Public Law 109-95, the Assistance for Orphans and Other Vulnerable Children in Developing Countries Act of 2005 (hereinafter, referred to as PL 109-95), was signed into law four years ago to respond to the global orphans and vulnerable children crisis. It calls for the U.S. Government (USG) response to the crisis to be comprehensive, coordinated and effective. This is the third annual report on PL 109-95 and it provides: global estimates of the number of highly vulnerable children; a summary of USG assistance programs for highly vulnerable children; a summary of progress coordinating the response among USG agencies; key strategic issues and opportunities; priorities for 2009-2010--and beyond; and a summary of the results and achievements of USG assistance. Appended to this report are: (1) Comprehensive Notes on Table 1: Highly Vulnerable Children: A Global Profile; and (2) NGO Comments on the Third Annual Report to Congress on PL 109-95. (Contains 3 tables, 73 endnotes, and 2 maps.)