The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) was established by the United States government in 2003 in response to the global AIDS crisis. PEPFAR works with non-governmental organizations and governments to reduce HIV/AIDS infections and improve living conditions for those affected by the disease.

Saving Lives Through Prevention, Treatment, and Care

HIV/AIDS remains a major threat to many nations worldwide and is the leading cause of deaths in sub-Saharan Africa, the epicenter of the pandemic. Approximately 1.7 million people die of AIDS in sub-Saharan Africa each year. However, there is reason to hope. According to UNAIDS, the number of people dying of AIDS-related causes has declined in recent years, dropping from 2.2 million in 2005 to 2.1 million in 2007. This is the first time such a decline has occurred in the history of the pandemic. The decline is thought to be due largely to the expanded availability of antiretroviral treatment, although improved prevention and care programs are likely factors as well.

PEPFAR partners with countries affected by the pandemic to improve infrastructure, extend access to health care, and develop educational outreach. Most PEPFAR projects fall into three general categories: prevention, treatment, and care. As of September 2008, resources from PEPFAR helped achieve the following results in these three categories:

• Supported antiretroviral prophylaxis for nearly 1.2 million pregnant women found to be HIV-positive, allowing nearly 240,000 infants to be born HIV-free.
• Supported life-saving treatment for more than 2.1 million men, women, and children.
• Supported care for more than 10.1 million people affected by HIV/AIDS worldwide, including more than 4 million orphans and vulnerable children.

Local Support to Fight a Global Epidemic

In its second phase, PEPFAR has established Partnership Frameworks, 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. As PEPFAR moves from an emergency response to a sustainable one, PEPFAR will use these frameworks to build capacity, develop educational outreach programs, and improve access to healthcare for those affected by HIV/AIDS. By doing so, PEPFAR will create programs that can be sustained by country governments in the future.

Additionally, PEPFAR has and continues to support community-based organizations, NGOs, and faith-based programs worldwide. PEPFAR also actively engages with public-private partnerships. By doing so, PEPFAR expands its ability to provide care to individuals affected by the disease and their families. Below are some examples of programs sponsored by PEPFAR:

• In Cambodia, the Kien Kes Buddhist Temple, located approximately 19 miles from Battambang, Provincial Town, offers home-based care programs to 70 villages in the region. The programs are supported by 26 volunteers who assist health center and temple staff during home visits. The program also provides shelter and foster family placement assistance for orphans in the region. More than 900 orphans received assistance through the program in 2005 alone.
• In Guyana, a public-private partnership struck by the Institute of Private Enterprise Development, the Guyana Telephone and Telegraph Company, and the Guyana Lotto Company provides small loans to people living with HIV/AIDS, enabling them to expand their small businesses. The loans provide a critical financial boost to those who might not otherwise qualify, either due to their economic status or because of discrimination.
• In Russia, PEPFAR supports efforts to prevent mother-to-child transmission of HIV. One program, conducted by the St. Petersburg city government, included a pilot project of rapid testing for pregnant women in labor with unknown HIV status. During the pilot, 80 percent of women tested for HIV using rapid tests received their results before delivering, and 98 percent of HIV-exposed infants received antiretroviral prophylaxis to prevent infection. The results led to widespread implementation of rapid testing programs in labor and delivery departments across Russia.

A Reason to Hope

PEPFAR remains committed to supporting prevention, treatment, and careprograms in Africa and elsewhere. In 2009, the administration announced its Global Health Initiative, a $63 billion initiative that will will continue our country’s leadership on global health priorities like HIV, TB and malaria, and expand the focus on integrating current programs that address maternal and child health, expand again into family planning and neglected tropical diseases.