In 2001, an AIDS pandemic threatened to destroy a generation of Africans. In country after country, people were needlessly dying even though new life-saving antiretroviral drugs were available at a reasonable cost. The humanitarian disaster called for dramatic action.

Against this backdrop, my administration decided to act and become part of the global effort to stop the spread of AIDS in the developing world. We began by helping create the multinational Global Fund to Fight AIDS, Tuberculosis and Malaria. It was a good start, but more was needed. So in 2003, with bipartisan support in Congress, we launched the President’s Emergency Plan for AIDS Relief (PEPFAR) to partner with officials in 15 countries hit hardest by the disease. Today, PEPFAR is active in more than 30 countries and, in total, provides funding to programs in 88 countries.

PEPFAR was built on a results-oriented strategy. Our first step was to intervene where we could make an immediate impact.
Unborn children whose mothers are HIV-positive are the saddest victims of the disease and among those who can be helped the most. So we began by providing pregnant women with medications that reduce mother-to-child transmissions of the disease. Then we expanded with prevention programs, care for orphaned children, and anti-retroviral treatments for those who suffer from HIV/AIDS.

I am proud of the contributions made by my fellow citizens. America’s initial PEPFAR commitment was $15 billion over five years. In 2008, the American people renewed their commitment and will now spend an additional $39 billion on PEPFAR and the Global Fund through 2013. I am also proud to have worked with Bono. His encouragement and inspiration played a vital role in winning support for these initiatives.

To some, the fight against HIV in Africa may have once seemed hopeless. A deadly disease with no cure posed a threat to African nations and a challenge to all of humanity. It also fed despair, which can lead to terrorism and violence.

But PEPFAR set the clear goal of saving lives and is getting results. A decade ago, an estimated 50,000 people were receiving antiretroviral treatments in sub-Saharan Africa. In 2010, PEPFAR provided antiretroviral treatment to more than 900,000 people in South Africa alone and to approximately 3.2 million people worldwide. Combined, the Global Fund and PEPFAR provided about 4.7 million people across the world with antiretroviral medications last year.

I wish every American could see the individuals whose lives have been transformed by our efforts. Thanks to PEPFAR, approximately 450,000 children have been born HIV-free since 2004 even though their mothers have the disease. I’ve met many HIV-positive mothers who have given birth to healthy children because of PEPFAR. One of them, Kunene Tantoh of South Africa, came to the White House with her son Baron in 2007. Watching him smile, I could see the life and vitality our efforts are making possible. Thanks to treatments she received, Kunene broke HIV’s bonds of death, and Baron was given a chance to live a full and productive life.

Read more about the fight against HIV/AIDS in our new report, “Progress. Proof. Promise.” Download the report here.

Since 2002, we’ve seen the number of Africans on life-saving HIV/AIDS medicines go from 50,000 to more than 4 million. People who are living with HIV are getting back to school and work. This is what happens when smart policy, moral suasion and a focus for real results takes place.

I wanted to share Mike Gerson’s new op-ed in Christianity Today not simply because he looks back at the success stories accomplished in US policy like PEPFAR, but also his imperative to keep up the efforts in fighting global challenges like AIDS. Mike Gerson would know. He was there on the ground floor as PEPFAR was turned from dream to reality.

“My best, most vivid experiences in government concerned global health. I sat in the Oval Office and watched President George W. Bush approve the Emergency Plan for AIDS Relief—the largest program in history to fight a single disease. I watched the president give his go-ahead for the President’s Malaria Initiative, designed to cut mortality rates in half in 15 highly endemic African countries.

Five or six years ago in a place such as Rwanda, about 4 percent of people who needed AIDS drugs received them. Today, that figure is above 70 percent. With American help, Rwanda cut its death rate from malaria by two-thirds in less than two years, mainly saving children under 5 years old.

These are some of the fastest, broadest achievements in the history of public health, and the progress is repeated across the continent. AIDS treatment in particular has not only saved lives—saved mothers to raise their children and teachers and nurses to serve their communities—it has also encouraged testing and decreased stigma. An infectious disease becomes less terrifying and more manageable when it is not a death sentence. Not all American foreign assistance is effective. But these two programs prove that overseas aid, under the right conditions, can be effective.

