{
  "id": "R41802",
  "type": "CRS Report",
  "typeId": "REPORTS",
  "number": "R41802",
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  "source": "EveryCRSReport.com, University of North Texas Libraries Government Documents Department",
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      "source": "EveryCRSReport.com",
      "id": 408847,
      "date": "2012-05-29",
      "retrieved": "2016-04-07T00:05:55.272133",
      "title": "The Global Challenge of HIV/AIDS, Tuberculosis, and Malaria",
      "summary": "The spread of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), tuberculosis (TB), and malaria across the world poses a major global health challenge. The international community has progressively recognized the humanitarian impact of these diseases, along with the threat they represent to economic development and international security. The United States has historically been a leader in the fight against HIV/AIDS, TB, and malaria; it is currently the largest single donor for global HIV/AIDS and has been central to the global response to TB and malaria. In its second session, the 112th Congress will likely consider HIV/AIDS, TB, and malaria programs during debate on and review of U.S.-supported global health programs, U.S. foreign assistance spending levels, and foreign relations authorization bills.\nOver the past decade, Congress has demonstrated bipartisan support for addressing HIV/AIDS, TB, and malaria worldwide, authorizing approximately $54 billion for U.S. global efforts to combat the diseases from FY2001 through FY2012. During this time, Congress supported initiatives proposed by President George W. Bush, including the President\u2019s Emergency Plan for AIDS Relief (PEPFAR) and the President\u2019s Malaria Initiative (PMI), both of which have demonstrated robust U.S. engagement in global health. Through the Global Health Initiative (GHI), President Barack Obama has led efforts to coordinate U.S. global HIV/AIDS, TB, and malaria programs and create an efficient, long-term, and sustainable approach to combating these diseases. \nDespite ongoing progress in fighting HIV/AIDS, TB, and malaria, these diseases remain leading global causes of morbidity and mortality. Many health experts urge Congress to capitalize on recent gains and bolster U.S. leadership and funding to combat these diseases. In contrast, some Members of Congress have proposed cuts to these programs as part of deficit reduction efforts. \nThis report reviews the U.S. response to HIV/AIDS, TB, and malaria and discusses several issues Congress may consider as it debates spending levels and priority areas for related programs. The report includes analysis of:\nFunding Trends: Combined funding for the three diseases has increased significantly over the past decade, from approximately $911 million in FY2001 to $7.4 billion in FY2012. The bulk of the increase over time has been targeted toward HIV/AIDS, although in recent years funding for global HIV/AIDS has begun to level off. When compared to FY2011, funding in FY2012 included decreases for global HIV/AIDS, and slight increases for global TB and malaria programs. Some health experts applaud what they see as a shift toward less expensive efforts that maximize health impact. Other experts warn that divestment from HIV/AIDS could significantly endanger the lives of those reliant on U.S. assistance and could reverse fragile gains made against the epidemic and other diseases.\nDisease-Specific Issues: HIV/AIDS, TB, and malaria each present unique challenges. Rising numbers of people in need of life-long HIV/AIDS treatment combined with reduced global HIV/AIDS funding have heightened concerns over the sustainability of treatment programs and incited debate over the appropriate balance of funding between antiretroviral treatment (ART) and other HIV/AIDS interventions. Growing rates of HIV/TB co-infection and drug-resistant TB strains have increased calls for escalating TB control efforts. Finally, growing resistance to anti-malaria drugs and insecticides threatens malaria control efforts, leading to calls for more attention to reducing resistance and developing new anti-malaria commodities.\nCross-Cutting Issues: Several cross-cutting issues are currently being debated, particularly in relation to increased efficiency and sustainability of HIV/AIDS, TB, and malaria programs under the GHI. These include\nHealth Systems Strengthening,\nCountry Ownership in Recipient Countries, \nResearch and Development, \nMonitoring and Evaluation, and \nEngagement with Multilateral Organizations. \nFor details on particular characteristics of the HIV/AIDS, TB, and malaria epidemics and the U.S. response, see the following CRS reports, by Alexandra E. Kendall.\nCRS Report R41645, U.S. Response to the Global Threat of HIV/AIDS: Basic Facts\nCRS Report R41643, U.S. Response to the Global Threat of Tuberculosis: Basic Facts\nCRS Report R41644, U.S. Response to the Global Threat of Malaria: Basic Facts",
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    },
    {
      "source": "University of North Texas Libraries Government Documents Department",
      "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc93871/",
      "id": "R41802_2012Feb23",
      "date": "2012-02-23",
      "retrieved": "2012-07-24T12:39:36",
      "title": "The Global Challenge of HIV/AIDS, Tuberculosis, and Malaria",
      "summary": "This report examines formal interagency collaborative arrangements and activities, which are intended to enhance joint efforts and cooperation among independent federal agencies with shared responsibilities and overlapping jurisdictions. This report highlights some of the current challenges posed by HIV/AIDS, TB, and malaria, as well as several crosscutting policy issues that the 112th Congress may consider as it determines U.S. global health funding for these three diseases, including: Health Systems Strengthening, Country Ownership, Research and Development, Monitoring and Evaluation; and Bilateral vs. Multilateral Support.",
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      "topics": [
        {
          "source": "LIV",
          "id": "HIV-positive persons",
          "name": "HIV-positive persons"
        },
        {
          "source": "LIV",
          "id": "AIDS (Disease)",
          "name": "AIDS (Disease)"
        },
        {
          "source": "LIV",
          "id": "Tuberculosis",
          "name": "Tuberculosis"
        },
        {
          "source": "LIV",
          "id": "Malaria",
          "name": "Malaria"
        }
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    {
      "source": "University of North Texas Libraries Government Documents Department",
      "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc40146/",
      "id": "R41802_2011May3",
      "date": "2011-05-03",
      "retrieved": "2011-08-27T10:13:38",
      "title": "The Global Challenge of HIV/AIDS, Tuberculosis, and Malaria",
      "summary": "This report examines formal interagency collaborative arrangements and activities, which are intended to enhance joint efforts and cooperation among independent federal agencies with shared responsibilities and overlapping jurisdictions. This report highlights some of the current challenges posed by HIV/AIDS, TB, and malaria, as well as several crosscutting policy issues that the 112th Congress may consider as it determines U.S. global health funding for these three diseases, including: Health Systems Strengthening, Country Ownership, Research and Development, Monitoring and Evaluation; and Bilateral vs. Multilateral Support.",
      "type": "CRS Report",
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      "topics": [
        {
          "source": "LIV",
          "id": "HIV-positive persons",
          "name": "HIV-positive persons"
        },
        {
          "source": "LIV",
          "id": "AIDS (Disease)",
          "name": "AIDS (Disease)"
        },
        {
          "source": "LIV",
          "id": "Tuberculosis",
          "name": "Tuberculosis"
        },
        {
          "source": "LIV",
          "id": "Malaria",
          "name": "Malaria"
        }
      ]
    }
  ],
  "topics": [
    "Foreign Affairs",
    "Health Policy"
  ]
}