On January 31, 2008, the House Committee on Foreign Affairs announced that a markup hearing would be held on February 7, 2008 which would consider a House bill entitled The Global HIV/AIDS, Tuberculosis and Malaria Reauthorization Act of 2008, for which no text or bill number was immediately available. On January 25, 2008, the White House announced that President Bush and Mrs. Bush would travel to five African countries from February 15-21, 2008, in part to enable the President "to review firsthand the significant progress since his last visit in 2003 in efforts to [...] fight HIV/AIDS, malaria, and other treatable diseases, as a result of the United States robust programs in these areas." President Bush had first stated his intention to visit Africa in 2008 during a November 2007 speech marking World AIDS Day, 2007. In the speech, he also called on the Congress to support his May 2007 call to double U.S. international funding for AIDS, to $30 billion over five years, starting in 2009. International AIDS issues are further covered in CRS Report RL33485, U.S. International HIV/AIDS, Tuberculosis, and Malaria Spending: FY2004-FY2008 , by [author name scrubbed]; CRS Report RL34192, PEPFAR: Policy Issues from FY2004 through FY2008 , by [author name scrubbed]; CRS Report RL33396, The Global Fund to Fight AIDS, Tuberculosis, and Malaria: Progress Report and Issues for Congress , by [author name scrubbed]; and CRS Report RL31712, The Global Fund to Fight AIDS, Tuberculosis, and Malaria: Background , by [author name scrubbed]. Sub-Saharan Africa ("Africa" hereafter) has been far more severely affected by HIV/AIDS than any other world region. In December 2007, the Joint United Nations (U.N.) Program on HIV/AIDS (UNAIDS) released an update on the global AIDS epidemic. It reported that in 2007, there were between 20.9 million and 24.3 million HIV-positive adults and children in Africa, including 1.7 million newly infected during the year. Africa has nearly 12% of the world's population but about 68% of the global total of infected persons. In 2007, about 1.6 million adults and children were estimated to have died of AIDS, comprising about 76% of global AIDS deaths in 2007, down from a 2006 estimate of about 2.1 million deaths, when African AIDS deaths made up about 72% of global AIDS deaths. Aggregate estimates of deaths caused by AIDS suggest that many as 30 million Africans may have died of AIDS since 1982, at the start of the epidemic, including those who perished in 2007. UNAIDS has projected that between 2000 and 2020, 55 million Africans will likely have lost their lives to AIDS, which is the primary cause of death in Africa. It causes more deaths than malaria in African adults, and kills many times more people than Africa's armed conflicts. Multiple health survey data show that the countries with the highest HIV/AIDS prevalence or infection rates globally are in Africa. The adult rate of infection in Africa in late 2005 was 6.1%, compared with 1% worldwide, but had dropped to 5% by 2007, compared to .8% worldwide. National prevalence rates for individual African countries are shown in Table 1 . The relative accuracy of such estimates may vary; see "Note," Table 1 . UNAIDS has reported that Africa's adult HIV infection rate, or prevalence, has begun to stabilize or decline moderately in recent years, having peaked around year 2000, as both the total adult and infected populations have increased. Stabilization means that numbers dying approximate the numbers of newly infected, and that net infections are thus halted or nearly curbed. HIV has become endemic in many countries; at a minimum, it will affect several future generations. There have been declines in Kenya, Zimbabwe, and urban areas in some countries. Prevalence had been increasing in southern Africa in recent years, apart from Zimbabwe and Angola. The 2007 UNAIDS update, however, found that apart from Mozambique—where prevalence was increasing—the epidemic had "reached" or was "approaching a plateau." It found that in Zimbabwe there was a "significant decline" in national prevalence rates, and that adult prevalence in East Africa was stable or beginning to decline. In West and Central Africa, adult prevalence was either generally stable or there were prevalence declines, as in Côte d'Ivoire, Mali, Benin, and parts of Burkina Faso. Recent prevalence declines are attributable to a combination of deaths of infected persons; declines in new infections due to behavioral change and increased access to testing; the scaling up of access to drug therapy; and, in some cases, improved social services and access to better nutrition. Southern Africa, where nine countries have adult infection rates above 10% ( Table 1 ) , is the most severely affected region. However, populous