The United States President's Emergency Plan For AIDS Relief (PEPFAR) is the global health funding by the United States to address the global HIV/AIDSepidemic and help save the lives of those suffering from the disease. The U.S. allocation of over $110 billion marks the largest investment by any country has ever made towards combating a single disease.[1] Launched by U.S. President George W. Bush in 2003, as of May 2020, PEPFAR has provided cumulative funding for HIV/AIDS treatment, prevention, and research since its inception, making it the largest global health program focused on a single disease in history until the COVID-19 pandemic.[2] PEPFAR is implemented by a combination of U.S. government agencies in over 50 countries and overseen by the Global AIDS Coordinator at the United States Department of State.[3] As of 2023, PEPFAR has saved over 25 million lives,[4][5] primarily in sub-Saharan Africa.[2][6]
PEPFAR began with President George W. Bush and his wife, Laura Bush, and their interests in AIDS prevention, Africa, and what Bush termed “compassionate conservatism.” According to his 2010 memoir, Decision Points, the two of them developed a serious interest in improving the fate of the people of Africa after reading Alex Haley’s Roots, and visiting The Gambia in 1990. In 1998, while pondering a run for the U.S. presidency, he discussed Africa with Condoleezza Rice, his future secretary of state; she said that, if elected, working more closely with countries on that continent should be a significant part of his foreign policy. She also told him that HIV/AIDS was a central problem in Africa but that the United States was spending only $500 million per year on global AIDS, with the money spread across six federal agencies, without a clear strategy for curbing the epidemic.[7]
The U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003[8] (or the Global AIDS Act) specified a series of broad and specific goals, alternately delegating authority to the president for identifying measurable outcomes in some areas, and specifying by law the quantitative benchmarks to be reached within discrete periods of time in others. The legislation also established the State Department Office of the Global AIDS Coordinator to oversee all international AIDS funding and programming.
In May 2022, Dr. John N. Nkengasong was confirmed by the U.S. Senate as the U.S. Global AIDS Coordinator and was officially sworn in on June 13, 2022. A little over a year later, Ambassador Nkengasong joined U.S. Secretary of State Anthony J. Blinken to launch State Department’s Bureau of Global Health Security and Diplomacy (GHSD) August 1, 2023, which he leads. [11]
In December 2014, PEPFAR announced a program PEPFAR 3.0 focusing on Sustainable Control of the AIDS epidemic. This program was designed to address the UNAIDS "90-90-90" global goal: 90 percent of people with HIV diagnosed, 90 percent of them on ART and 90 percent of them virally suppressed by the year 2020.[12]
Focus countries
When PEPFAR was signed into law 15 resource-limited countries with high HIV/AIDS prevalence rates were designated to receive the majority of the funding. The 15 "focus countries" were Botswana, Côte d'Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Vietnam, and Zambia. Most of the $15 billion for the program was to be spent on these focus countries, $4billion was allocated for programs elsewhere, and for HIV/AIDS research (the other $1billion was contributed to the Global Fund).[citation needed]
With the reauthorization of PEPFAR in 2008 there was a shift away from the "focus country" approach by authorizing the development of a Partnership Framework model for regions and countries, with the aim of ensuring long-term sustainability and country leadership. Through bilaterally-funded programs, PEPFAR works in partnership with host nations to support treatment, prevention and care for millions of people in more than 85 countries. Partnership Frameworks provide a 5-year joint strategic framework for cooperation between the U.S. Government, the partner government, and other partners to combat HIV/AIDS in the host country through service delivery, policy reform, and coordinated financial commitments.See the PEPFAR World Wide Activities Map and PEPFAR Dashboard.
Implementing agencies
The AIDS pandemic has been stabilised in Southern and East Africa, with life expectancy rising.
