in 2006, and, unless prevention efforts are highly successful, millions more will become infected every year (UNAIDS, 2006). Of the nearly 7 million people in low- and middle-income countries now estimated to need ART or to face an early death, fewer than one-quarter are receiving the therapy (WHO, 2006a), and millions more of those already infected with HIV will eventually need it. Fewer than 1 in 10 pregnant women infected with HIV in low- and middle-income countries are benefiting from ARVs to prevent transmission to their babies, and at most 12 percent of the children born to these women who require ART are receiving it (WHO, 2006a). With ART and appropriate care, AIDS is a chronic disease—it can be managed but not cured—and people receiving ART will need to be on it for the rest of their lives. Only a fraction of the legions of devastated families and orphaned children are currently receiving the support services they need, and the number of children orphaned by AIDS globally is projected to exceed 20 million by 2010 (UNICEF, 2006).

The Committee believes that continued commitment by the United States, along with all other donors, to supporting the fight against the HIV/AIDS pandemic will be required until countries have developed sustainable programs, and that continued U.S. leadership is necessary to prevent complacency and battle fatigue and to bring the virus under control.

REFERENCES

DHHS (Department of Health and Human Services). 2004. HHS proposes rapid process for review of fixed dose combination and co-packaged products. http://www.hhs.gov/news/press/2004pres/20040516.html (accessed September 6, 2006).

FDA (Food and Drug Administration). 2006. President’s Emergency Plan for AIDS Relief approved and tentatively approved antiretrovirals in association with the President’s emergency plan. http://www.fda.gov/oia/pepfar.htm (accessed January 11, 2007).

GAO (Government Accountability Office). 2005. Global HIV/AIDS epidemic: Selection of antiretroviral medications provided under U.S. emergency plan is limited (GAO-05-133). Washington, DC: GAO.

GAO. 2006. Global health: Spending requirement presents challenges for allocating prevention funding under the President’s Emergency Plan for AIDS Relief (GAO-06-395). Washington, DC: GAO.

GIST (Global Implementation Support Team). 2006. Fact sheet: The Global Implementation Support Team: Coordinating UN action and provision of technical support for accelerating HIV/AIDS responses in countries. http://data.unaids.org/pub/BrochurePamphlet/2006/2006_gist_en.pdf (accessed January 12, 2007).

IOM (Institute of Medicine). 2005a. Scaling up treatment for the global AIDS pandemic: Challenges and opportunities. Washington, DC: The National Academies Press.

IOM. 2005b. Plan for a short-term evaluation of PEPFAR implementation. Washington, DC: The National Academies Press.

Mathers, C., and D. Loncar. 2006. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine 3(11):e442.



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