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 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 representative for global health diplomacy at the U.S. Department of State. “Also because of PEPFAR, we have seen more than a 50% reduction in new HIV infections in women 15 to 24 years of age, and a 65% reduction in new infections among men in the same age range.”
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.”
As we celebrate #PEPFAR20 and its #20YearsOfImpact, @USAmbPEPFAR reflects on the tremendous progress achieved and the honor and privilege it is to serve as #PEPFAR Coordinator, especially as we advance toward ending HIV/AIDS as a public health threat by 2030. pic.twitter.com/3AytE6wmQ2— PEPFAR (@PEPFAR) January 28, 2023
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. “We will build on our decades of progress to reach the sustainable development goal of ending AIDS by 2030, work to eliminate the stigma and inequities that keep people from accessing care and keep the voices of people living with HIV/AIDS at the center of our response. I look forward to working with Congress on PEPFAR’s reauthorization this year.”
Writing in a Washington Post opinion piece over the weekend, 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 the COVID-19 pandemic, thus helping safeguard people’s health across the globe.
Urging continued support of the program, Gates added, “PEPFAR could do so much more. There are amazing innovations in the pipeline, such as CAB-LA [long-acting cabotegravir, available in the United States under the brand name Apretude], the first injectable long-acting prophylaxis, that could make it much easier for people to protect themselves from infection.
“Because HIV is no longer a death sentence,” Gates continued, “it can be easy to underestimate the dangers it poses. In the long term, we must find an HIV vaccine (potentially using mRNA technology) or even a cure for AIDS, which, based on advances in gene therapy, could be as little as 10 or 15 years away. Until then, 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”
In related news, last month PEPFAR outlined a five-year strategy outlining how the United States will help reach the United Nations sustainable development goal of ending the global AIDS pandemic as a public health threat by 2030. To read more about the strategy, titled “Fulfilling America’s Promise to End the HIV/AIDS Pandemic by 2030,” read the POZ article “Five Pillars of the Updated U.S. Global AIDS Program PEPFAR.”