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Fall/Winter 2010 Vol. 10 Number 3

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Institute of Medicine

Rethinking Africa's Challenges

Africa's economic and social challenges are as vast as its geography and natural beauty. One of sub-Saharan Africa's most serious public health problems is HIV/AIDS. In 2008, two-thirds of the 33 million people infected with HIV worldwide were Africans. More than 90 percent of the 2.7 million new infections that year occurred there. Yet only half of Africans who should have been receiving lifesaving antiretroviral therapy were actually in treatment. By 2020, the number of infected in Africa is projected to grow to more than 30 million people.

What can Africa and we in the developed world do to stop, slow, or even adequately treat this seemingly relentless wave of new infections? On the occasion of World AIDS Day 2010, the Institute of Medicine released Preparing for the Future of HIV/AIDS in Africa: A Shared Responsibility, which called for an important change in how we approach this epidemic in Africa long term.

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) so far has provided approximately $32 billion to HIV/AIDS-related programs in Africa. Combined with private philanthropy, this has been an impressive demonstration of international support. But IOM's new study calls on African public health authorities to develop 20-year road maps for combating the epidemic, including larger investments and a greater emphasis on finding and implementing effective prevention methods that will work in Africa. To do that, African countries will need to assess and meet their national health care work force requirements and adopt more efficient models of care and treatment. Countries like the United States can contribute by supporting -- and helping to build -- national and institutional partnerships so that Africa can lead the way toward its own sustainable and a healthier future.

None of this will be easy. As you will learn in this issue of In Focus, sub-Saharan Africa faces another daunting and immediate challenge: a lack of access to electric power. Seventy percent of the population there lives without electricity, a fact that has a multitude of health implications. Such massive challenges call out to all of us -- and to African nations themselves -- to work in determined ways to invent new, effective approaches to serve a continent and its people.

    Institute of Medicine

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Copyright 2010 by the National Academy of Sciences