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Washington, D.C., Population Action International, 2008.  p.This report was developed through review of the early literature on HIV/AIDS policies and programs in non-industrialized countries and of media material promoting prevention of heterosexual transmission of HIV in those countries. Material from the early days of the epidemic was difficult to obtain. Most materials were long ago archived or are in personal files in "basements". While the report focuses on the experiences of three countries, it also examines the early responses of international organizations to HIV in many other developing countries. Additional data were obtained using a snowball sampling technique through which the authors contacted people who had worked in HIV/AIDS prevention strategies. The pool of respondents is not intended to be exhaustive, but the respondents provide important voices of those working in the developing world at the beginning of the epidemic.
Paris, France, UNESCO, Education Sector, Division for the Coordination of UN Priorities in Education, Section on HIV and AIDS, 2007. 83 p. (ED-2006/WS/43)The purpose of this publication is to share UNESCO's experience and our thinking behind a number of projects that have sought to address the needs of some of the disadvantaged and in particular those impacted by drug misuse. The experience of these projects demonstrates key factors that impinge progress towards social inclusion: homelessness; unemployment; discrimination and stigma; low levels of education; health inequalities; crime and violence. (excerpt)
[New York, New York], Population Council, Frontiers in Reproductive Health, 2007 Jul. 117 p.Population Council approached by Head and Deputy Head of OB/GYN Dept at Dantec Hospital and Burkina Maternity Hospital in Senegal and Burkina Faso, respectively. Study designed by Population Council, CRESAR, CEFOREP, MoH in both countries. Ethical standards assessed by ethical review committee in each country followed by Population Council's Internal Review Board. Operations research to introduce and test improved model of PAC. Research team included representatives from CRESAR/CEFOREP, MoH, donors, other stakeholders and service providers. (excerpt)
[New York, New York], Population Council, Frontiers in Reproductive Health, 2007 Jul.  p.Progress in the initial stages of the documentation process can be slow, though it gathers momentum over time. Successful communication channels such as email are important for maintaining the momentum. Familiarity with applying the GRIPP framework and process and having existing networks in the field adds value to the product. An initial lack of knowledge about stakeholders can slow down the documentation process. However, the documentation process can help discover who these stakeholders are and the usefulness of the study to them. Case study information is much easier to recall and richer when the research is still current or only recently concluded. A snowballing effect, which results in getting more stakeholder perspectives than originally thought, can occur during the process. A study may have clinical and social and other dimensions, which have very different processes and outcomes with relation to a given research study. Each needs to be followed up in order to fully understand the utilisation and effectiveness of the research. A well-positioned facilitator may be the best placed to assume a neutral position and document the research process. Many of the obstacles in relation to the documentation process that were encountered could be overcome if researchers built the documentation process into their research schedule. (excerpt)
Global Issues. 2005 Jan; 11-13.Numbering 1.7 billion, today’s youths are the largest generation ever to enter the transition to adulthood. Comprising 30 percent of the population in the developing world, young people present a set of urgent economic, social, and political challenges that are crucial to long-term progress and stability. The values, attitudes, and skills acquired by this generation of young men and women—and the choices they make— will influence the course of current events and shape our future world in fundamental ways. Youths are encountering formative stages in life. When given a chance to participate, youths have played a catalytic role in promoting democracy, increasing incomes, helping communities develop, and slowing the AIDS epidemic. In Uganda and Zambia, teens and young adults have been key to reducing HIV infection rates through their adoption of more responsible behaviors. (excerpt)
Implementing GIPA: how USAID missions and their implementing partners in five Asian countries are fostering greater involvement of people living with HIV / AIDS.
Washington, D.C., Futures Group International, POLICY Project, 2004 Jan.  p. (USAID Contract No. HRN-C-00-00-00006-00)On behalf of the Asia/Near East Bureau (ANE) of the U.S. Agency for International Development (USAID), the POLICY Project undertook an assessment of how the Greater Involvement of People Living with HIV/AIDS (GIPA) Principle is being implemented in the ANE region. Five USAID Missions and 12 implementing agencies (IAs) in the region participated in the assessment, which was undertaken in May and June 2003 in Cambodia, India, Nepal, Philippines, and Viet Nam. The purpose of the assessment was to ascertain how Missions, IAs, and NGOs are incorporating GIPA principles into their organizations and into the programmatic work they support and implement. A self-administered questionnaire was completed by 23 respondents from Missions, IAs, and NGOs. The assessment found a high level of awareness of GIPA and a commitment by most organizations to foster and promote GIPA principles, within their organizations and in the work they carry out. Ninety-one percent of respondents from the three types of organizations believe that their organizations’ planning, programs, and policymaking activities are or would be enhanced by GIPA. (excerpt)
The level of effort in the national response to HIV / AIDS: the AIDS Program Effort Index (API), 2003 round.
