As a result of the remarkable successes the United States Government has achieved with partner nations against HIV/AIDS, malaria and tuberculosis in the past decade, the GHI seeks to expand existing U.S. Government commitments to broaden the impact of our activities upon broader health systems. As the U.S. Global AIDS Coordinator, I welcome the GHI commitment to further PEPFAR’s efforts in HIV/AIDS, and I look forward to building upon the tremendous successes PEPFAR has achieved.

Reflecting the principles of the GHI, under our new PEPFAR Five-Year Strategy, PEPFAR is transitioning from an emphasis on an emergency response to a sustainable one. To accomplish this, PEPFAR is working with partner governments to increase their ownership of, and capacity to lead, HIV/AIDS responses in country. Achieving this outcome requires a heightened effort to improve health systems at the country level. PEPFAR will deepen our work with countries to expand their capacity to deliver the health interventions they designate as priorities. As we build health systems, PEPFAR will also use these systems as a platform to directly support treatment for more than four million individuals living with HIV/AIDS, prevention of more than 12 million new infections, and care for more than 12 million individuals affected and infected by HIV/AIDS, including 5 million orphans and vulnerable children.

Cultivating a sustainable response to the range of global health issues is no easy task. The Administration is dedicating unprecedented funding — totaling $63 billion over six years — towards the GHI. This figure is nothing short of remarkable: compared to the preceding six-year period from 2003-2008, this resource commitment for 2009-2014 represents more than a doubling of funds. Included in this in an increase in funding for PEPFAR, allowing us to expand the reach and maximize the impact of our HIV/AIDS programming.

This initiative represents a new and innovative way of doing business for the U.S. Government, promoting coordination among agencies and programs to avoid duplication of efforts and maximize the impact of each dollar invested. As part of GHI, PEPFAR will work closely with other United States Government programs to build the efficiency and effectiveness of national health systems, strengthening their ability to meet the variety of health needs individuals face, including HIV-related needs.

You can read his full post here.

You can read the full interview here.

The forum was the first of many US regional “Conversation Gatherings” leading up to the 3rd Lausanne Congress on World Evangelization happening this October in Cape Town, South Africa. The Lausanne Congress was first organized in 1974 by Rev. Billy Graham and Dr. John Stott, in Lausanne, Switzerland. This year’s Congress in Cape Town—held in collaboration with the World Evangelical Alliance—will bring together 4,000 leaders from more than 200 countries to confront the critical issues of our time: other world faiths, poverty, and HIV/AIDS among others—as they relate to the future of the Church and world evangelization.

In our lead-up conversation to Cape Town this morning, ONE partners World Vision and the National Association of Evangelicals (NAE) called for greater action to help beat back senseless poverty and disease.

Galen Carey, NAE’s Director of Government Affairs, emphasized the particular need to take action around the Millennium Development Goals (MDGs). “2010 is a critical year for the MDGs, and one way to get involved is through Micah Challenge’s 10.10.10 campaign.”

World Vision’s Bob Zachritz noted important success stories, such as PEPFAR and its work against global AIDS. Calling for greater community and partnership, Zachritz noted that “the US government cannot beat AIDS alone. Bill Gates cannot beat AIDS alone. Nor can the Church beat AIDS alone. We have to creatively work together.”

Find out even more about the Lausanne Congress in Cape Town—including ways that you can participate—on their website.

Here’s an excerpt:

THE FIRST five years of the President’s Emergency Plan for AIDS Relief (PEPFAR) have been a success. More than 2 million people in poor foreign countries are now on antiretroviral medications through the program created by President George W. Bush in 2003. A study released in March showed that PEPFAR averted “about 1.2 million deaths.” But with five people becoming infected for every two who get treatment through PEPFAR, the program is unsustainable without a change in strategy. The new five-year plan issued last week by Eric Goosby, the U.S. global AIDS coordinator, seems to be a sensible approach.

President Obama started the expansion of PEPFAR’s mission last May. The budget went from $48 billion over five years to $51 billion over six years. Many organizations, including Doctors Without Borders, continue to worry that Mr. Obama is “flat-lining” funding for the vital program. But this ignores Mr. Obama’s move to make PEPFAR the center of a larger $63 billion global health initiative to develop more comprehensive and integrated approaches to care.

To that end, PEPFAR 2 has three pillars: prevention, integration and improved health-care systems in the 15 participating countries, which include Haiti, Vietnam, Guyana and 12 sub-Saharan nations. While getting people into treatment has been relatively easy, preventing them from becoming HIV-positive has been the harder nut to crack. Under the new strategy, women and mothers will be the focus of prevention efforts, with a particular emphasis on preventing mother-to-child transmission of HIV. To foster a more integrated approach to care, PEPFAR patients will also be treated for tuberculosis, malaria and previously untreated tropical diseases. The administration believes that with its effort to beef up medical personnel and assist governments to manage epidemics, overall health systems will improve.

Specifically, PEPFAR’s next phase will:

1. Transition from an emergency response to promotion of sustainable country programs.
2. Strengthen partner government capacity to lead the response to this epidemic and other health demands.
3. Expand prevention, care, and treatment in both concentrated and generalized epidemics.
4. Integrate and coordinate HIV/AIDS programs with broader global health and development programs to maximize impact on health systems.
5. Invest in innovation and operations research to evaluate impact, improve service delivery and maximize outcomes.

