HIV/AIDS Fight Targets Health, Related Development Issues

Washington -- Twenty-five years into the global struggle against HIV/AIDS, international partners are calling for a redoubling of effort, coordination and funding to battle an infectious disease whose burden stretches beyond the health care system to affect development.
The United States is a world leader in the response to HIV/AIDS, and on September 26, as part of its 2007 commitment to the Global Fund to Fight AIDS, Tuberculosis and Malaria, the U.S. government transmitted more than $531 million to that organization.
The contribution, made through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), brings the total investment of the American people in the Global Fund to more than $2.5 billion since its launch in 2001.
“On the ground, where it matters most,” PEPFAR’s coordinator, Ambassador Mark Dybul, told USINFO, “there is strong coordination of PEPFAR and Global Fund programs to ensure that they complement each other.”
Through PEPFAR's partnerships with the Global Fund, and with private-sector, community and faith-based organizations, he added, “the people of many developing nations are now confronting this pandemic in an effective and coordinated manner."
On May 30, President Bush announced that he would work with Congress to reauthorize PEPFAR -- which expires at the end of fiscal year 2008 -- for another five years and $30 billion. This proposal would double the initial $15 billion commitment made in 2003. (See related article.)
But during a September 20 briefing on PEPFAR and the Global AIDS Response at the Woodrow Wilson International Center for Scholars in Washington, Dr. Peter Piot, executive director of the Joint United Nations Programme on HIV/AIDS, urged the United States to give even more to PEPFAR so other nations will do the same.
“We saw that when President Bush announced in his State of the Union in 2003 that this country will put $15 billion on the table in the fight against AIDS. This was followed by others -- the first one being the United Kingdom -- and then others. This has happened again and again. That is the power of American leadership.”
PREVENTION
It takes large numbers to tell the AIDS story. Around the world, 39.5 million people live with HIV/AIDS; there were 4.3 million new infections in 2006; 32 million people have died since the beginning of the pandemic; and every day, 8,500 people die of AIDS.
Today, thanks largely to PEPFAR, 1.1 million people are receiving treatment. But it is not enough.

A lab technician for a youth foundation checks blood samples at the International Conference on HIV/AIDS in Africa. (© AP Images)
“In 2006,” U.S. House of Representatives member Nita Lowey said during the PEPFAR briefing, “for every person who received treatment, another six people became infected. This statistic translates into an additional 60 million infections by 2015 if the world has not dramatically shifted its prevention paradigm.”
The first PEPFAR program changed the world forever by initiating treatment, she added. “Our next program must reflect a true commitment to prevention.”
PEPFAR supports prevention activities that focus on sexual transmission, mother-to-child transmission, transmission through unsafe blood and medical injections and greater HIV awareness through counseling and testing.
In 2006, some 22.6 percent of PEPFAR funds for the 15 focus countries, or $396 million, went to resources for prevention, treatment and care.
“In the next iteration of what the Global Fund does,” said Kent Hill, assistant administrator in the Bureau for Global Health at the U.S. Agency for International Development (USAID), “we are going to [need] an increase in the amount and quality of effort on prevention to make a difference there.”
BEYOND HEALTH CARE
Equally important to the struggle against HIV/AIDS is addressing what the authorizing language of the Leadership Act, which created PEPFAR, called “related activities.” Hill calls these “wraparound” issues, and they are linked intimately with the disease.
“Gender issues are related to human rights,” he said in prepared remarks. “Orphans’ issues are immediately connected to education and access to all sorts of other health interventions. Economic growth issues are involved because HIV undermines the work force, and HIV-positive individuals often cannot work or face discrimination. HIV-positive women ... need mosquito nets and access to reproductive health information and services.”
To deal with these wide-ranging issues, PEPFAR is “connecting the dots of international development” by increasingly linking its programs with other development initiatives that are having a real impact in countries and communities.
These include the President’s Malaria Initiative, to increase the impact on public health and reach more at-risk populations; the African Education Initiative, to improve educational opportunities for Africa’s children; U.S.-supported food aid programs, to bolster nutrition among those with AIDS; and the Millennium Challenge Corporation, to promote sustainable economic growth.
With a focus on sustainability, Hill said, PEPFAR support is allowing USAID’s energy office in the Bureau for Economic Growth, Agriculture and Trade to work with partners to provide technical assistance on integrating energy issues into overall planning.
Applications range from identifying electrification rates in country districts to investigating solar energy options.
“The people of severely affected nations have accomplished so much in their fight against HIV/AIDS,” Hill said, “and the American people are privileged to partner with them through PEPFAR.”
More information about PEPFAR is available on the program’s Web site.
(USINFO is produced by the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)