Six or seven years into a noble experiment, we have learned some lessons. We have learned that measuring outcomes matters. We have learned that boldness matters. National scale-ups and countrywide plans encourage real development, because they require the creation of supply, management, and human resource systems—the kind of accountability and transparency that can benefit an entire health system and society.”

You can read the full piece on Christianity Today’s website.

The President’s Emergency Fund for AIDS Relief (PEPFAR) launched in 2003 by President Bush and is the largest effort by any nation to combat a single disease and provides life-saving care to millions of people every year.

The first panel of witnesses, which included Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention and administrator of the Agency for Toxic Substances and Disease Registry, discussed how HIV/AIDS treatment could work as prevention of future cases. He also said we should work together with diverse groups of community members, governments, religious groups and hospitals to create better results.

Dr. Wafaa El-Sadr, director of the International Center for AIDS Care and Treatment Programs, and Paula Akugizibwe of AIDS and Rights Alliance of Southern Africa talked said that treating AIDS connects to maternal and child health and that stigmatization of HIV/AIDS in many communities can make it difficult for people to receive necessary treatment. Congress talked about making PEPFAR’s work sustainable, improving efficiency and effectiveness and preventing mother-to-child transmission of HIV/AIDS.

In the end, both the members and the witnesses agreed that they share the common goal of saving more lives through programs like PEPFAR and agreed to work together toward that goal. As a ONE team member, I couldn’t have agreed more.

Last night, New Hampshire Senate candidate Bill Binnie held an event at the baseball stadium here in Manchester, N.H. I went with some ONE members to talk to him about ONE and let him know more about our efforts to encourage continued bold US leadership in the fight against AIDS, malaria and hunger in Africa.

As soon as we got to the stadium we were greeted by our New Hampshire ONE Vote Republican Chair, John Lyons, who kindly took a quick photo with us for the ONE blog.

I also saw many former political staffers who got to know ONE during our ONE Vote effort in 2008. People from Mike Huckabee’s campaign, John McCain’s campaign and others all remembered and complimented ONE’s bipartisan efforts to celebrate recent US efforts to fight AIDS and poverty — like the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, TB, and Malaria Act that passed the Senate in 2008 — with support from Democrats like Sens. Biden and Kerry and Republicans like Sununu and Coburn.

Known to many ONE members as PEPFAR, the plan that President Bush originally announced in 2002 has helped prevent the spread of HIV, putting more than 5 million people on 40-cent pills to fight AIDS. This is something that all ONE members and all Americans should take great pride in!

Americans from everywhere are coming together and uniting with ONE to support urgent, life-saving action and stand tall with proud Africans who struggle each day to overcome extreme poverty and beat back corruption. Good people from both sides of the political aisle and both sides of the oceans have stood tall in the past few years to help save lives and build a better and more prosperous world for all.

Today, with ONE Vote 2010, we celebrate those great efforts and aim to make sure that our leaders continue to enact better policy for the world’s poorest people in the future!

Be sure to connect with other ONE Vote 2010 New Hampshire members on Facebook and Twitter.

Set in Nairobi, Kenya, MTV’s three-part miniseries tells the story of six college friends chasing after sex, money, and love. The story focuses on Ayira – a girl who can’t choose between her soul mate and a wealthy older man. But the drama is more than a narrative of the hopes and fears of its cast – it is a poignant commentary on the effects of a dangerous lifestyle in a society plagued by the threat of HIV and AIDS.

MTV’s Georgia Arnold calls the show’s underlying educational messages about HIV “almost subliminal,” but partners UNICEF and PEPFAR (the US President’s Emergency Plan for AIDS Relief) confirm the well-concealed communication. The partners hoped Ayira’s story would educate African youth about the need to be tested for HIV, the effects of having multiple sexual partners and the importance of openly talking about HIV in order to combat the stigma associated with the virus.

Researchers at Johns Hopkins University in Baltimore say the messaging worked. Results of the researchers’ survey found that 60 percent of Kenyan youths identified the main lessons of the show. Nearly half of the interviewed groups reported talking about the show’s characters and its messaging with family and friends. An estimated 90 percent of Kenyan viewers and 60 percent of Zambian viewers reported the show impacted their thinking.