Washington, D.C., USAID, 2003 Dec.  p.The success of HIV/AIDS programs can be affected by many factors, including political commitment, program effort, socio-cultural context, political systems, economic development, extent and duration of the epidemic , and resources available. Many programs track low-level inputs (e.g., training workshops conducted, condoms distributed) or outcomes (e.g., percentage of acts protected by condom use). Measures of program effort are generally confined to the existence or lack of major program elements (e.g., condom social marketing, counseling and testing). To assist countries in such evaluation efforts, several guides have been developed by the Joint United Nations Program on HIV/AIDS (UNAIDS), the World Health Organization (WHO), the United States Agency for International Development (USAID) and other organizations (see, for example, “Meeting the Behavioural Data Collection Needs of National HIV/AIDS and STD Programmes” and “National AIDS Programs: A Guide to Monitoring and Evaluation of HIV/AIDS Programs”). However, information about the policy environment, level of political support, and other contextual issues affecting the success and failure of national AIDS programs has not been addressed previously. (excerpt)
Measuring the level of effort in the national and international response to HIV / AIDS: The AIDS Programme Effort Index (API). Summary report.
Geneva, Switzerland, UNAIDS, . 24 p.UNAIDS, USAID and the POLICY Project have developed the AIDS Programme Effort Index (API) to measure programme effort in the response to the HIV/AIDS epidemic. The index is designed to provide a profile that describes national effort and the international contribution to that effort. The API was applied to 40 countries in 2000. The results show that programme effort is relatively high in the areas of legal and regulatory environment, policy formulation and organizational structure. Political support was somewhat lower but increased the most from 1998. Monitoring and evaluation and prevention programmes scored in the middle range, about 50 out of 100 possible points. The lowest rated components were resources and care. The API also measured the availability of key prevention and care services. Overall, essential services are available to about half of the people living in urban areas but to only about one-quarter of the entire population. International efforts to assist country programmes received relatively high rating in all categories except care. The results presented here will be supplemented later in 2001 with a new component on human rights. (excerpt)
Measuring the level of effort in the national and international response to HIV / AIDS: The AIDS Program Effort Index (API).
Geneva, Switzerland, UNAIDS, 2001 Feb. 31 p.UNAIDS, USAID and the POLICY Project have developed the AIDS Program Effort Index (API) to measure program effort in the response to the HIV/AIDS epidemic. The index is designed to provide a profile that describes national effort and the international contribution to that effort. The API was applied to 40 countries in 2000. The results show that program effort is relatively high in the areas of legal and regulatory environment, policy formulation and organizational structure. Political support was somewhat lower but increased the most from 1998. Monitoring and evaluation and prevention programs scored in the middle range, about 50 out of 100 possible points. The lowest rated components were resources and care. The API also measured the availability of key prevention and care services. Overall, essential services are available to about half of the people living in urban areas but to only about one-quarter of the entire population. International efforts to assist country programs received relatively high rating in all categories except care. The results presented here will be supplemented later this year with a new component on human rights and a score that compares countries on program effort. (excerpt)
Global HealthLink. 2001 Jul-Aug; (110):11, 17.With a population of more than 6 million, expected to double in just 22 years, and with the highest infant mortality rate in the hemisphere, high maternal mortality rates and low contraceptive use, our objective was to find hope among people recovering from 36 years of civil war. In August, the Global Health Council is taking a congressional delegation to Guatemala and Honduras on a study tour to show the strides made and challenges unmet. Two hours outside of Guatemala City is San Juan Comalapa, Chimaltenango, where we visited a small rural clinic providing maternal and child health (MCH) services. This clinic is one of many supported by the U.S. Agency for International Development’s (USAID) 1997 “Better Health for Rural Women and Children” grant to the Guatemalan Ministry of Health (MOH), focused on reducing the gap in health care services between rural Mayans and urban Latino populations. A result of the 1996 Peace Accords, this program is considered the largest health reform example in the world of a MOH contracting out to NGOs to extend basic health services to poor populations. (excerpt)
New York, New York, IWHC, 2003. 11 p.Internationally and domestically, in our courts and in our schools, at the UN and on Capitol Hill, it is no exaggeration to say that the White House is conducting a stealth war against women. This war has devastating consequences for social and economic development, democracy, and human rights—and its effects will be felt by women and girls worldwide. (excerpt)
