What is PEPFAR?

PEPFAR (The President's Emergency Plan for AIDS Relief) channels United States' development assistance to support life-saving treatment, prevention and care for people suffering from HIV/AIDS around the world. PEPFAR was announced by President Bush in 2003 as a five-year, $15 billion initiative. Currently, a bipartisan bill to increase AIDS, tuberculosis and malaria funding to $50 billion over the next five years is working its way through Congress.

How does PEPFAR work?

PEPFAR works both bilaterally (funding from the U.S. directly to another country) and multilaterally (funding from the U.S. to agencies that channel finances from many different donor countries). PEPFAR is mostly operated through the Office of the Global AIDS Coordinator (OGAC), which works with U.S. embassies and agencies such as USAID and the CDC to design and implement PEPFAR programs. These agencies collaborate with foreign governments, including 15 focus countries that are some of the hardest hit countries by the epidemic, to develop HIV/AIDS programs that meet countries' specific needs. Though PEPFAR's bilateral HIV/AIDS and TB programs are focused in 15 of the hardest hit countries, PEPAR reaches another 108 countries and funds research on prevention, treatment care, and vaccines for the epidemic.

A substantial portion of PEPFAR's annual funds also go to the Global Fund to Fight AIDS, Tuberculosis and Malaria, which operates in a total of 136 countries, expanding the reach of the initiative and supplementing our efforts in the hardest hit areas.

What has PEPFAR achieved?

Before the establishment of PEPFAR and the Global Fund, an HIV/AIDS diagnosis was a death sentence for millions of people in the world's poorest countries. Even after drug prices were brought down to 36 cents a day, most countries did not have the resources to purchase them and build the infrastructure to deliver them on a mass scale. PEPFAR and the Global Fund transformed this situation by providing desperately needed financial and technical support to countries coping with the epidemic. In 2004, only 400,000 people were receiving life-saving antiretroviral drug treatment in low-and-middle income countries around the world; this number had grown to 2 million by December 2007 thanks to PEPFAR and Global Fund- supported programs.

Since its establishment, PEPFAR-sponsored programs have delivered substantial results around the world, including the following:

  • Contributed to putting 1.45 million people on life-saving antiretroviral treatment
  • 6.7 million people provided with care, including more than 2.7 million orphans and vulnerable children
  • 30 million people provided with voluntary counseling and testing (VCT) for HIV
  • Services to prevent mother-to-child transmission of HIV provided during ten million pregnancies.

PEPFAR has also been instrumental in setting up comprehensive systems for service delivery. For example in Rwanda, PEPFAR funding enabled the implementation of TRACnet, a web-based system that collects and disseminates ART program reporting, drug shortages and CD-4 tests. Over 85% of TRACnet users input data via mobile phones. TRACnet has been deployed in 50 out of 53 health facilities offering antiretroviral treatment in Rwanda, accounting for 95% of all patients on treatment.

Expanding PEPFAR's reach

Despite this remarkable progress, the fight against AIDS is still far from over. In 2007, over 2.1 million people died of AIDS-related complications and only 28% of people in need of ARVs were receiving them. The number of new infections is rising quickly- over 2.5 million people were newly infected with HIV in 2007.

The bipartisan PEPFAR bill, known as the Lantos-Hyde U.S. Global Leadership Against HIV/AIDS, TB and Malaria Act, seeks to combat these trends and expand the reach of PEPFAR by injecting $50 billion into the fight for the next five years. This bill includes $4 billion in funding for tuberculosis and $5 billion in funding for malaria over the next five years. The bill was passed by the House of Representatives with an overwhelming 308-116 vote for approval, increasing pressure on the Senate to move forward quickly on the legislation.

With this increase in resources, the new PEPFAR seeks to:

  • Stop 12 million cases of HIV infection
  • Double the number of people on antiretroviral treatment to 3 million people (including 450,000 children)
  • Care for five million children who have been orphaned by AIDS

The new legislation will also transition PEPFAR from an emergency response to a sustainable program, providing for expanded training for 140,000 new health care professionals and community care workers. The bill also strongly focuses on prevention, a necessary evolution of the program in order to stop the spread of the disease. The new legislation includes comprehensive efforts that place a special emphasis on women and on the underlying factors which make them vulnerable to HIV infection, including a focus on violence against women.

Read more about PEPFAR here: http://www.data.org/issues/what_is_PEPFAR_0607.html

Read more about what countries have been able to achieve through PEPFAR here: http://www.pepfar.gov/press/76029.htm

More Resources:

HIV/AIDS
World Health Organization
UNAIDS
Global Fund to fight AIDS, TB, and Malaria
World Bank AIDS program (MAP)
President's Emergency Fund for AIDS Relief (PEPFAR)

TB
World Health Organization
Global Fund TB page
Global Health Council
Stop TB Partnership
Partners in Health

Malaria
World Health Organization
WHO Global Program on Malaria
Malaria No More
Roll Back Malaria Partnership
Nothin' But Nets
President's Malaria Initiative
Global Fund to fight AIDS, TB, and Malaria
Global Health Council