Office of the Global AIDS Coordinator (OGAC)
Housed in the Department of State, the Office of the Global AIDS Coordinator oversees the implementation of PEPFAR and ensures coordination among the various agencies involved in the U.S global response to HIV/AIDS. United States Ambassadors from the State Department provide essential leadership to interagency HIV/AIDS teams and engage in policy discussions with host-country leaders.[13]
U.S. Agency for International Development
An independent federal agency, USAID receives overall foreign policy guidance from the Secretary of State and is the agency primarily responsible for administering civilian foreign aid. USAID supports the implementation of PEPFAR programs in nearly 100 countries, through direct in-country presence in 50 countries and through seven other regional programs.[13]
Department of Health and Human Services (HHS)
Under PEPFAR, the Department of Health and Human Services (HHS) implements PEPFAR-funded prevention, treatment and care programs through the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), and Substance Abuse and Mental Health Services Administration (SAMHSA). The Office of Global Health Affairs within HHS coordinates all of the HHS agencies to be sure PEPFAR resources are being used effectively.[citation needed]
Centers for Disease Control and Prevention (CDC)
As part of the Department of Health and Human Services, the Centers for Disease Control and Prevention uses PEPFAR funding to implement its Global AIDS Program (GAP). GAP works with highly trained physicians, epidemiologists, public health advisers, behavioral scientists, and laboratory scientists in 29 countries, who are part of USG teams implementing PEPFAR. Through partnerships with host governments, Ministries of Health, NGOs, international organizations, U.S.-based universities, and the private sector, GAP assists with HIV prevention, treatment, and care; laboratory capacity building; surveillance; monitoring and evaluation; and public health evaluation research.
Department of Defense (DoD)
The Department of Defense (DoD) implements PEPFAR programs by supporting HIV/AIDS prevention, treatment, care, strategic information, human capacity development and program/policy development in host military and civilian communities. The DoD HIV/AIDS Prevention Program (DHAPP) is the DoD Executive Agent for the technical assistance, management, and administrative support of the global HIV/AIDS prevention, care and treatment for foreign militaries.[14]
Department of Commerce (DoC)
The Department of Commerce (DoC) provides support for PEPFAR by furthering private sector engagement through public-private partnerships. Housed within DoC, the U.S. Census Bureau assists with data management and analysis, survey support, estimating infections averted and supporting mapping of country-level activities.[15]
Department of Labor (DoL)
The Department of Labor (DoL) implements PEPFAR workplace-targeted projects that focus on the prevention and reduction of HIV/AIDS-related stigma and discrimination. DoL programs (in over 23 countries) consist of three main components: increasing knowledge aboutHIV/AIDS, implementing workplace policies to reduce stigma and discrimination and building capacity of employers to provide support services.[citation needed]
Peace Corps
With programs in 73 countries, the Peace Corps is heavily involved in the fight against HIV/AIDS.Peace Corps volunteers provide long-term capacity development support to nongovernmental, community-based, and faith-based organizations as they provide holistic support to people living with and affected by HIV/AIDS.[citation needed]
The U.S. President's Emergency Plan for AIDS Relief: Five-Year Strategy report from 2009 outlines the PEPFAR strategy and programs for the fiscal years 2010-2014.[citation needed]
Prevention
To slow the spread of the epidemic, PEPFAR supports a variety of prevention programs: the ABC approach (Abstain, Be faithful, and correct and consistent use of Condoms); prevention of mother to child transmission (PMTCT) interventions; and programs focusing on blood safety, injection safety, secondary prevention ("prevention with positives"), counseling and education.[citation needed]
Initially, a recommended 20% of the PEPFAR budget was to be spent on prevention, with the remaining 80% going to care and treatment, laboratory support, antiretroviral drugs, TB/HIV services, support for orphans and vulnerable children (OVC), infrastructure, training, and other related services. Of the 20% spent on prevention, one third, or 6.7% of the total, was to be spent on abstinence-until-marriage programs in fiscal years 2006 through 2008, a controversial requirement (see below). The other two thirds was allotted for the widespread array of prevention interventions described above, including counseling, education, injection safety, blood safety and condoms.[citation needed]
The 2008 reauthorization of PEPFAR eliminated the 20% recommendation for prevention efforts, including the requirement for abstinence programs.[16]
Treatment
In addition to providing antiretroviral therapy (ART), PEPFAR supports prevention and treatment of opportunistic infections, as well as services to prevent and treat malaria, tuberculosis, waterborne illness, and other acute infections. PEPFAR supports training and salaries for personnel (including clinicians, laboratorians, pharmacists, counselors, medical records staff, outreach workers, peer educators, etc.), renovation and refurbishment of health care facilities, updated laboratory equipment and distribution systems, logistics and management for drugs and other commodities. This is intended to ensure the sustainability of PEPFAR services in host countries, enabling long-term management of HIV/AIDS.