Lancet. 2003 Oct 4; 362(9390):1152-1153.By AIDS day 2002, HIV/AIDS in Africa had killed 20.4 million and infected 29.4 million people. This number of deaths is seven times that in the Nazi holocaust, and it approaches the death toll associated with transatlantic slave trading. Treatment for AIDS includes monitoring of disease progression, psychosocial support, provision of adequate nutrition, teaching healthy living and survival skills, prophylaxis and treatment of opportunistic infections, and antiretroviral treatment. Such holistic treatment can now be provided at an all-inclusive cost of about US$600 dollars per year. Yet most African countries and donors still judge this amount to be too costly. The cost of not treating a person with AIDS includes the loss of output of each patient; loss of income of care-givers; cost of treatment in homes, clinics, and hospitals; funeral costs; death and survivor benefits; and the cost of orphan care and support. These costs are met by patients, families, employers, governments, and society at large. On economic grounds alone treatment should be provided for all those for whom the present value of expenses exceeds the cost of not giving treatment. Results of several studies show that this situation is now true for many classes of people and workers. The issue has become not whether we can afford to treat, but whether we can afford not to. Here, I review imagined obstacles and faulty arguments against large-scale treatment programmes, and show that unwillingness to pay is the main reason for inaction. (excerpt)
The safety and feasibility of female condom reuse: report of a WHO consultation, 28-29 January 2002, Geneva.
Geneva, Switzerland, WHO, 2002. , 15 p.According to the recommendations of the first consultation, this second meeting (January 2002) was planned to review the resulting data and to develop further guidance on the safety of reuse of the female condom. The specific objectives and anticipated outcomes of this second consultation were to: Review the results and evaluate the implications of the recently completed microbiology and structural integrity experiments and the human use study; Develop a protocol or set of instructions for disinfecting and cleaning used female condoms safely; Outline future research areas and related issues for programme managers to consider when determining the balance of risks and benefits of female condom reuse in various contexts and settings. (excerpt)
Behavioral interventions for the prevention of sexual transmission of HIV. [Intervenciones conductuales para la prevención de la transmisión sexual del VIH]
Washington, D.C., Institute of Medicine, International Forum for AIDS Research, . 8 p.The fourth meeting of the International Forum for AIDS Research was organized around three overall objectives: a) to consider a model for categorizing behavioral interventions; b)to share information about current behavioral intervention programs in which IFAR members are involved; and c) to foster discussion about the adequacy of present strategies. The meeting began with an analytical phase that explored aspects of methodology, followed with presentations on selected programs, and concluded with a generic case study exercise that highlighted different social scientific perspectives on producing change in human behavior. (excerpt)
Defining future U.S. PVO agendas: building capacity in partnership with indigenous groups responding to the AIDS pandemic. Proceedings from the 1993 Annual National Council for International Health PVO / AIDS Workshop, June 24-25, 1993, Arlington, Virginia.
Washington, D.C., National Council for International Health, 1994. , 60 p.The National Council for International Health (NCIH), in collaboration with the Johns Hopkins HIV/AIDS Prevention in Africa Support Program, hosted the NCIH Private Voluntary Organizations (PVOs)/AIDS workshop entitled "Defining Future PVO Agendas: Building Capacity in Partnership with Indigenous Groups Responding to the AIDS Pandemic," in Arlington, Virginia, on June 24-25, 1993. Funded by the US Agency for International Development (USAID) with support from the Rockefeller Foundation, the workshop's purpose was to explore the partnership potential between US-based PVOs and indigenous nongovernmental organizations (NGOs) combating the HIV/AIDS pandemic in developing countries. Participants comprised 30 PVOs and over 30 indigenous and international NGOs, foundations, and bilateral and multilateral agencies. The framework for the 2-day workshop included presentations on the role of NGOs in providing health care, defining and establishing partnerships, and the grassroots perspective on the possibility of true partnership. In addition, panel discussions and working groups addressed donor perspectives on partnership and the needs of indigenous organizations, mechanisms of organizational support through partnership, the operationalization of PVO/NGO collaborative efforts, and partnership effectiveness.
Statement of the U.S. to the 21st Special Session of the General Assembly, Overall Review and Appraisal of the Implementation of the Programme of Action of the International Conference on Population and Development, presented by Under Secretary of State Frank E. Loy. Press release.
