January 28 marked a milestone in U.S. global HIV advocacy: The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) celebrated an “extraordinary 20 years of impact,” as Ambassador John N. Nkengasong, MD, said in a U.S. Department of State announcement.
President George W. Bush, a Republican, announced the launch of PEPFAR during his 2003 State of the Union address. Although effective HIV treatment became available in 1996, the lifesaving meds were not accessible in many countries across the globe, notably those in sub-Saharan Africa, where an HIV diagnosis remained a death sentence. PEPFAR aimed to change that.
“Through PEPFAR, we have saved 25 million lives, and 5.5 million babies have been born HIV-free. Over a million clients have received pre-exposure prophylaxis [PrEP] to prevent HIV infection,” wrote Nkengasong, who serves as the U.S. global AIDS coordinator and special represen-tative for global health diplomacy at the Department of State.
He added, “Where only 50,000 people in sub-Saharan Africa were on HIV treatment in 2003, today, PEPFAR supports lifesaving antiretroviral treatment for over 20 million adults and children in Africa and beyond. The public health infrastructure PEPFAR built with our partner countries has been leveraged to support responses for COVID-19, Ebola, and other emerging infectious diseases.”
Through PEPFAR, the United States has invested over $100 billion, including financial resources to the Global Fund to Fight AIDS, Tuberculosis and Malaria, according to the State Department.
Historically, PEPFAR has enjoyed bipartisan support. “My administration is committed to continuing to lead the global HIV/AIDS response,” President Joe Biden, a Democrat, said in a White House statement praising PEPFAR. “I look forward to working with Congress on PEPFAR’s reauthorization this year.”
Writing in a Washington Post opinion piece, Bill Gates, cochair of the Bill and Melinda Gates Foundation, noted that in recent years, many of the systems put in place to fight HIV were redirected to respond to COVID-19, thus helping safeguard people’s health across the globe.
Urging continued support of the program, Gates added, “We must continue to find and treat people living with the virus. This will not be possible without the continued leadership of the United States—which includes the reauthorization of PEPFAR this year.”