PEPFAR Reaches 14 Million People With HIV Globally

When the US President’s Emergency Plan for AIDS Relief (PEPFAR) was created 15 years ago, HIV was considered a death sentence to the majority of people who had it, and just 50,000 people in Africa were receiving HIV treatment. As this month marks the fifteenth anniversary, PEPFAR now supports over 14 million people on HIV treatment globally, according to a press release from the initiative.

Since the launch of PEPFAR by President George W. Bush in 2003, significant progress has been made in combatting the epidemic. Most people living with HIV are able to live as long as those without the disease, the growing usage of pre-exposure prophylaxis has aided in preventing new HIV infections, and expanded treatment options help those with the disease achieve viral suppression. Between 2002 and 2015, CD4 cells counts at the start of combination antiretroviral therapy (cART) increased, and the proportion of individuals with severe immunodeficiency at the start of cART decreased among all income groups.

“Over the past 15 years, PEPFAR has transformed the impossible into the possible by rapidly accelerating access to lifesaving HIV prevention and treatment services,” said Ambassador Deborah L. Birx, MD, US Global AIDS coordinator and special representative for Global Health Diplomacy, in a statement. “We have not only saved more than 14 million mothers, fathers, daughters, and sons, but also accelerated global progress toward ending AIDS as a public health threat.”

According to the press release, PEPFAR has enabled more than 2.2 million babies to be born HIV-free to HIV-positive mothers and helps more than 6.4 million orphans, children, and their caregivers affected by the disease. PEPFAR has also supported more than 15.2 million men and boys in voluntary male circumcision to protect them from contracting HIV.

Latest data from PEPFAR show a 25% to 40% decline in new HIV diagnoses among adolescent and young adult women in nearly two-thirds of communities implementing PEPFAR’s Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe partnership through 10 African countries.

Recent strides made can be attributed to the government’s PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020) released last year. The strategy set a goal of achieving control of the epidemic in 10 high-burdened countries by the end of 2020 through pursuit of the Joint United Nations Program on HIV and AIDS 90-90-90 framework—90% of people living with HIV know their status, 90% of those who know their status are accessing treatment, and 90% of those on treatment have suppressed viral loads.

The newest data show that 5 high-burdened African countries are approaching control of their epidemics. To achieve epidemic control, PEPFAR underscores the importance of:

• Acceleration of optimized HIV testing and treatment strategies particularly to reach men under age 25
• Expansion of HIV prevention, particularly for young women under age 35 and men under age 30
• Continuous use of granular epidemiologic and cost data to improve partner performance and increase program impact and effectiveness
• Renewed engagement with faith-based organizations and the private sector
• Strengthened policy and financial contributions by partner governments in the HIV/AIDS response