New program targets were also announced around prevention (support the prevention of 12 million new HIV infections, double the number of at-risk babies born HIV-free), care and support and treatment (provide direct support for more than 4 million people on treatment, support care for more than 12 million people), and sustainability (support training and retention of more than 140,000 new health care workers to strengthen health systems).

Forthcoming annexes will provide further information about specific areas within the strategy.

Ambassador Eric Goosby, U.S. Global AIDS Coordinator, just participated in a town hall-style session with the Kaiser Family Foundation to discuss PEPFAR’s new five-year strategy earlier today. You can view the webcast here.

Since its creation in 2002, the Global Fund has supported:

• 2.5 million people on antiretroviral treatment for AIDS
• Detection and treatment of 6 million cases of infectious tuberculosis
• Distribution of 104 million bed nets to protect families from malaria

Since its launch in 2003, PEPFAR has supported:

• Life-saving antiretroviral treatment for over 2.4 million people.
• Direct care for nearly 11 million people affected by HIV/AIDS, including 3.6 million orphans and vulnerable children.
• Prevention of mother-to-child transmission programs that allowed nearly 340,000 babies of HIV-positive mothers to be born HIV-free.

Please note that there is overlap in these numbers due to concurrent efforts on the part of these mechanisms (e.g., the total number of those on antiretroviral treatment for AIDS is not 2.5 million plus 2.4 million), and we will not know the new global total for a couple months.

Excerpt below, full interview here

Q: What are you spending most of your time on now?

Goosby: The main focus has been in understanding what we’ve done in the first five years in the PEPFAR programs (and) in each location how our response in both prevention and treatment do or do not relate to the demographics of the epidemic in each of these settings. In each city, there are multiple epidemics. Each has their own population, and movement of the virus through that population. And we’re looking at how well our prevention programs understand that movement of the virus, and if they have indeed positioned themselves in front of it.

A second focus … has been appreciating the complexity of our partnering network within the country, in the NGO community in particular. It’s been astonishing to see how well we have done in urban populations.

But now the fragility of these health systems is what I’m most concerned about it. They are as fragile as the NGO who is involved in the delivery, and that is dependent on continued resources from us to support them in that effort.

This is a pretty cool development, and my immediate impression of the page is that it’s a really nice platform to disseminate up-to-the-minute information about the program and to interact with constituents. You can check out the page, and become a fan, at www.facebook.com/PEPFAR. You can also now follow PEPFAR on Twitter.

Also, Nandini Oomman and Christina Droggitis from the Center for Global Development offer some sharp analysis and suggestions for PEPFAR’s engagement with social networking here.

Here are a few key excerpts from Secretary Clinton’s remarks on the agreement:

“This framework represents a new approach to our government’s fight against HIV/AIDS. It emphasizes a bottoms-up approach tailored for and by the country we are assisting. It represents an expansion of local capacity and health care systems that can last over time. It represents long-term planning and more intensive pursuit of prevention. It represents the use of measurements to assure effectiveness and accountability. It will allow for greater coordination among the many parties involved in preventing and treating HIV/AIDS. And finally, it will place greater attention of the affect of HIV/AIDS on women.”

“I am pleased that, thanks to the very swift work between the minister of health and the global AIDS coordinator, we are going to more than double funding for PEPFAR in Angola.”

While Angola is already a PEPFAR focus country, through this new agreement, the U.S. and Angola will work together to strengthen health systems; improve monitoring and evaluation; bolster HIV prevention activities (particularly mother-to-child transmission); address TV/HIV co-infection; address discrimination issues; encourage testing; and promote the people living with HIV/AIDS in all levels of planning and implementation.
Funding will reportedly increase from $7 million to $17 million.

-Lisa Fleisher

It is officially August Recess and here in Florida we are taking advantage of the opportunity to meet locally with our elected officials and their staff while they are in town.

Earlier today, we had the chance to sit down with Josh Maddock, District Representative for Congressman Ron Klein (Fl-D-22). We told Josh all about ONE and the more than 4,000 ONE members living right here in the 22nd Congressional District which spans the eastern coast of Florida from Boca Raton up through parts of Jupiter.

First and foremost, we thanked Josh for Rep. Klein’s previous support on some of our legislative priorities, including the reauthorization of PEPFAR and the Jubilee Act. We were also pleased to report that Rep. Klein voted against the Lewis/Culberson amendment which, if passed, would have cut significant funding from the FY2010 Foreign Affairs Appropriations Bill.

As a member of the Foreign Affairs Committee, we knew that Rep. Klein would be familiar with recent efforts to re-write the Foreign Assistance Act with the goal of restructuring and improving coordination and aid effectiveness. We asked that Rep. Klein consider joining the more than 100 members of Congress who are already cosponsors of this important bill.

Before leaving, we also talked about the importance of developing a long-term approach to improve agricultural sustainability and asked that Rep. Klein become a cosponsor of H.R. 3077, The Global Food Security Act. We know that the United States is a global leader in providing emergency food and disaster assistance, however, these interventions, while critical, are not sustainable solutions to improve the lives of millions that are vulnerable to food insecurity.

-Sara J. Paterni