In Democratic Republic of the Congo, the WHO World Health Report (2004) indicates an adult mortality⁷ rate per 1000 population of 585 for males and 449 for females. Life expectancy for males is 41.0; for females 46.1. Healthy life expectancy is 35.0 for males; 39.1 for females.⁸

HIV/AIDS is a huge burden for sub-Saharan Africa. Throughout the region in 2003, an estimated 23-27 million people were thought to be living with the disease which also caused up to 2.5 million deaths. This represents a huge loss and impacts significantly on health systems and social and family structures.

Democratic Republic of the Congo is a country in Central Africa that has been seriously affected by the HIV/AIDS epidemic. Estimates suggest that in Democratic Republic of the Congo, between 450,000 and 2.6 million people were living with HIV/AIDS at the end of 2003. In the same year, up to 220,000 adults and children are thought to have died from the disease (Table 2).

Table 2 Democratic Republic of the Congo HIV and AIDS estimates, end 2003.

UNAIDS reports:

The Democratic Republic of the Congo (DRC) is in a post-conflict period following five years of devastating war. The 2003 peace agreement brought a decisive turning point, with the adoption of a transitional constitution and government bodies. With support from the international community, backed by the UN peacekeeping mission (MONUC), the country is now engaged in the reunification of the army and the organization of democratic elections, the first in 30 years. The HIV/AIDS epidemic is among several major challenges confronting the DRC. Improved security conditions have, at least, enabled increased access to vulnerable populations and greater possibilities for humanitarian intervention. Available data from the isolated surveillance activities conducted in eastern DRC suggest that the prevalence rate may be much higher compared to that observed in the western part of the country, where prevalence among young people points to a growing epidemic. A multisectoral programme and a committee under the leadership of the president have been set up by a presidential decree.

UNAIDS has provided continual support to the DRC, which helped sustain the national response during the most difficult period. The DRC is among UNAIDS priority countries for an intensified effort in support of the national response. UNAIDS gave technical support to develop Global Fund proposals that were approved for US$ 112 million. Similarly, it supported the development of the MAP proposal that was also granted. The political advocacy effort has included several high-level visits to the DRC, including visits by the UN Secretary-General and the UNAIDS Executive Director. During the past three years, UNAIDS successfully assisted the formulation of the National Strategic Plan. UNAIDS is supporting HIV/AIDS prevention and care activities in the military base of Kamina, which has received limited support because of its remote location and difficult access. An outstanding effort has been made in the area of political advocacy for a stronger leadership at the highest level and the adoption of a multisectoral approach. As a result, the head of state has been increasingly speaking out both nationally and internationally.⁹