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PEPFAR unveils new strategy but more funds needed

Barack Obama. Wikipedia
US President-elect Barack Obama
A shift from an emergency response to sustainable, country-driven HIV programming is at the heart of a new five-year strategy recently announced by the US President’s Emergency Plan for AIDS Relief (PEPFAR).

“We’re going to begin transitioning from an emergency response to a sustainable one through greater engagement with and capacity building of governments,” Ambassador Eric Goosby, US Global AIDS Coordinator, said as he unveiled the plan in Washington DC on 1 December.

“We need to do more, especially around supporting the creation of mid-level government capacity to oversee, manage and eventually finance these programmes.”

In 2003, former President George Bush launched PEPFAR, which has provided more than US$18 billion in HIV/AIDS funding - the largest international health initiative dedicated to a single disease.

In 2008, Congress approved the extension of PEPFAR for another five years and increased its funding to $48 billion.

Between 2010 and 2014, PEPFAR intends to support the prevention of more than 12 million new HIV infections, double the number of at-risk babies born HIV-free, provide direct support for more than four million people on treatment and provide all youth in PEPFAR prevention programmes with knowledge of HIV transmission and prevention.

In addition, the strategy details plans to provide care to more than 12 million people – including five million orphans and vulnerable children – and supports the training and retention of more than 140,000 new healthcare workers.

PEPFAR’s support for treatment has been widely praised, and researchers have estimated that 1.2 million deaths in Africa were averted between 2004 and 2007 as a direct result of interventions funded by PEPFAR.

Read more:
 How much bang for the PEPFAR buck?
 Obama expands health agenda, but not funding
 AIDS funding at "dangerous turning point"
 Changes afoot for US global AIDS policy
However, a new “report card” by a coalition of AIDS organizations gives US President Barack Obama a D+ for his performance during his first year and warns that unless US funding increases, putting more people on treatment will not be possible.

Critics have accused Obama of backtracking on promises to provide at least $50 billion by 2013 for the global fight against AIDS, to double the number of people on AIDS treatment and increase the number of health workers by at least one million.

“Can do better”

“Funding for PEPFAR has essentially been flat-lined, which means that there will not be enough money to fulfil the goals of the new strategy,” Paul Davis, director of global campaigns for Health Global Access Project, a group of US-based AIDS and human rights activists, told IRIN/PlusNews. “In many PEPFAR countries, enrolment in treatment programmes has already been halted, so how can they hope to increase treatment numbers?”

Davis noted that while PEPFAR under Bush was criticized for placing ideology above science in its emphasis on abstinence-only prevention programmes, Obama also failed to recognize that putting more people on treatment was the best way to prevent new HIV infections and AIDS-related deaths.

“The evidence we have now is that putting more people on treatment would go a long way in reducing the number of HIV infections occurring, so treatment is where more money should go,” he added. “Otherwise, there is little chance that universal access to treatment targets will be achieved.”

“President Obama could earn an ‘A’ if he seizes this opportunity and if he crafts a budget request for FY [financial year] 2011 that puts US investments in global AIDS back on track and includes prominent support for a bold HIV treatment target to be achieved by 2013,” the report card said.

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This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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