(March 2005) AIDS continues to have a devastating impact around the globe, but nowhere has that impact been as great as in sub-Saharan Africa. It is estimated that more than 25 million Africans who live and work in the sub-Saharan region are HIV positive. Many of these individuals have AIDS, and in 2003 alone, an estimated three million were newly infected. In August of that same year. AIDS Action Executive Director Marsha A. Martin, DSW visited "ground zero" of the pandemic as part of an official U.S. delegation organized by the AIDS Responsibility Project. The 12-member delegation included members of the Presidential Council on HIV/AIDS (PACHA), senior congressional staff, and advocates from AIDS-related public interest groups in the United States. A film crew accompanied the delegation.

The following special report is Dr. Martin's photo diary of the trip. As an accounting of the trip, the diary seeks to provide the reader with a fresh understanding of the backdrop against which the government of the United States will be providing care, treatment, and support services in Africa.

In 2003, President Bush introduced a landmark initiative in his State of the Union address: the President’s Emergency Plan for AIDS Relief (PEPFAR). PEPFAR has set several goals for its fourteen focus countries*: to make treatment available to ten million people, to provide care and support to more than two million orphans, and to assist all countries in the development and implementation of national plans to address HIV/AIDS.

The trip to Africa, which included stops in South Africa, Botswana, and Uganda, was intended to examine the continent’s readiness for participation in PEPFAR. Over the course of ten days, the trip provided learning experiences for the delegation, taking them on visits to existing programs and to meetings with U.S. government representatives and their in-country partners. In addition, because President Bush’s first AIDS initiative, introduced in 2002,targeted mothers and children, the delegation also visited and learned about existing efforts to prevent mother-to-child transmission (PMTCT) through voluntary counseling and testing (VCT), perinatal treatment programs utilizing anti-retroviral (ARV) drugs and existing home-based care programs.

While providing opportunity to get a first-hand look at the HIV/AIDS crisis and the response to it across sub-Saharan Africa, the trip also facilitated meetings with national, regional, and local governmental and non-governmental leaders and organizations involved in responding to HIV/AIDS. During the meetings, the delegation learned of specific concerns and needs within the context of President Bush’s initiative.

*In 2004, President Bush increased the number of PEPFAR focus countries to 15, with the addition of Vietnam.