The Foreign Service Journal - May 2017
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MAY 2017


During the last three years, PEPFAR has completely

realigned and refocused the program in every country

with business process improvements that increased its

impact in a budget-neutral environment. These include

targeting investments using granular, site-level data; rig-

orous partner management to increase performance and

efficiency; and intensive quarterly monitoring of the entire

program. Our use of data to drive accountability, find

efficiencies and leverage partnerships has made PEPFAR

a cost-effective model for foreign assistance programs


Through the PEPFAR platform, the U.S. government

has accelerated the progress toward a world more secure

from infectious disease threats. PEPFAR’s investments

in countries with sizable HIV/AIDS burdens bolster their

ability to swiftly address Ebola, avian flu, cholera and

other outbreaks, which ultimately enhances global health

security and protects America’s borders. These lessons

and experiences will continue to inform and improve our

response, and those of our partners, to unforeseen health


Ending the global public health and security threat

posed by the HIV/AIDS epidemic is doable, although it

will not happen easily or automatically. One of the most

critical areas for action is reducing new HIV infections

among adolescent girls and young women. Every year,

390,000 adolescent girls and young women are infected

with HIV—more than 1,000 a day. In sub-Saharan Africa

the numbers are even more staggering: nearly 3 out of

4 adolescents newly infected with HIV are female, and

in some countries

young women are up

to 14 times more likely

to contract HIV than

young men. Address-

ing girls’ vulnerability

is especially urgent

because the population

of young women and

men in sub-Saharan Africa has doubled since the epi-

demic began, from 100 million to 200 million.

One of the reasons for girls’ vulnerability is the stag-

geringly high rate of sexual assault: from 25 to 45 percent

of young women experience sexual assault before the age

of 25. In our partner countries, PEPFAR is calling on com-

munities of faith—which are a healing presence in areas

affected by gender-based violence—to once again stand

with us, and support the campaign to protect girls and

women from sexual assault. This will put us on the path

to upholding the dignity and autonomy of all women and

girls and overcoming one of the most horrific obstacles to

finally ending the epidemic.

Each day we are motivated by the memory of the 35

million men, women and children who have died from

AIDS-related illnesses. We are driven to work harder and

smarter for the nearly 37 million people who are still liv-

ing with HIV. The promise of controlling and ultimately

ending the AIDS epidemic is now within reach. What once

seemed impossible is now possible, but it will continue to

take data-driven action and focus to get the job done.


Young women receive

PEPFAR support in



U.S. Global AIDS Coordinator and U.S. Special Representative

for Global Health Diplomacy Ambassador-at-Large Deborah

L. Birx oversees the implementation of the U.S. President’s

Emergency Plan for AIDS Relief, as well as all U.S. government

engagement with the Global Fund to Fight AIDS, Tuberculosis

and Malaria. An M.D., Ambassador Birx is a world-renowned

medical expert and leader in the field of HIV/AIDS, with a

three-decades-long career focusing on HIV/AIDS immunology,

vaccine research and global health.