Today over 40 million people around the world are infected with HIV; more than two-thirds of those infected are in Sub-Saharan Africa and the Caribbean. By 2010, life expectancy in some of the countries hardest hit by HIV/AIDS might fall to only 30 years—a reversal to the level of a century ago.

HIV/AIDS is also a major health threat in Russia, and there is a strong potential for rapid spread of the infection in countries with big populations like China and India.

HIV/AIDS is one of the largest challenges the global community has ever faced. Since 1981, more than 25 million people have died of AIDS. Last year alone, 3 million people died of AIDS. Less than 1% of people in need of treatment in Africa are undergoing antiretroviral therapy (ART). One reason for that is the high cost of these drugs, which are 30 times the amount most poorest countries spend annually on each citizen’s health.

HIV/AIDS disproportionately affects women. In 2001, of young women aged 15–24 years, 6%–11% were living with HIV, compared with 3%–6% of young men in that age group.

HIV/AIDS is affecting long-term prospects for development in poor countries and is reversing decades of progress. The most profoundly affected countries are experiencing a dramatically diminished workforce.

In Sub-Saharan Africa, one in five working-age adults—teachers, health workers, political leaders, civil servants, small business owners, soldiers, and parents—has HIV/AIDS.

For countries suffering the biggest losses from AIDS, national income is likely to drop by as much as 20% by 2020, leaving countries trapped in poverty.

HIV/AIDS drains health care budgets that are already low. Compared with annual health care expenditures of $2,000 per person in rich countries, the governments of some of the world’s poorest countries spend as little as $10 per person.

Prevention: Behavioral changes are one way to stop spread of the virus. Taking measures to screen the blood supply, and using safe injection equipment in medical care is another. Medicines to prevent mother-to-child transmission are also available.

Treatment: Antibiotics can be used to treat “opportunistic” infections, and antiretroviral therapy (ART) can help prolong the life of those who are HIV-infected.

Care: Care and support for HIV/AIDS-affected families in order to increase awareness and fight stigma associated with the disease are essential. Such steps can help children stay in school, and allow family members to continue working.

Better health systems: Rebuilding or strengthening public health systems for the distribution of treatment and medication will help those most in need.

Prevention of mother-to-child transmission (PMTCT): A combination of ART and counseling on breast-feeding alternatives for mothers with HIV. (One study showed that PMTCT successfully reduced transmission from mother to child by 50% in Uganda.)

Education, behavior change programs, and bold leadership: Aggressive public education campaigns and condom distribution and enforcement, particularly for commercial sex workers, are actions governments can take to demonstrate high-level political will.

Global activism: The high cost of HIV/AIDS drugs needs to be reduced. Altered patent laws have made it easier for some developing countries to produce and import generic versions of medicines.

Nearly half (45%) of Americans believe that the U.S. spends too little to fight HIV/AIDS. (AIDS is second only to illicit drug smuggling as an issue for which Americans believe the U.S. is spending too little.)

An overwhelming majority of Americans (86%) believes that the U.S. should not try to prevent African countries from developing generic AIDS drugs.

Sources: Public Opinion Strategies and Greenberg Quinlan Rosner Research, 2001; Americans on Africa, Program on International Policy Attitudes and Knowledge Networks, 2003.