PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020)
PEPFAR’s transformative, lifesaving impact is unassailable, but our work is not finished to country and PEPFAR uses granular data and surveys to understand and rapidly confront these accomplish our mission. The HIV/AIDS pandemic continues to evolve in every community and changes. PEPFAR is defined by the constant change needed to address new risk groups, new health challenges, and persistent gaps.
In September 2017, the Trump Administration launched the PEPFAR Strategy For Accelerating HIV/AIDS Epidemic Control (2017-2020) to provide a road map for ensuring that every American taxpayer dollar with which we are entrusted is maximizing impact and constantly driving progress toward achieving HIV/AIDS epidemic control.
The Strategy guides accelerated implementation at scale in 13 high-burden countries with the greatest potential to achieve HIV/AIDS epidemic control by 2020. It also reaffirms PEPFAR’s continued support for HIV/AIDS efforts in more than 50 countries worldwide and commitment to ensure access to HIV services by all populations, including key populations and other vulnerable groups.
Secretary Michael R. Pompeo released the 2018 PEPFAR Strategy Progress Report at the 73rd Session of the United Nations General Assembly in September 2018, which details the significant achievements made in the first year of the Strategy’s implementation. With the U.S. government’s support, and through our collaboration with many partners, up to 13 countries are on pace to control their HIV/AIDS epidemic by 2020. Additional PEPFAR-supported countries could achieve epidemic control by 2020 if they accelerate their efforts, focus resources, and implement policies to ensure access to HIV prevention and treatment services for those most in need.
Using Data to Drive Policies and Impact
PEPFAR uses data to focus investments on evidence-based interventions in the geographic areas and populations with the greatest HIV/AIDS burden for maximum impact. Utilizing data for decision-making is critical to reach those in most need of HIV prevention and treatment services. Programmatic and surveillance data on HIV incidence, viral suppression, prevalence, across gender and all age groups are essential to evaluating progress toward the achievement of epidemic control. PEPFAR disaggregates all of its data by sex, age, and geography. This allows us to target and tailor our efforts to reach the specific and unique needs of those we serve.
PEPFAR shows the power of what is possible through compassionate, cost-effectiveness, accountable, and transparent American foreign assistance. At every level of the program, we use data to increase program effectiveness, efficiency, and performance with geographic and epidemiologic focus; mobilize increased resources and critical policies for impact among partner countries; support local partners for sustainable implementation; and validate outcomes, program costs and results. For the past decade, this rigor has allowed PEPFAR to significantly expand our results and impact with little or no budget increase.
Population-Based HIV Impact Assessments
PEPFAR remains a global leader in the use of granular data to drive health care results and increase impact, including through our pioneering use of large national household surveys – Population-Based HIV Impact Assessments (PHIAs) – to track progress and identify key gaps toward high-burden countries reaching epidemic control while triangulating survey findings with program data.
The PHIA results from twelve African countries show that eight of them are making significant progress toward controlling their HIV/AIDS epidemics, having either approached or exceeded the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets for 2020. These countries have translated resources from PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria into highly impactful programs that transcend poverty and weak health systems to reach clients with critical HIV prevention and treatment services. Four additional countries – Nigeria, Haiti, Kenya, and Rwanda – will release PHIA data on a rolling basis through 2019 and 2020.
The PHIA results also remind us that progress toward achieving HIV/AIDS epidemic control requires not only financial investment but also effective collaboration and mutual accountability between partner governments and communities. With this collaboration and accountability lacking, some countries are not making significant strides to ensure people are aware of their HIV status. Without a supportive partner country policy environment, U.S. government HIV investments cannot be as effective or efficient, thereby slowing or stalling progress.
PEPFAR is working with partner countries to urgently address these and other policy barriers in order to accelerate progress toward achieving HIV/AIDS epidemic control. All countries should rapidly adopt relevant World Health Organization policies and fully implement them at scale in order to address key impediments to health care access by the most vulnerable and poor, such as stigma and discrimination; formal and informal fees for health services; and sexual violence, including the alarming rates of violence faced by those ages 9-14 years.
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