Although researchers cannot measure the number of actions prevented after viewing Shuga, UNICEF and PEPFAR agree people are already overcoming one of the biggest obstacles – talking openly about HIV. The more they talk, the more likely they are to practice safe sex.

Talk of Shuga grew so much in fact, that the partnering organizations barely needed to promote the series. African youth themselves used social networks to publicize the show.

Considering Shuga’s success, MTV, UNICEF and PEPFAR are already planning a sequel.

Key excerpt and corresponding video clip below:

The U.N. says by 2008, about 141,000 Ugandans were receiving antiretroviral therapy. But Mugyenyi can recall a time when less than 10,000 of Uganda’s HIV/AIDS sufferers were able to receive life-saving treatment.

“I once did a round, [when I had to] literally go around bodies of people lying in corridors to get to those on the bed,” said Mugyenyi. “But that situation has been changed by PEPFAR.”

But at one of the research center’s outreach facilities — Hope Clinic — they’re worried about funding.

In an internal memo dating from October 2009, obtained by CNN, the U.S. Centers for Disease Control and Prevention told Ugandan clinics like Hope they should “expect to have a set flat-lined budget for antiviral drug procurement.”

Health workers at Hope Clinic say that means changes for clinics that in recent years have given free treatment to every patient who walked through the door.

Patients already enrolled in antiviral treatment continue to get their drugs, but now new patients go on a waiting list. A treatment slot opens when a patient dies. Mugyenyi said they turn away up to 20 patients every day.

“As people who saw the devastation of the past, we fear we may have a setback,” he told CNN. “The achievements we have made over the years with PEPFAR — we might begin to see a reversal of the benefits we have seen.”

He explains:

As a key component of President Obama’s Global Health Initiative (GHI), which explicitly embraces a woman- and girl-centered approach to health issues, PEPFAR is working to reaffirm and expand its focus on women and girls in the context of HIV/AIDS prevention, treatment and care. This $30 million initiative is one way that we are doing so.

PEPFAR’s increased GBV response will build upon the existing PEPFAR platforms in these three countries, working to increase the reach, coordination, and efficacy of GBV programs. Our hope is that this initiative will move us closer to our goal of sustainable GBV responses by moving small, pilot projects to tailored, coordinated and integrated national responses.

To ensure this, we will strengthen our current partnerships with governments, non-governmental organizations and civil society in Mozambique, Tanzania and the Democratic Republic of Congo, as well as other countries in which we work. We will also support comprehensive GBV response packages for victims of violence at health facilities, increase GBV prevention programs to address the underlying causes of violence, and improve linkages with other sectors and addressing policy and address structural barriers. PEPFAR will partner with countries and build synergies both across U.S. Government agencies and other partners that focus on GBV-related development issues, such as education, reproductive health, democracy and governance, and economic growth. As we move to expand the reach of programs to fight gender-based violence, we will strengthen our monitoring and evaluation efforts to ensure that interventions implemented are effective and contribute to the broader global effort.

Eric Goosby, the U.S. Global AIDS Coordinator, wrote that the NY Times article “conveyed an unjustifiably negative picture of the global AIDS fight.” He wrote that, “While challenges remain, we are building on and expanding our successes, not walking away from them. This is a global responsibility, and we are using this success story to invite other governments and donors to join us in meeting it.”

A nurse who has helped treat AIDS patients in Ethiopia also wrote that she was disheartened by the article, but found encouragement “that maybe, just maybe, the urgency of the situation is now clear to the American people, and we will join forces and call on President Obama to build upon, not shift from, the success of Pepfar.”

Check out all the letters here and, if you haven’t yet, you can read a good analysis by ONE’s Josh Lozman and Erin Hohlfelder here.

It’s easy, and perhaps justified, to feel frustration after reading the pieces on HIV/AIDS in this week’s New York Times. Despite the huge growth in funding for HIV/AIDS in recent years–driven by a coalition of bipartisan politicos, grassroots advocates, philanthropists, and celebrities—our efforts have not been enough, and the goal of universal access to AIDS treatment, prevention, and care remains unrealized.