New York, New York, United States Mission to the United Nations, 1999 Jul 2.  p.This paper presents a press release delivered by US Under Secretary of State Frank E. Loy to the 21st Special Session of the General Assembly, Overall Review and Appraisal of the Implementation of the Programme of Action of the International Conference on Population and Development. It highlights the impact of Cairo on population program development and implementation. Among the accomplishments cited were: 1) increased access to and improved quality of reproductive health services; 2) new initiatives in female education; and 3) integration of reproductive health and women empowerment through collaborations with nongovernmental organizations. The priorities identified by the US to ensure the realization of the Cairo objectives include: 1) female empowerment; 2) improving the quality and access of reproductive health services; 3) reduction of maternal mortality; 4) prevention of HIV/AIDS pandemic; 5) support, design, and implementation of youth-centered development and health programs; 6) mobilization of resources and political will; and 7) strengthening of community, national, and international partnerships.
HINDU. 1999 Apr 19; 4.The successful experiences of Tamil Nadu (TN) in the control and prevention of HIV/AIDS provides vital clues for the second phase of the Rs. 1,150-crore World Bank-funded national AIDS control program which will begin in July. The National AIDS Control Organization (NACO) is looking at TN for concrete answers in several areas before it composes its guidelines for the second phase. Key areas of focus in the second phase will be high-risk groups, control of STDs, people living with AIDS, communication structures and blood safety. NACO and the funding agency has been impressed by TN s method of mobilizing NGOs in the massive anti-HIV/AIDS campaign and its handling of the cost of the care. In addition to the Tamil Nadu State AIDS Control Society (TNSACS), the AIDS Prevention and Control Project of the Voluntary Health Services (supported by USAID) also contributed to the impressive performance of this State.
Arlington, Virginia, Center for International Health Information, 1997 Dec. 16 p.This booklet presents highlights of 1995-97 activities of the US Agency for International Development's (USAID's) HIV/AIDS program. After a brief description of the current status of the pandemic, USAID's response, and its new strategy, the booklet provides a more in-depth examination of the HIV/AIDS pandemic, the highlights of USAID HIV/AIDS prevention activities during the past decade, and USAID's focus on prevention, which focuses on promoting safer sex behavior, increasing condom availability and use, and controlling sexually transmitted diseases (STDs). The next section of the booklet reviews USAID's proven interventions, such as behavior change communication and research, condom social marketing, and the development of services to prevent and treat STDs. An example is then given of how the three interventions were used successfully to stem transmission in Thailand. The booklet continues by explaining how USAID has targeted its response to developing countries (where it can have a significant impact on slowing the pandemic), youth, and women, and how peer educators and community outreach activities have been used to spread the prevention message. Next, the booklet discusses how USAID has expanded its partnerships with the World Health Organization's Global Programme on AIDS, with UNAIDS, and with Japan. The final section details the new USAID strategy for the future that will continue to focus on the three aspects of prevention and will also seek to mitigate the impact of HIV/AIDS on individuals and communities. The booklet also contains case studies of various USAID-funded projects.
Family Health International 25th Anniversary Symposium: Improving Reproductive Health Worldwide, November 23, 1996, Research Triangle Park, NC.
Research Triangle Park, North Carolina, FHI, 1996. , 22 p.This report of the 25th Anniversary Symposium of Family Health International (FHI) opens with an overview that summarizes three presentations: 1) a description of FHI's organization presented by its President; 2) a commentary on FHI's first 25 years and future challenges using Thailand as a model of a developing country that achieved strong economic development, slower population growth, and lower mortality during this period; and 3) a sketch of the US Agency for International Development's involvement in population programs. The second part of the report reproduces three more detailed reports on the operation of FHI. The first detailed essay relates the history of FHI's efforts in the area of contraceptive research and defines four distinct time periods: the early 1970s when FHI collected data, the later 1970s to early 1980s when FHI initiated strategies to improve research, the mid-1980s when FHI began to focus on achieving regulatory approval of new products, and the 1990s when research has expanded into new areas. The second essay covers FHI's research into ways to prevent transmission of sexually transmitted diseases and HIV/AIDS, including the evaluation of barrier methods and vaccine trials. The third essay describes how women's perspectives are incorporated into research following the principles that women's rights are human rights and that women's welfare is an end in itself. The report ends with a summary of the closing comments of the FHI's Chief Executive Officer who noted that FHI has grown tremendously in 25 years but that the agency continues its mandate to collect first-class data for use by policy-makers while pursuing new activities.