PEPFAR-supported care and treatment services are implemented by a wide array of U.S.-based and international groups and agencies. Among the largest "Track1.0" (treatment) partners are Harvard University,[17] Columbia University's International Center for AIDS Care & Treatment Programs (ICAP),[18] the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF),[19] and the AIDSRelief consortium of Catholic Relief Services.[20]
Care
For those who have already been infected with HIV/AIDS, PEPFAR provides HIV counseling, resources for maintaining financial stability, etc. Special care is given to orphans and vulnerable children (OVCs) and services are provided that meet the unique needs of women and girls, including victims of sex trafficking, rape, abuse, and exploitation (see fact sheet on Gender and HIV/AIDS). Finally, the Emergency Plan works closely with country leaders, military groups, faith-based organizations, etc. in an attempt to eliminate stigma.
Health Systems Strengthening
PEPFAR has directly and indirectly contributed to the health systems strengthening of recipient countries including improving laboratory capacity as well as improving monitoring and evaluation including introduction of the electronic medical record systems.[21] Another area of health system strengthening that PEPFAR has contributed to is its ability to increase the pandemic response to other infectious diseases such as COVID-19.[22] Research by Anand Reddi and colleagues has documented the effectiveness and sustainability of PEPFAR programs by emphasizing the need for integrated approaches to HIV care that can strengthen overall health systems in resource limited settings.[23]
Antiretroviral Local Manufacturing
The U.S. government is supporting African production of antiretrovirals (ARVs) to address the continent's HIV epidemic. In July 2024, PEPFAR plans to expand its purchase of ARVs from local suppliers to serve 2 million African patients.[24]
Results
The results of the program include:
As of September 30, 2023, PEPFAR has saved 25 million lives.[25]
As of September 30, 2023, PEPFAR supported antiretroviral treatment for nearly 20.47 million people worldwide.[26]
In 2023, PEPFAR supported 1.95 million people to newly enroll for antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV infection.[27]
PEPFAR in FY2023 supported 2.5 million adolescent girls and young women were reached through DREAMS HIV prevention services.[28]
PEPFAR directly supported HIV testing and counseling for more than 71 million people in fiscal year 2023.[29]
PEPFAR supported antiretroviral drug prophylaxis to prevent mother-to-child transmission (MTCT), resulting in 5.5 million babies born HIV-free.[30]
PEPFAR directly supported 7.0 million orphans, vulnerable children and their caregivers in fiscal year 2023.[31]
PEPFAR directly supported approximately 32.5 million male circumcision procedures worldwide cumulatively from 2017 through Dec 2023.[32]
The U.S. is the first and largest donor to the Global Fund to Fight AIDS, Tuberculosis, and Malaria. To date, the U.S. has provided more than $7 billion to the fund.
Of the estimated 8 million individuals in low- and middle-income countries who currently receive treatment, nearly 6.8 million receive support through PEPFAR bilateral programs, the Global Fund, or both.
There is additional evidence in the published literature that funding towards PEPFAR vis-a-vis antiretroviral therapy also affirmed maternal and child health in addition to HIV treatment outcomes[33][34]
Accountability and funding
Since the start of PEPFAR in 2003, the program has utilized multi-year appropriations. PEPFAR reports to Congress on an annual basis, providing programmatic and financial data as required by law. The Fourteenth Annual Report to Congress on the President's Emergency Plan for AIDS Relief is available on the official PEPFAR website,[35] as are more specific reports, financial information and other information.
