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to this success, according to global health experts, was PEPFAR’s creation of health infrastructure throughout sub-Saharan Africa from the ground up, including establishing over 3,000 testing labs, training 340,000 health care workers and developing a sprawling system for monitoring the epidemic — all of which proved instrumental in helping the region weather Covid-19. In 2021, 38.4 million people were living with HIV worldwide, according to estimates from the Joint United Nations Programme on HIV/AIDS (UNAIDS). Of them, 28.7 million were on treatment, up from 7.8 million in 2010. Thanks in large part to the fact that successfully treating HIV eliminates sexual transmission of the virus, the estimated annual transmission rate has dropped 52%, to 1.5 million, since 2010, while the annual death rate has declined 68% since peaking in 2004, to 650,000. A health care worker in the store closet of the Rutsanana Primary Care Clinic in Harare, Zimbabwe, which provides care and treatment for people with HIV.Benjamin Ryan A December report from the nonpartisan health policy organization KFF further found that PEPFAR’s work was associated with a 2.1-point average increase in GDP per capita growth rate in 90 nations that received support from the program between 2004 and 2018. Today, the overall global HIV epidemic is at
is now a professor at the Georgetown University Medical Center. The president, Dybul said, insisted that the goal was to create a sustainable long-term program that would not sink or swim based on one man’s reputation or legacy. “This is about the American people,” Dybul recalled Bush saying. Recommended NBC OUT & PROUD TikTok executive comes out as nonbinary OUT POLITICS AND POLICY DeSantis tries to revoke Orlando Philharmonic’s liquor license over drag show After the faith community and activists pushed from the outside, and after a bipartisan pack of congressional leaders hustled from within, Congress appropriated the funds Bush requested in May 2003. One of those congressional leaders, Rep. Barbara Lee, D-Calif., said this is “how democracy should work.” Keys to success Had PEPFAR and the Global Fund never stepped up to address the global HIV crisis in poorer nations, “It would have been a moral crisis of unimaginable proportions,” said Ambassador John Nkengasong, who was confirmed by the Senate as PEPFAR’s director in May. Key
a precarious crossroads, according to UNAIDS, with the war in Ukraine and the Covid-19 pandemic having destabilized efforts to provide prevention, testing and treatment services. New infections have risen in three regions: Eastern Europe and Central Asia, Latin America, and North Africa and the Middle East. But in the 13 sub-Saharan African nations where PEPFAR has prioritized its resources, HIV epidemic metrics continue to dramatically improve. PEPFAR has accomplished such success despite being essentially flat-funded since the beginning of the Obama administration, at about $5.4 billion annually. (The U.S. has also provided at least $1 billion annually to the Global Fund.) First lady Laura Bush and President George W. Bush at a PEPFAR site in Ethiopia in 2011.PEPFAR Many, including Fauci, credit Birx with leveraging the power of granular epidemiological analyses of national epidemics in Africa to identify ways that a program already geared to demand tangible results — more people on treatment, fewer infections and deaths — could direct policies, programs and resources even more efficiently and effectively. “She’s a data junkie,” Fauci said of Birx, who trained as an immunologist under him in the mid-1980s. However, a February 2020 State Department Office of Inspector General audit of PEPFAR offered scathing criticism of Birx’s leadership style, calling it “dictatorial,” “directive” and “autocratic.” Fauci argued such characterizations were sexist. “She’s a strong woman,” Fauci said of his protégée. “Some people get put aback by that. I don’t. If it were a guy doing that, I think they would say, ‘Wow, what a great job you’re doing.’” “Was I relentless?” Birx said. “Yes, and I will never apologize for that, because that’s what it takes to battle pandemics.” Challenges ahead Global health experts caution that PEPFAR faces challenging times as it strives to benefit populations that are traditionally harder to reach. Crucially, only 52% of children with HIV in sub-Saharan Africa are on antiretrovirals, compared with 76% of adults, according to UNAIDS. Plus, recent analyses have found that half
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