PEPFAR
Over the weekend, the New York Times printed several letters in response to last week’s articles on the fight against HIV/AIDS in Africa. The letters provide an interesting cross-section of perspectives and responses on where America’s fight against global AIDS stands.
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.
Written with Erin Hohlfelder:
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.
I just got this press release in my inbox that I thought readers might be interested in. According to the State Department, the President’s Emergency Plan for AIDS Relief (PEPFAR) has committed an additional $30 million to support three partner countries– Tanzania, Mozambique, and the Democratic Republic of Congo– in their efforts to scale up gender-based violence prevention and response efforts.
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.
Last night’s “60 Minutes” had an extensive report on the President’s Emerigency Plan for AIDS Relief (or PEPFAR as it’s more commonly known). Readers of the ONE Blog are probably familiar with PEPFAR, a program instituted under President George W. Bush that provides anti-retroviral treatment to millions of people affected by the global HIV/AIDS epidemic.
“60 Minutes” went to Uganda to see first-hand how PEPFAR is saving lives:
Watch CBS News Videos Online
U.S. Global AIDS Coordinator Eric Goosby has taken to the DipNote blog to broadly outline the future of the Global Health Initiative as well as State’s “PEPFAR Five-Year Strategy”. It’s a pretty helpful insight into how the Administration is going about combating HIV/AIDS in the coming years:
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.
UN Dispatch picked up a great interview conducted by Science Speaks with US Global AIDS Ambassador Eric Goosby in which he talks about the future of PEPFAR, universal access, and a host of other issues.
You can read the full interview here.
This morning in DC, I gathered with a group of Evangelical church leaders to reflect on how best to take action on global issues facing the faith community, especially in the face of extreme global poverty.
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.