Global AIDS funding is provided in the Foreign Operations and Labor, Health and Human Services appropriations bills, which, if the process goes smoothly, are agreed to by the House and Senate in advance of the federal fiscal year beginning October 1. The Office of the Global AIDS Coordinator (OGAC) budgets according to the allocations provided by Congress and the policy of the Administration. Funding figures by program are reported to Congress by the Office of the Global AIDS Coordinator.[citation needed]
For FY 2013, President Obama requested $6.42 billion, including more than $4.54 billion for bilateral HIV/AIDS programs and $1.65 billion for the Global Fund. For FY 2014, President Obama requested $6.73 billion, including more than $4.88 billion for bilateral HIV/AIDS programs and $1.65 billion for the Global Fund.[36]
Annual data on the PEPFAR budget, spending by budget code, and impact estimates are available online at PEPFAR Panorama Spotlight. Funding amounts to specific in-country implementing mechanisms and partners are only available for the year 2013 onward.[citation needed]
Some critics of PEPFAR feel that American political and social groups with moral rather than public health agendas are behind several requirements of PEPFAR, pointing to the mandates that one-third of prevention spending in 2006–2008 be directed towards abstinence-until-marriage programs and that all funded organizations sign an anti-prostitution pledge. This pledge requires all organizations that receive PEPFAR funding to have a policy that explicitly opposes prostitution and sex trafficking which some activists compared to a loyalty oath.[39] A number of AIDS organizations felt such a policy would alienate their efforts to reduce HIV contraction rates among sex workers.[40]
In 2005, it was reported from United Nations' envoy leader for HIV/AIDS in Africa Stephen Lewis that the Bush administration's abstinence policy may have contributed to a shortage of condoms in Uganda.[41][42][43]
The requirement for prevention spending was lifted with the PEPFAR reauthorization in 2008,[16] but some critics worry that some funds could still be spent on abstinence programs. The Center for Health and Gender Equity and Health GAP outline their criticism of PEPFAR on a website known as PEPFAR Watch. The previous 33% earmark has since been replaced by a requirement that if more than 50% of PEPFAR funds are allocated to non-abstinence promotion measures, the US Global AIDS Coordinator must report to Congress. However, the new reporting requirement continues to emphasize abstinence and fidelity to the exclusion of comprehensive approaches, such as those that include education about male and female condoms. This can cause a chilling effect for organizations receiving PEPFAR funding, who may censor their prevention activities and fall short of providing comprehensive HIV prevention services to women, men, and young people.[citation needed]
PEPFAR also does not fund needle exchange programs, which are widely regarded as effective in preventing the spread of HIV.[49]
Conditions
Many have argued that PEPFAR's emphasis on direct funding from the United States to African governments (bilateral programs) have been at the expense of full commitments to multilateral programs such as the Global Fund. Reasons given for this vary, but a major criticism has been that this enables the U.S. "to maximize its leverage with other countries through the funds available for distribution" since the "Global Fund and other multilateral venues do not possess the same top-down leverage as does the United States in demanding fundamental national-level reforms".[50] However, since the inception of PEPFAR there has been a shift away from strictly bilateral funding to more multilateral programs.