CONTRACEPTION. 1995 Oct; 52(4):223-8.In November 1991 in Cotonou, Benin, 30 sex workers complained that the World Health Organization (WHO) blue condoms were not as good as the USAID condoms. The National AIDS Programme had replaced the USAID condoms with WHO condoms. Leading complaints about WHO condoms were in order of importance: causes pain in vagina, too short, too small, insufficient lubrication, breaks easily, and several condoms needed per client due to breakage. Samples of both condoms underwent laboratory tests to learn more about the complaints. Informal interviews were conducted with professionals in contact with users (e.g., family planning workers and condom vendors) and condom users (prostitutes, bar girls, and men). There were some differences between the two condom types. For example, the USAID condom exerted 20-30% less pressure on the penis than the WHO condom. However, researchers considered the differences to be too small to completely explain the complaints. Two social workers had done a suboptimal job of explaining to sex workers how to unroll condoms. Other than these sex workers, others accepted the WHO condom well. Both condoms had at least the same strength, suggesting that other factors likely explain the complaints (e.g., breakage). The WHO condom had less lubricant than the USAID condom (223 vs. 451 mg), yet the amount was within the range of that on the commercial market. One batch of WHO condoms had much less lubricant than other WHO batches. Even though the sex workers complained that the WHO condom was too short, it was actually longer than the USAID condom, suggesting that the WHO condoms were not unrolled completely. These findings indicate the need to teach correct application procedures to condom users and to make condoms as immune as possible to incorrect or suboptimal techniques (e.g., changes in lubricant).
AIDS ANALYSIS AFRICA. 1995 Jun; 5(3):9-10.Cameroon participated in World Health Organization (WHO)-coordinated global AIDS control efforts for about 10 years, when the HIV/AIDS epidemic was just beginning in Cameroon. The government established a National AIDS Committee and AIDS Control Service to provide information on prevention of HIV/AIDS. The National AIDS Program was donor-oriented, donor-driven, donor-sustained, and donor-sustaining. It failed, as illustrated by a strong increase in HIV seroprevalence between 1989 and 1992 from 60 to 1304 cases. The donors then abandoned Cameroon. Government officials did not decentralize the program, largely because they believed that districts and communities are incapable of understanding HIV/AIDS-related issues and of managing money from donors. Since the primary health care (PHC) system broke down, it was impossible to integrate HIV/AIDS control activities into PHC, needed for program sustainability. The government did not commit financial resources to the national AIDS program. When donors first provided monies to Cameroon, the economy was strong. 10 years later, a politically and economically unstable situation prevails in Cameroon. WHO has recalled all its staff in Cameroon. The donors often attached conditions that hurt HIV-infected persons. The European Union did not implement a project to train laboratory technicians in the screening and diagnosis of AIDS because of problems encountered with its blood banking and its youth projects, also in Cameroon. Both of these projects have ended. The USAID Office closed in 1994 with about three months' notice, allegedly due to clashes with the Cameroon government. Not all persons working with the funding agencies have totally abandoned Cameroon, however. The government needs to be more concerned about its people and allocation of resources. As Cameroon struggles with its problems, HIV/AIDS is increasing in Cameroon.
AFRICA WOMEN AND HEALTH. 1993 Apr-Jun; 1:24-6.Within the framework of a pilot project, nearly 100 pharmacies in Cameroon will start selling antibiotics in a treatment kit for sexually transmitted diseases (STDs). The objective is to control STDs as well as to reduce the transmission of AIDS, because the presence of genital ulcers increases the risk of getting infected with HIV fifty-fold. The Ministry of Health is sponsoring the project in collaboration with Family Health International and Population Services International with fund from the U.S. Agency for International Development. This social marketing project hopes to attract clients with low product prices and availability, thereby improving the quality of STD treatment. About 90% of people with STDs go to a local healer or pharmacist, where they receive inadequate treatment. Antibiotics are often sold by untrained staff, who cannot provide instructions for use. Incomplete dosages fail to cure the infection and contribute to the increase of resistant bacterial strains. The strict controls over antibiotics were relaxed recently. In 1991, the U.S. food and Drug Administration allowed the over-the-counter sale of an antibiotic drug to treat vaginal candidiasis. The Cameroon treatment kit will include appropriate antibiotics to treat the most common strains of gonorrhea and chlamydia, promote correct condom use, and include 2 packages of condoms and a partner referral card to seek treatment. A number of baseline studies are underway, including surveillance among pregnant women and commercial sex workers to learn about the prevalence of STDs, and research concerning the pathogenesis of male urethritis. The strong private pharmacy distribution system will help realize the project. The campaign messages will focus on proper STD treatment and lowering the chances of getting AIDS. Advertising will link treatment with prevention and the Prudence condom, while radio commercials and leaflets will promote the kits as an effective means of treatment for STDs.
