"The United States Congress and the American people have been generous in this effort, and Americans can know that their generosity is making a significant difference."
--President George W. Bush World AIDS Day December 1, 2005
The number of people living with HIV has never been higher-over 40 million worldwide, including approximately 5 million new infections in 2005, according to UNAIDS. Many nations face rapidly growing epidemics even as HIV/AIDS reduces average life spans.
President Bush promised to lead the fight against global HIV/AIDS in 2003 with the launch of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR/Emergency Plan) - $15 billion to fight HIV/AIDS in more than 120 countries around the world. Bilateral programs include a special emphasis on 15 focus countries in Africa, the Caribbean, and Asia that together account for approximately one-half of the world's 40 million HIV infections.
In fiscal year 2005, the Emergency Plan provided approximately $2.8 billion to the fight, and for fiscal year 2006 the U.S. commitment has grown to over $3.2 billion. President Bush has requested over $4 billion for fiscal year 2007.
This financial commitment is accompanied by ambitious goals. These include supporting the prevention of 7 million new infections, supporting treatment for 2 million HIV-infected people, and supporting care for 10 million peoples infected and affected by HIV/AIDS, including orphans and vulnerable children, in an accountable and sustainable way.To reach these goals, the Emergency Plan is implementing the most complex and diverse prevention, treatment and care strategy in the world.
PEPFAR is working in partnership with host nations to bring high quality programs to scale today, while supporting the development of sustainable local capacity for these programs to continue in the future. In fiscal year 2005, the Emergency Plan supported training or retraining for more than 536,000 service providers (with individuals being trained in multiple areas in certain cases) and supported 14,960 project sites in the focus countries.
Over 80 percent of all implementing partners in fiscal year 2005 were indigenous organizations. Emergency Plan partners include community- and faith-based organizations, as well as U.S.-based universities and others in twinning relationships with local organizations. The New Partners Initiative, launched by President Bush on World AIDS Day 2005, will continue to expand and to diversify PEPFAR's partner base by enlisting new organizations.
From the beginning of the Emergency Plan, the United States did not promise good intentions, but results—and accountability for achieving them. Two years after implementation, there is no doubt that the action of the Emergency Plan has produced results. These results may be measured in numbers, but what these numbers represent are children, women, and men who are alive today because of America's action in partnership with host nations.
The U.S. supports the most diverse portfolio of HIV/AIDS prevention activities of any international partner: the targeted ABC approach (Abstain, Be faithful, correct and consistent use of Condoms where appropriate) to prevent sexual transmission, and the expansion of programs that focus on mother-to- child transmission, blood safety and safe medical injections, intravenous drug use, HIV-discordant couples, women, men, and alcohol abuse, among other key issues.
Growing evidence of all three of the ABC behaviors, and of corresponding reductions in HIV prevalence in certain countries, highlight the importance of support for ABC programs to prevent sexual transmission of HIV. Combined funding for abstinence and fidelity programs was $75.6 million in 2005 and $63.3 million in 2004.
Funding for intervention programs that support the provision of condoms and related activities rose to $65.7 million in 2005, a $20.5 million increase from the $45.2 million spent in 2004. This targeted approach results in a comprehensive and effective prevention strategy that helps individuals personalize risk and develop tools to avoid risky behaviors under their control.
Before the Emergency Plan for AIDS Relief, only 50,000 people of the more than 4 million people in sub-Saharan Africa needing immediate AIDS treatment were getting medicine—think about that, only 50,000 people. After two years of sustained effort, approximately 400,000 sub-Saharan Africans are receiving the treatment they need.
--President George W. Bush World AIDS Day December 1, 2005
In achieving this success, the Emergency Plan has moved faster than any other bilateral or multilateral initiative to support the expansion of HIV/AIDS services, using a network model of care to bring life-extending treatment to areas that are among the world's most difficult to serve.
All HIV-infected children, women, and men deserve quality treatment. The Emergency Plan coordinates with host nation contributions and other partners under national strategies to provide the full spectrum of treatment services. Quality treatment includes: trained clinical and laboratory personnel and counselors for adherence, prevention and healthy living; physical infrastructure, including laboratory equipment as well as systems for distribution, logistics and management for drugs and other commodities; treatment for opportunistic infections and other basic care; and much more.
"We appreciate the work of people who are affiliated with churches or mosques and other faith groups. When our government can work together with faith-based organizations, we will."
--First Lady Laura Bush, July 13, 2005
Emergency Plan support is not limited to activities to keep people from being infected with HIV and to keep people who become infected alive. PEPFAR also supports societies in developing comprehensive responses that address the full range of HIV/AIDS related challenges in order to enable nations to move from despair to hope. Care for orphans and vulnerable children strengthens the capacity of families and communities to care for children in their midst. The Emergency Plan also supports programs to care for people living with HIV/AIDS and to provide HIV counseling and testing in a growing number of countries.
Responding to the Need of Children
With governmental and nongovernmental host country and international partners, the United States is scaling up a family-based approach to prevention, treatment and care, especially for children infected with and affected by HIV/AIDS.
Children have distinctive needs that must be addressed in a comprehensive, multisectoral way, with programs of high quality that can be sustained by families and communities for the long term. While there is much left to do, the Emergency Plan has brought an intensive focus to children and HIV/AIDS by supporting pediatric HIV prevention, diagnosis, and treatment, as well as care for orphans and vulnerable children (OVC). Highlighting PEPFAR's commitment to pediatric treatment, approximately 7 percent of those receiving treatment at U.S.-supported sites in the focus countries in fiscal year 2005 were children - a number that is expected to rise as pediatric programs are scaled up in the coming years.
Addressing the Needs of Women and Girls
The Emergency Plan is working to ensure that the activities it supports provide equitable access to services for both women and men and meet the unique needs of women and girls, including orphans and victims of sex trafficking, rape, abuse, and exploitation.