Recruitment of locals
PEPFAR has been criticized for having a negative impact on the health systems in regions receiving its funding through its recruitment practices. Although Congress made attempts to limit its impact by prohibiting "topping off" salaries and limiting funding for healthcare worker training (thereby eliminating per diems as a method of augmenting salaries), PEPFAR funded programs effectively paid its local staff up to a hundred times more than that of the local healthcare structure.[51]
Rather than strictly through salaries, program staff received benefits such as housing and education subsidies. Countries, already stressed by the number of trained physicians and nurses emigrating to western nations, have seen the presence of PEPFAR programs significantly decrease the number of skilled medical professionals willing to work within the domestic healthcare infrastructure. As a result, the overall health of these communities are placed in jeopardy, but funds, physicians, and nurses are diverted to combat HIV/AIDS exclusively within the framework of PEPFAR.[citation needed]
Investigations
On June 15, 2011, the Department of Health and Human Services Office of Inspector General (OIG) published a report critical of the Centers for Disease Control and Prevention's (CDC's) administration of PEPFAR funds. The report read in part: "Our review found that CDC did not always monitor recipients' use of [PEPFAR] funds in accordance with departmental and other Federal requirements.... [M]ost of the award files did not include all required documents" to demonstrate proper monitoring.[52] On the November 19, 2012, the OIG published a report critical of the CDC Namibia Office's monitoring of the use of PEPFAR funds.[53]
Randall L. Tobias is an American governmental figure and former chief executive officer of Eli Lilly and Company. A Republican, he was appointed the first United States Director of Foreign Assistance, and served concurrently as the administrator of the U.S. Agency for International Development (USAID), with the rank of ambassador.
The Global AIDS Coordinator at the United States Department of State is the official responsible for overseeing U.S.-sponsored humanitarian aid programs to combat the AIDS epidemic around the world. The Global AIDS Coordinator holds the rank of Ambassador-at-Large and Assistant Secretary.
Abstinence-only sex education is a form of sex education that teaches not having sex outside of marriage. It often excludes other types of sexual and reproductive health education, such as birth control and safe sex. In contrast, comprehensive sex education covers the use of birth control and sexual abstinence.
The Office of National AIDS Policy, established under President Clinton in 1993, coordinates the continuing domestic efforts to implement the President's National HIV/AIDS Strategy. In addition, the office works to coordinate an increasingly integrated approach to the prevention, care and treatment of HIV/AIDS. As a unit of the Domestic Policy Council, the Office of National AIDS Policy coordinates with other White House offices. It is led by a director, who is appointed by the president.
The very high rate of human immunodeficiency virus infection experienced in Uganda during the 1980s and early 1990s created an urgent need for people to know their HIV status. The only option available to them was offered by the National Blood Transfusion Service, which carries out routine HIV tests on all the blood that is donated for transfusion purposes. The great need for testing and counseling resulted in a group of local non-governmental organizations such as The AIDS Support Organisation, Uganda Red Cross, Nsambya Home Care, the National Blood Bank, the Uganda Virus Research Institute together with the Ministry of Health establishing the AIDS Information Centre in 1990. This organization worked to provide HIV testing and counseling services with the knowledge and consent of the client involved.
The diplomatic relationship between the United States of America and Zambia can be characterized as warm and cooperative. Relations are based on their shared experiences as British colonies, both before, after and during the struggle for independence. Several U.S. administrations cooperated closely with Zambia's first president, Kenneth Kaunda, in hopes of facilitating solutions to the conflicts in Rhodesia (Zimbabwe), Angola, and Namibia. The United States works closely with the Zambian Government to defeat the HIV/AIDS pandemic that is ravaging Zambia, to promote economic growth and development, and to effect political reform needed to promote responsive and responsible government. The United States is also supporting the government's efforts to root out corruption. Zambia is a beneficiary of the African Growth and Opportunity Act (AGOA). The U.S. Government provides a variety of technical assistance and other support that is managed by the Department of State, U.S. Agency for International Development, Millennium Challenge Account (MCA) Threshold Program, Centers for Disease Control and Prevention, Department of Treasury, Department of Defense, and Peace Corps. The majority of U.S. assistance is provided through the President's Emergency Plan for AIDS Relief (PEPFAR), in support of the fight against HIV/AIDS.
HIV/AIDS in Lesotho constitutes a very serious threat to Basotho and to Lesotho's economic development. Since its initial detection in 1986, HIV/AIDS has spread at alarming rates in Lesotho. In 2000, King Letsie III declared HIV/AIDS a natural disaster. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS) in 2016, Lesotho's adult prevalence rate of 25% is the second highest in the world, following Eswatini.
