The AIDS epidemic in Sub-Saharan Africa continues to affect all facets of life throughout the subcontinent. Deaths related to AIDS have driven down the life expectancy rate of residents in Zambia, Kenya, and Uganda with far-reaching implications. This book details the current state of the AIDS epidemic in Africa and what is known about the behaviors that contribute to the transmission of the HIV infection. It lays out what research is needed and what is necessary to design more effective prevention programs.

Since the 1980s HIV/AIDS has occupied a singular position because of the rapidly emergent threat and devastation the disease has caused, particularly in sub-Saharan Africa. New infections continue to create a formidable challenge to households, communities, and health systems: last year alone, 2.7 million new infections occurred globally. Sub-Saharan Africa remains the epicenter of the suffering, with around two-thirds of infected individuals worldwide found there, and a disproportionate number of deaths and new infections. For years there have been widespread and concerted efforts to prevent the spread of HIV/AIDS, identify a cure, and understand and mitigate the deleterious social and economic ramifications of the disease. Despite these efforts, and some apparent successes, there is still a long way to go in terms of altering behaviors in order to realize the objective of dramatic reductions in the spread of HIV/AIDS in Africa. The authors in this volume examine the HIV/AIDS crisis in Africa, which persists despite major strides in averting deaths due to antiretroviral therapy. They tell an important story of the distinct nature of the disease and its socioeconomic implications.

HIV/AIDS is a catastrophe globally but nowhere more so than in sub-Saharan Africa, which in 2008 accounted for 67 percent of cases worldwide and 91 percent of new infections. The Institute of Medicine recommends that the United States and African nations move toward a strategy of shared responsibility such that these nations are empowered to take ownership of their HIV/AIDS problem and work to solve it.

This report presents three hypothetical case studies for how the AIDS epidemic in Africa could evolve over the next 20 years based on policy decisions taken today by African leaders and the rest of the world; and considers the factors likely to drive the future responses of African countries and the international community. The scenarios draw on the age-old tradition of story-telling, rather than using data projections, to explore the wider context of the AIDS epidemic, reflecting the complexity of the subject matter.

Forty years ago, the age-old battle against infectious diseases as a major threat to human health was believed close to being won. However, by the late twentieth century, the increase of emerging and reemerging infectious diseases was evident in both low and high income countries. About 30 new infectious diseases have been identified in the last 20 years. Among the "new" diseases, and most importantly, the Human Immunodeficiency Virus (HIV) epidemic, with 40 million persons infected and 25 million deaths since its first description, presents one of the most significant health, societal and security challenges facing the global community. The interaction of HIV/AIDS with tuberculosis, malaria and bacterial infections have increased HIV-related morbidity and mortality, and in turn, the HIV pandemic has brought about devastating increases in tuberculosis. Understanding the population impact and the dynamics of infection diseases in the most affected region is critical to efforts to reduce the morbidity and mortality of such infections, and for decisions on where to use limited resources in the fight against infections. This book aims to contribute to these efforts by offering a demographic and epidemiological perspective on emerging and reemerging infections in sub-Saharan Africa.

In sub-Saharan Africa, older people make up a relatively small fraction of the total population and are supported primarily by family and other kinship networks. They have traditionally been viewed as repositories of information and wisdom, and are critical pillars of the community but as the HIV/AIDS pandemic destroys family systems, the elderly increasingly have to deal with the loss of their own support while absorbing the additional responsibilities of caring for their orphaned grandchildren. Aging in Sub-Saharan Africa explores ways to promote U.S. research interests and to augment the sub-Saharan governments' capacity to address the many challenges posed by population aging. Five major themes are explored in the book such as the need for a basic definition of "older person," the need for national governments to invest more in basic research and the coordination of data collection across countries, and the need for improved dialogue between local researchers and policy makers. This book makes three major recommendations: 1) the development of a research agenda 2) enhancing research opportunity and implementation and 3) the translation of research findings.