PEPFAR
The Washington Post editorial board yesterday took a look at the President’s Emergency Plan for AIDS Relief established by George W. Bush. The Post calls President Obama’s 5-year strategy (which we took a look at here) a “sensible approach”. You can read the full column here.
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.
On World AIDS Day, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) launched its Five-Year Strategy, outlining the direction of the program for its next phase. The strategy takes into account lessons learned in the first five years of the program, increases commitments around service delivery, and further emphasizes sustainability.
Specifically, PEPFAR’s next phase will:
- Transition from an emergency response to promotion of sustainable country programs.
- Strengthen partner government capacity to lead the response to this epidemic and other health demands.
- Expand prevention, care, and treatment in both concentrated and generalized epidemics.
- Integrate and coordinate HIV/AIDS programs with broader global health and development programs to maximize impact on health systems.
- 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.
The Global Fund to Fight AIDS, Tuberculosis and Malaria, and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) recently announced impressive new results on their impact in fighting disease around the world.
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.
Global Health Magazine just posted this interesting interview with Ambassador Eric Goosby, the U.S. Global AIDS Coordinator. In it he discusses the President’s Emergency Plan for AIDS Relief (PEPFAR) at length as well as the Obama Administration’s plans for combating the global AIDS epidemic.
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.
Some friends recently alerted me to the fact that the President’s Emergency Plan for AIDS Relief (PEPFAR) is now officially on Facebook.
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.
Earlier today, Secretary Clinton signed a landmark agreement with Angola aimed at combating HIV/AIDS. This new “partnership framework” emphasizes a ground-up approach and lays out a five-year plan in which the U.S. President’s Emergency Plan For AIDS Relief (PEPFAR) will support health priorities laid out in Angola’s HIV National Strategic Plan.
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