HIV/AIDS in Eswatini was first reported in 1986 but has since reached epidemic proportions. As of 2016, Eswatini had the highest prevalence of HIV among adults aged 15 to 49 in the world (27.2%).
Mozambique is a country particularly hard-hit by the HIV/AIDS epidemic. According to 2008 UNAIDS estimates, this southeast African nation has the 8th highest HIV rate in the world. With 1,600,000 Mozambicans living with HIV, 990,000 of which are women and children, Mozambique's government realizes that much work must be done to eradicate this infectious disease. To reduce HIV/AIDS within the country, Mozambique has partnered with numerous global organizations to provide its citizens with augmented access to antiretroviral therapy and prevention techniques, such as condom use. A surge toward the treatment and prevention of HIV/AIDS in women and children has additionally aided in Mozambique's aim to fulfill its Millennium Development Goals (MDGs). Nevertheless, HIV/AIDS has made a drastic impact on Mozambique; individual risk behaviors are still greatly influenced by social norms, and much still needs to be done to address the epidemic and provide care and treatment to those in need.
HIV/AIDS in Nigeria was a concern in the 2000s, when an estimated seven million people had HIV/AIDS. In 2008, the HIV prevalence rate among adults aged between 15 and 49 was 3.9 percent, in 2018 the rate among adults aged between 15 and 65 was 1.5 percent. As elsewhere in Africa, women are statistically more likely to have HIV/AIDS. The Nigeria HIV/AIDS Indicator and Impact Survey was the world's largest and presented statistics which showed the overall numbers were lower than expected. Antiretroviral treatment is available, but people prefer to take the therapy secretly, since there is still noticeable discrimination against people with HIV/AIDS.
HIV and AIDS is a major public health issue in Zimbabwe. The country is reported to hold one of the largest recorded numbers of cases in Sub-Saharan Africa. According to reports, the virus has been present in the country since roughly 40 years ago. However, evidence suggests that the spread of the virus may have occurred earlier. In recent years, the government has agreed to take action and implement treatment target strategies in order to address the prevalence of cases in the epidemic. Notable progress has been made as increasingly more individuals are being made aware of their HIV/AIDS status, receiving treatment, and reporting high rates of viral suppression. As a result of this, country progress reports show that the epidemic is on the decline and is beginning to reach a plateau. International organizations and the national government have connected this impact to the result of increased condom usage in the population, a reduced number of sexual partners, as well as an increased knowledge and support system through successful implementation of treatment strategies by the government. Vulnerable populations disproportionately impacted by HIV/AIDS in Zimbabwe include women and children, sex workers, and the LGBTQ+ population.
UNAIDS has said that HIV/AIDS in Indonesia is one of Asia's fastest growing epidemics. In 2010, it is expected that 5 million Indonesians will have HIV/AIDS. In 2007, Indonesia was ranked 99th in the world by prevalence rate, but because of low understanding of the symptoms of the disease and high social stigma attached to it, only 5-10% of HIV/AIDS sufferers actually get diagnosed and treated. According to the a census conducted in 2019, it is counted that 640,443 people in the country are living with HIV. The adult prevalence for HIV/ AIDS in the country is 0.4%. Indonesia is the country in Southeast Asia to have the most number of recorded people living with HIV while Thailand has the highest adult prevalence.
Cases of HIV/AIDS in Peru are considered to have reached the level of a concentrated epidemic.
Eric Goosby is an American public health official, currently serving as Professor of Medicine and Director of the Center for Global Health Delivery, Diplomacy and Economics, Institute for Global Health Sciences at University of California, San Francisco. Dr. Goosby previously served as the UN Special Envoy on Tuberculosis as well as previously served as the United States Global AIDS Coordinator from 2009 until mid-November 2013. In the role, Goosby directed the U.S. strategy for addressing HIV around the world and led President Obama's implementation of the President's Emergency Plan for AIDS Relief (PEPFAR). Goosby was sworn in during June 2009 and resigned in November 2013, taking a position as a professor at UCSF, where he directs the Center for Global Health Delivery and Diplomacy, a collaboration between UCSF and the University of California, Berkeley.