NETWORK. 1993 May; 13(4):22-4.Social marketing is a strategy which addresses a public health problem with private-sector marketing and sales techniques. In condom social marketing programs, condoms are often offered for sale to the public at low prices. 350 million condoms were sold to populations in developing countries through such programs in 1992, and another 650 million were distributed free through public clinics. The major donors of these condoms are the US Agency for International Development, the World Health Organization, the UN Population Fund, the International Planned Parenthood Federation, the World Bank, and the European Community. This marketing approach has promoted condom use as prevention against HIV transmission and has dramatically increased the number of condoms distributed and used throughout much of Africa, Latin America, and Asia. Donors are now concerned that they will not be able to provide condoms in sufficient quantities to keep pace with rapidly rising demand. Findings in selected countries, however, suggest that people seem willing to buy condoms which are well promoted and distributed. Increasing demand for condoms may therefore be readily met through greater dependence upon social marketing programs and condom sales. Researchers generally agree that a social marketing program must change for 100 condoms no more than 1% of a country's GNP in order to sell an amount of condoms equal to at least half of the adult male population. Higher prices may be charged for condoms in countries with relatively high per-capita incomes. Since prices charged tend to be too low to cover all promotional, packaging, distribution, and logistical management costs, most condom distribution programs will have to be subsidized on an ongoing basis.
NETWORK. 1993 May; 13(4):16-7.Much has been learned about which AIDS prevention interventions are effective and what an AIDS prevention program should look like. It is also clear that important program issues must be worked out at the country level if effective interventions are to be had. Programs with successful interventions and approaches in most countries, however, have yet to be implemented on a sufficiently large scale. While some national programs are beginning to use proven interventions and are moving toward implementing full-scale national AIDS programs, most AIDS prevention programs do not incorporate condom marketing, are not using mass media and advertising in a well-programmed way, do not have peer projects to reach most at-risk populations, and do not have systems in place to diagnose and treat persons with sexually transmitted diseases (STD). Far more planning and resources for AIDS prevention are needed from national and international public and private sectors. International efforts by the World Health Organization (WHO), UNICEF, UNDP, UNESCO, UNFPA, and the World Bank have increased markedly over the past few years. Bilaterally, the US, Sweden, United Kingdom, Canada, Netherlands, Norway, Denmark, Japan, Germany, France, and other countries are contributing to WHO/GPA and to direct bilateral AIDS prevention activities. USAID happens to be the largest single contributor to WHO/GPA and is also the largest bilateral program with its $168 millions AIDSCAP funded over 5 years. AIDSCAP integrates condom distribution and marketing, STD prevention and control, behavioral change and communication strategies through person-to-person and mass media approaches, and strong evaluation components. AIDSCAP can help fulfill the need to demonstrate that programs can be developed on a country-wide level by showing how behavior can be changed in a broad geographical area.
USAID HIGHLIGHTS. 1991 Fall; 8(3):1-4.This article considers the epidemic proportion of AIDS in developing countries, and discusses the U.S. Agency for International Development's (USAID) reworked and intensified strategy for HIV infection and AIDS prevention and control over the next 5 years. Developing and launching over 650 HIV and AIDS activities in 74 developing countries since 1986, USAID is the world's largest supporter of anti-AIDS programs. Over $91 million in bilateral assistance for HIV and AIDS prevention and control have been committed. USAID has also been the largest supporter of the World Health Organization's Global Program on AIDS since 1986. Interventions have included training peer educators, working to change the norms of sex behavior, and condom promotion. Recognizing that the developing world will increasingly account for an ever larger share of the world's HIV-infected population, USAID announced an intensified program of estimated investment increasing to approximately $400 million over a 5-year period. Strategy include funding for long-term, intensive interventions in 10-15 priority countries, emphasizing the treatment of other sexually transmitted diseases which facilitate the spread of HIV, making AIDS-related policy dialogue an explicit component of the Agency's AIDS program, and augmenting funding to community-based programs aimed at reducing high-risk sexual behaviors. The effect of AIDS upon child survival, adult mortality, urban populations, and socioeconomic development in developing countries is discussed. Program examples are also presented.