health gains, as well as with investments in research.

• The U.S. pledge of $500 million to the Global Fund represents approximately one-fourth of all commitments to the Fund to date. The United States joins other donor and recipient governments, foundations, non-governmental organizations, and the private sector in contributing to and managing the Fund’s resources.
• In addition, the U.S. Agency for International Development (USAID) strategy "Expanded Response to HIV/AIDS" focuses on the prevention of new infections, care and treatment for individuals and communities, addressing the needs of children affected by HIV/AIDS, increasing the capacity of developing country health systems, and developing new tools to prevent HIV transmission and to provide improved services for those living with HIV/AIDS. These efforts are currently being expanded to 23 priority countries while maintaining basic prevention and care programs in an additional 25 countries. Funding totaled $435 million in fiscal year (FY) 2002 and is projected to increase to $540 million in FY 2003. More than 70 percent of USAID’s support for HIV/AIDS activities is allocated to nearly one thousand non-governmental organizations worldwide.
• In addition to Global Fund commitments, the U.S. Department of Health and Human Services (HHS) will spend a total of $343 million internationally on HIV/AIDS activities in FY 2002, with a requested increase to $377 million in FY 2003. The Global AIDS Program (GAP) of the HHS Centers for Disease Control and Prevention is active in 24 countries, working to prevent HIV infection, improve care and support (with the HHS Health Resources and Services Administration), and build capacity to address the global HIV/AIDS pandemic. GAP, with $155 million in FY 2002 funding, provides financial and technical assistance through partnerships with communities, governments, and national and international entities working in resource-constrained countries. The HHS National Institutes of Health (NIH) is investing $2.5 billion in FY 2002 on HIV/AIDS research, with international activities accounting for approximately $188 million of this total.
• The U.S. Department of Labor (DOL) operates an international HIV/AIDS workplace education program in cooperation with government, business, and labor leaders to target the workplace as a forum for combating HIV/AIDS. DOL presently works in 8 countries and is in the process of soliciting proposals to expand the program. The program is projected to expand to include an additional 9 countries. Total funding allocated to the program for FY 2000 – FY 2002 is $20,500,000.
• To help increase awareness of AIDS in foreign militaries, the Department of Defense (DoD) operates a multi-million dollar HIV/AIDS Prevention (DHAP) program in close collaboration with the Department of State and 21 African governments. DOD works in partnership with academia and non-governmental organizations to develop these intervention programs. The DHAP Program is now projected to expand its assistance to several additional sub-Saharan African countries.
• The Peace Corps provides HIV/AIDS-related training to all Volunteers, with 73 percent of posts providing more extensive training in community-level HIV/AIDS interventions. Volunteers at all 25 Peace Corps posts in Africa, and in 79 percent of programs worldwide, are conducting HIV/AIDS-related activities, touching the lives of more than 376,000 host country individuals. These activities include facilitating HIV/AIDS prevention and awareness and training youth HIV/AIDS peer educators.

President Bush has announced a new $500 million International Mother-and-Child HIV Prevention Initiative for Africa and the Caribbean, and partnerships to implement and expand this effort are currently being explored. For malaria, the expansion of the USAID NetMark activity, designed to make affordable insecticide-treated bednets available on a national scale (currently focussed on Ghana, Nigeria, Senegal, and Zambia), will be featured at the World Summit on Sustainable Development. The envisioned expansion will reach an additional ten countries in sub-Saharan Africa and four countries in Latin America and/or Asia. As a participant in Stop TB, the United States is working with partners to ensure expanded implementation of the internationally accepted DOTS (directly observed treatment, short course) strategy to increase tuberculosis cure rates, decrease deaths, and prevent the emergence of multi-drug resistant TB.