U.S. Government Support for the Fight Against HIV/AIDS

At the end of 2002, an estimated 42 million people were living with HIV/AIDS, the overwhelming majority living in the developing world. The United States is strongly committed to working with the international community to save lives by preventing new infections, helping people already infected with HIV/AIDS, and contributing to the search for a cure.

Overall U.S. Government Assistance
The Bush Administration has requested $2 billion for fiscal year 2004 to fund bilateral and multilateral efforts in the fight against HIV/AIDS, Tuberculosis, and Malaria, which is a 30% increase over FY03 ($1.6 billion), a 73% increase over FY02 ($1.1 billion), and a 143% increase over FY01 ($840 million).

The President’s Emergency Plan for AIDS Relief (PEPFAR)
In his State of the Union Address this year, President Bush announced his Emergency Plan for AIDS Relief (PEPFAR). It provides $15 billion, including nearly $10 billion in new funding, to fight the HIV/AIDS pandemic over the next five years, focusing on 14 of the hardest-hit countries. The PEPFAR pledges $1 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) over the next 5 years, increasing the total U.S. commitment to over $1.6 billion since the Fund’s inception. This figure amounts to around 36% of total current pledges.

Programs of Various Government Agencies
U.S. bilateral international assistance for HIV/AIDS programs is primarily channeled through the U.S. Agency for International Development and the Department of Health and Human Services. There are additional programs at the Department of Labor and the Department of Defense.

U.S. Agency for International Development (USAID)

• In FY03, USAID spending for bilateral HIV/AIDS initiatives and related activities will reach $625.9 million, not including contributions to the Global Fund. FY03 spending is a 36% increase over the FY02 level of $461 million.
• USAID’s HIV/AIDS strategy is comprised of six components: preventing HIV transmission; caring, treating, and supporting people affected by HIV/AIDS; working with children affected by HIV/AIDS; employing surveillance; encouraging other donor countries and organizations; and engaging national leaders.
• The vast majority of USAID's HIV/AIDS field assistance goes to non-governmental organizations that have direct connections to the poorest of the poor and those most vulnerable to infection.

Department of Health and Human Services (HHS)

• In FY03, HHS will spend $444 million on bilateral international HIV/AIDS programs and research, including surveillance, interventions, and evaluation, in addition to contributions to the Global Fund. Of that total, the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) will spend $194 million and $250 million respectively on HIV/AIDS.
• The elements making up the CDC's Global AIDS Program (GAP) are: primary prevention; surveillance and infrastructure development; and care, support, and treatment.

Department of Defense (DOD) and Department of Labor (DOL)

• By working with African militaries, DOD helps create policies dealing with HIV/AIDS within a military setting -- developing prevention education programs that reach both African troops and African communities.
• DOL supports projects that target the workplace for prevention education and strengthen the response to HIV/AIDS by providing technical assistance to government, employees, and labor leaders.

U.S. Government Support for Research

Research and development programs, both in the U.S. and abroad, have direct benefits for the international community, in the form of new drugs and other medical and scientific advances. In FY02, the U.S. spent a total of $2.6 billion on domestic and global HIV/AIDS research. For FY03, this amount is expected to increase 9.1% to $2.85 billion.

• HHS is the largest public sector investor in HIV/AIDS research in the world. In FY03, NIH will spend its $250 million international HIV/AIDS budget on research outside the U.S. The CDC also funds international HIV/AIDS research.
• DOD runs a military HIV research program to develop and evaluate new vaccines and treatments, as well as policies for the prevention of HIV transmission.
• In FY01 and FY02, USAID spent almost 6% of its HIV/AIDS budget on vaccine research and development of microbicides.

U.S. Contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria
The U.S. is an active participant in and supporter of the two-year-old Global Fund to Fight AIDS, Tuberculosis and Malaria. The U.S. has made the largest pledge, $1.65 billion, to the Fund: $100 million in the FY01 budget, $200 million in FY02, $350 million in FY03, and a pledge of an additional $1 billion over five years beginning in FY04. Of the current $4.6 billion pledged to the Fund by all sources, nearly $800 million was made available for disbursement in 2002. Of this, the U.S. contributed $275 million.

Further Information
Information on the President’s Emergency Plan for AIDS Relief, The Global Fund, and other HIV/AIDS initiatives can be found at:

• The White House website (http://www.whitehouse.gov/infocus/hivaids/index.html)
• The State Department website (http://www.state.gov/g/oes/hlth/)
• The Global Fund website (http://www.globalfundatm.org/)