In the 25 years since the HIV/AIDS pandemic began, more than 25 million lives have been lost to the disease. Today, an estimated 38.6 million people worldwide are infected with HIV, the virus that causes AIDS. Each year, an additional four million people, including 700,000 children, are newly infected. In developing countries hardest hit by the disease, particularly in sub-Saharan Africa, HIV/AIDS has drastically reduced adult life expectancy and orphaned 15 million children.

In recognition of this vast human suffering, governments and international organizations launched various initiatives to provide life-saving antiretroviral treatment (ART) to HIV-infected people. Despite these commitments and the progress that has been made, both treatment and prevention efforts have fallen well short of goals. In sub-Saharan Africa, more than 80 percent of HIV-infected people, including 1.9 million children, who need ART are not receiving it. New infections also continue to occur at staggering rates.

In 2002, the Columbia University Mailman School of Public Health launched one of the first global HIV/AIDS care and treatment programs. Recognizing that women are the cornerstone of families and are disproportionately affected by HIV, the Mailman School established the MTCT-Plus Initiative to focus on providing care and treatment to HIV-infected women and, through them, their families. The MTCT-Plus Initiative, supported by multiple foundations, transformed the conventional approach to HIV care and treatment by linking efforts to prevent mother-to-child transmission of HIV (PMTCT ) with comprehensive programs focused on the health of mothers and their families.

In 2004, based on the successful model of care pioneered by the MTCT-Plus Initiative, the Mailman School established the International Center for AIDS Care and Treatment Programs (ICAP). The program, funded by the United States government under the President’s Emergency Plan for AIDS Relief (PEPFAR), works with national and local partners to support HIV-related programs. ICAP supports more than 400 sites in 14 resource-limited countries around the world, principally in sub-Saharan Africa. They include: Cameroon, Cote d’Ivoire, Ethiopia, Kenya, Lesotho, Mozambique, Nigeria, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia, and Thailand.