Nigeria in West Africa, with an estimated 3.9% adult infection rate (end-2005), had an estimated 2.9 million infected people, the largest number in Africa apart from South Africa. There, between 5.5 million and 6.1 million [UNAIDS average and South African government estimates] are infected—the largest such population in the world. Since the 1980s, HIV in Africa has been viewed by many researchers as being spread primarily by heterosexual contact, though some believe that the role of unsafe medical practices in the spread of HIV may have been underestimated. Both sexual and medical HIV transmission prevention are components of the President's Emergency Plan for AIDS Relief (PEPFAR). There were roughly 13.73 million women HIV-positive women in Africa in 2007, up from about 13.2 million HIV-positive women in Africa in 2005. They comprised about 59% of infected adults in Africa and about 76% of HIV-positive females globally in late 2005; women comprised a slightly higher proportion of all AIDS infections in Africa, 61%, by 2007. Young women are notably at risk. In 2005, about 4.3% of African women aged 15 to 24 were HIV-positive, compared with 1.5% of young men. Figures for these groups had dropped from 6.9% for women and 2.2% for men in 2004. Africa's AIDS epidemic has a proportionally much greater effect on children in Africa than in other world regions. According to UNAIDS, over 600,000 African infants become infected yearly with HIV through mother-to-child transmission (see "Maternal Transmission," below), during pregnancy, at birth, or through breast-feeding. Most die before the age of two. Nonetheless, roughly 2.24 million African children under age 15 were living with AIDS in 2007, down slightly from an estimated 2.3 million in late 2005. Nearly 90% of HIV-positive children worldwide live in Africa. Less than 10% of these African children receive basic support services. An estimated 12 million children less than 17 years of age, slightly less than 10% of all African children, are believed to have lost one or both parents to AIDS in recent years. The number of orphans in Africa is large but appears to be decreasing slightly. There were an estimated 11.4 million orphans due to AIDS in Africa in 2007. In late 2005, according to UNAIDS, there were about 12 million AIDS orphans (children 17 and under who had lost one or both parents to HIV) in Africa, up from about 10.2 million in late 2003, when AIDS orphans comprised in the range of 28% of all orphans in the region. The apparent decrease raises the possibility that a 2004 U.N. study that projected that by 2010 their number would rise to 18.4 million, or 36.8% of all orphans on the continent, may have underestimated the impact of factors leading to a slight decline in HIV prevalence trends. Because of AIDS-related social stigma, HIV-positive orphans are at high risk for malnourishment, abuse, and denial of education. UNICEF has recommended that the capacity of families and communities to protect and care for orphans be strengthened, that social and state protection services be provided for orphans and vulnerable children (OVCs), and that public education about HIV-affected children HIV-affected be increased. In October 2005, Human Rights Watch alleged in a report that African governments have largely not addressed the myriad barriers to education faced by AIDS-affected OVCs. P.L. 108 - 25 included sense of Congress language recommending that 10% of U.S. HIV/AIDS international assistance should fund services for orphans and vulnerable children. The Assistance for Orphans and Other Vulnerable Children in Developing Countries Act of 2005 ( P.L. 109 - 95 ) became law in November 2005. It authorizes U.S. assistance for basic care for orphans and vulnerable children in developing countries, including aid for community-based care, school food programs, education and employment training, psycho-social support, protection of inheritance rights, and AIDS care. AIDS experts attribute Africa's AIDS epidemic to a variety of economic and social factors, but place primary blame on the region's poverty, which has deprived Africa of effective systems of health information, health education, and health care. As a result, Africans suffer from high rates of untreated sexually-transmitted infections other than AIDS, increasing their susceptibility to HIV. African health systems often have limited capabilities for AIDS prevention work, and HIV counseling and testing are difficult for many Africans to obtain. Until very recently, AIDS treatment was generally available only to elites. Poverty forces large numbers of African men to migrate long distances in search of work, and while away from home they may have multiple sex partners, increasing their risk of infection.