Yet if we look at where we are today, major progress has been achieved. In 2002, before PEPFAR was announced and the Global Fund was established, there were only 50,000 people on antiretrovirals, and many doubted that widespread distribution of treatment was even feasible. Today, through leadership from the United States, the G8, and some African countries, that number is more than 4 million globally, including nearly 3 million in Africa. The success of these investments is tangible; anyone who has traveled through the developing world can see what progress looks like in the millions of people who are alive today and who are grateful for our investments.

We’ve anticipated for some time that the spike in political will for AIDS funding would not last forever. Also, experts have been saying for years that leading aggressive treatment efforts without equally rigorous prevention programs to match would become unsustainable. These worries and warnings are now becoming reality. The financial crisis is at least partly to blame. Budget crunches globally—particularly in the US and across Europe—have made it really difficult to find the same big increases for global health programs like PEPFAR and the Global Fund that we’ve grown accustomed to and have needed over the last few years. The Global Fund – the world’s largest provider of tuberculosis and malaria services to the poor and the second largest of HIV/AIDS services – is currently facing a financial crisis as it struggles to attract enough investment from donors to continue funding programs that already exist.

The articles also highlight other factors that have perhaps collectively slowed the momentum around the AIDS fight. The Obama Administration, through its Global Health Initiative, has advocated for a prioritization of new global health funding for cost-effective interventions around maternal and child health, malaria, and neglected tropical diseases. This is not inherently wrong, and in fact many of those areas have long been overlooked and underfunded during the period when AIDS funding grew. However, AIDS is not “done”, and it requires continued scaling up of funding for both prevention and treatment efforts. AIDS is called a crisis for a reason: without continued increases in funding, people will die.

Some African governments also need to look in the mirror (and their back pockets) before blaming donors for a lack of funding. Two of the countries mentioned in McNeil’s articles – Uganda and Kenya – have been plagued by corruption scandals. Our global health programs can only succeed if the governments are accountable for investments and penalized if they misuse those investments. And many of these programs have established and been praised for very strong accountability mechanisms. The problem is, of course, that those who suffer as a result of corruption and the penalties that come with it are not the government officials who try to misuse the money, but poor people who need medicine to stay alive. “Improved governance” is not just about better-functioning bureaucracies; it’s also about creating an environment in which donors can trust that their money will be used (well) to save millions more lives.

In spite of all these obstacles, we believe resolutely that the fight against AIDS is one that we can win. But at the end of the day, we all know that doing so requires bold new investments. That’s what drives our current campaign at ONE to ensure that there aren’t cuts to President Obama’s budget request, particularly to his international affairs account—from which AIDS, maternal child health, and other global health money flows. When we read the articles, it’s easy to wring our hands and think “how could we let this happen?” But proposed cuts to the international affairs budget (see Conrad, Kent) pit global health programs that are equally as vital against each other for funding—a true Sophie’s choice when we think about saving lives across the developing world.

We take these New York Times articles as a rallying cry. Your voices – our voices – have become even more important. We must spread the word that investments in global health work; now is not the time to walk away.

From the official statement:

Gender-based violence is a world-wide pandemic that poses significant health and human rights concerns to vulnerable populations. GBV directly fosters the spread of HIV/AIDS, and limits women and girls’ ability to negotiate sexual practices, to disclose HIV status, and to access services due to fear of GBV. PEPFAR’s increased GBV response will build upon the existing platforms in these three countries and their experience with GBV and HIV activities to increase the reach, coordination, and efficacy of GBV programs in these nations.

To pursue this intensified approach, PEPFAR will strengthen its current partnerships with governments, non-governmental organizations and civil society to scale up GBV work in the three countries. PEPFAR will support comprehensive GBV response packages for victims of violence at select health facilities, increase GBV prevention programs to address the underlying causes of violence, and improve linkages with other sectors and addressing policy and structural barriers. PEPFAR will also look for synergies with U.S. Government agencies and other partners that already focus on GBV-related development issues, such as education, reproductive health, democracy and governance, and economic growth.

Along with increased GBV interventions, this initiative will support countries to enhance monitoring and evaluation of GBV programs in order to help assess progress toward program goals and improve the effectiveness of GBV responses.

We’ll have more on this soon.