ICAP at Columbia University's Mailman School of Public Health supports programs and research that address HIV/AIDS and related conditions and works to strengthen health systems. ICAP currently supports HIV/AIDS prevention, care and treatment programs in 19 African countries including: Angola, Cameroon, Côte d'Ivoire, Democratic Republic of Congo, Ethiopia, Kenya, Lesotho, Malawi, Mali, Mozambique, Namibia, Sierra Leone, South Africa, South Sudan, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe. It also works in Central Asia, Ukraine, Georgia, Myanmar, Brazil, Guatemala, China, Jordan, Lebanon, and Turkey. ICAP supports several hundred project sites, which provide HIV prevention, care and treatment to hundreds of thousands of individuals.
Global Health Initiatives (GHIs) are humanitarian initiatives that raise and disburse additional funds for infectious diseases – such as AIDS, tuberculosis, and malaria – for immunizations and for strengthening health systems in developing countries. GHIs classify a type of global initiative, which is defined as an organized effort integrating the involvement of organizations, individuals, and stakeholders around the world to address a global issue.
Treatment as prevention (TasP) is a concept in public health that promotes treatment as a way to prevent and reduce the likelihood of HIV illness, death and transmission from an infected individual to others. Expanding access to earlier HIV diagnosis and treatment as a means to address the global epidemic by preventing illness, death and transmission was first proposed in 2000 by Garnett et al. The term is often used to talk about treating people that are currently living with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) to prevent illness, death and transmission. Although some experts narrow this to only include preventing infections, treatment prevents illnesses such as tuberculosis and has been shown to prevent death. In relation to HIV, antiretroviral therapy (ART) is a three or more drug combination therapy that is used to decrease the viral load, or the measured amount of virus, in an infected individual. Such medications are used as a preventative for infected individuals to not only spread the HIV virus to their negative partners but also improve their current health to increase their lifespans. When taken correctly, ART is able to diminish the presence of the HIV virus in the bodily fluids of an infected person to a level of undetectability. Consistent adherence to an ARV regimen, monitoring, and testing are essential for continued confirmed viral suppression. Treatment as prevention rose to great prominence in 2011, as part of the HPTN 052 study, which shed light on the benefits of early treatment for HIV positive individuals.
The Catholic Medical Mission Board (CMMB) is an international, faith-based NGO, providing long-term, co-operative medical and development aid to communities affected by poverty and healthcare issues. It was established in 1912 and officially registered in 1928. CMMB is headquartered in New York City, USA, and currently has country offices in Haiti, Kenya, Peru, South Sudan, and Zambia.
American International Health Alliance (AIHA) is a nonprofit organisation aiming for assisting the global health. The organisation has managed more than 175 partnerships and project across the globe. In 2012, AIHA obtained the support of President's Emergency Plan for AIDS Relief [PEPFAR] project to strengthen the blood service in Central Asia, Ukraine, and Cambodia. Due to its structure based on the programmatic modal and dynamic condition, this organisation is suitable to assist the community or worldwide countries which have limited resources, and it is beneficial for sustainable evolution. AIHA is contributing to improve the worldwide health conditions. This organisation has been associated and largely contributed in the HIV-related area since 2000.
The United States is the largest donor of multilateral global health funds. According to the Office of Management and Budget, the U.S. government contributes <1% of the federal budget for foreign aid including global health activities. In 2023, the U.S. contributed 12.9 billion USD towards global health activities across several health verticals including HIV, Tuberculosis, Malaria and COVID-19.
↑ Leeper, Sarah; Reddi, Anand (2010). "United States global health policy: HIV/AIDS, maternal and child health, and The President's Emergency Plan for AIDS Relief (PEPFAR)". AIDS. 24 (14): 2145–2149. doi:10.1097/QAD.0b013e32833cbb41. PMID20606571.
↑ Reddi, Anand (November 1, 2010). "Aids: Time to Refocus". The New York Times. Retrieved June 11, 2024.
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