The Foreign Service Journal - May 2017
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MAY 2017




e can control and ultimately end the global HIV/AIDS

epidemic as a public health threat. Fifteen years

ago, this was unimaginable. At that time, reports from the

front lines, particularly in sub-Saharan Africa, were dire.

In many countries, an HIV diagnosis was a death sen-

tence. The prior gains in global health and development

were being lost. In the hardest-hit regions of sub-Saharan

Africa infant mortality had doubled, child mortality had

tripled and life expectancy had dropped by 20 years. The

rate of new HIV infections in the highest-burden regions

was exploding, and people were getting sick and dying

during the most productive years of their lives. The virus

was devastating families, communities and countries as

moms, dads, teachers, nurses and doctors all succumbed

to the new plague.

Today, the global HIV/AIDS landscape has been

dramatically transformed, thanks in large part to the

U.S. President’s Emergency Plan for AIDS Relief and its

partners. Using the best science, often provided by the

National Institutes of Health, and with strong bipartisan

support in Congress and across administrations, PEPFAR

has helped replace despair and death with hope, life and


PEPFAR was launched by President George W. Bush

in 2003 as an “act of mercy beyond all current interna-

tional efforts to help the people of Africa.” PEPFAR is

led and coordinated by the Department of State’s Office

of the Global AIDS Coordinator and Health Diplomacy,

and implemented on the ground through an interagency

model that draws on the critical contributions of the U.S.

Agency for International Development; the U.S. Depart-

ment of Health and Human Services and its agencies; the

Department of Defense; the Peace Corps; the Department

of Labor and the Department of the Treasury. Supported

by appropriations from the U.S. Congress, the program

has demonstrated the value of a whole-of-government

approach focused on achieving clearly defined and mea-

surable targets. It is also an expression of the compassion

and generosity of the American people.

In the countries that PEPFAR supports, our ambas-

sadors and deputy chiefs of mission have been essential

in moving policies forward that increase the program’s

effectiveness and mobilize host countries’ resources

year over year to expand services. PEPFAR also benefits

greatly from our close collaboration with partner govern-

ments and global partners, including multilateral institu-

tions, civil society, faith-based organizations, the private

sector, philanthropic organizations and people living with


The results have been breathtaking. As of Sept. 30,

2016, PEPFAR was supporting nearly 11.5 million people

with life-saving antiretroviral treatment—a 50-percent

increase since 2014 and up from the fewer than 50,000

people who were on treatment in sub-Saharan Africa

when PEPFAR and the Global Fund to Fight AIDS, Tuber-

culosis and Malaria began. With PEPFAR support, nearly

two million babies have been born HIV-free to pregnant

women living with the virus—almost twice as many as in

2013—and their mothers have been kept healthy and alive

to protect and nurture them. Recent public health impact

assessments in three African countries show that the HIV/

AIDS epidemic is becoming controlled there, and evidence

suggests that we are poised to control the epidemic in 10

African countries over the next four years.

Eunice (right) is HIV-positive but, thanks to PEPFAR-supported

programs that help prevent transmission of the disease from

mother to child, her baby was born HIV-negative.


PEPFAR: Making the Impossible Possible