Developing countries appreciate PEPFAR assistance

The American people, through PEPFAR, have been providing generous support in HIV/AIDS impact mitigation to 15 of the world´s most seriously affected countries by way of financial, logistical, medical and health information services to support them in meeting the challenge of the HIV/AIDS pandemic. These PEPFAR partnerships are generally viewed as a strong U.S. leadership display particularly from President George W. Bush in making a positive global impact in transforming the face of the world to make it free of AIDS. Earlier the United States was also the largest contributor to the Global Fund to Fight AIDS, Tuberculosis and Malaria. In the starting year, 2003, as part of PEPFAR, the U.S. Government had pledged an additional $1 billion to the Global Fund over a five-year period. To date, the U.S. has contributed more than $2.5 billion which has substantially helped other countries meet their challenges at the local community level.

Particularly in many of the US and developing countries´ media, President George W. Bush´s leadership effort is considered a role model for world leaders as much as one of the success stories for the US State Department led by Secretary of State Condoleezza Rice. With recently increased spending levels approved by the U.S. House on February 28 for the President´s Emergency Program for AIDS Relief (PEPFAR) the U.S. Government has now received special encouragement to triple its fight against the world´s most infectious disease. Earlier the U.S. Government had committed $18.8 billion to the fight against global HIV/AIDS, exceeding the original figure by $ 3 billion. But after President George W. Bush´s request while visiting several African countries recently where he saw first hand the devastating effect of AIDS and regional appreciation among African leaders of America´s efforts, he requested that the amount be remarkably increased to meet the global challenges head-on. Congress decided to reauthorize PEPFAR with a stronger intervention and support mandate by tripling the amount. The new figure amounting to nearly US$ 50 billion enables stronger American effort to make a visible impact in the developing countries fight against AIDS.

PEPFAR already seems to be making a visible impact in its well placed global assistance to the developing world. PEPFAR funding dispersion between 2004 – 2008 demonstrates that the funding was done in a manner to effect both short and long term change. About 58 percent of PEPFAR funds supported bilateral programs in the 15 focus countries; 16 percent of PEPFAR funds supported the Global Fund; 11 percent of PEPFAR funds supported other bilateral programs; and, 15 percent of PEPFAR funds supported other important activities, including National Institute of Health research and tuberculosis and HIV programs. As President Bush remarked on World AIDS Day 2007, "The money that you have spent is being spent wisely and saving lives. Some call this a remarkable success. I call it a good start."

PEPFAR has also been consistently improving on its planning and reporting processes which use dedicated operational plans, scientific target-setting, efficient data entry, and results based reporting to translate lessons learned into practical and verifiable action. The focus always has been on maximizing resource impact. For instance, according to PEPFAR, globally it has supported life-saving antiretroviral treatment for approximately 1,445,500 men, women and children through September 30, 2007. Also, after the first 36 months of PEPFAR involvement in the 15 most affected countries and other global AIDS affected regions, more than 95 percent of funding was obligated and approximately 60 percent to meet actual emergency response, which must be considered a remarkable testament to the dedication of U.S. Government personnel to save as many lives as possible, as rapidly as possible.

PEPFAR reported as of September 30, based on its power of partnerships that it had conducted over 33 million HIV counseling and testing sessions since the inception of the Emergency Plan. It also supported training or retraining of 112,800 individuals to provide counseling and testing. PEPFAR´s priorities for HIV counseling and testing include performing it in clinical settings with the availability of antiretroviral and opportunistic infection treatment, where there is an urgent need to ensure that people who are ill with HIV-related symptoms are tested for HIV; ensure access to counseling and testing for the general population; couple counseling; promotion of all forms of HIV counseling and testing; linking counseling and testing to other HIV services; and, expansion of rapid test kit technology.

As the largest international health initiative ever initiated by any nation on earth to address a single disease, PEPFAR hopes to provide antiretroviral treatment (ART) to 2 million HIV-infected people in resource-limited settings, to prevent 7 million new infections, and to support care for 10 million people (the "2-7-10 goals"). The U.S. Leadership against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (or the Global AIDS Act) has established the State Department Office of the Global AIDS Coordinator to oversee all international AIDS funding and programming. Ambassador Mark R. Dybul since his appointment in July 2006 has very active as the U.S. Global AIDS Coordinator and frequently visits many of the developing countries where the AIDS cases are present. According to Dybul, the program estimated in 2007 that it had supported the provision of ART to approximately 1,101,000 people, which is a tremendous achievement for the U.S. government.

Another important aspect of the US national commitment is in helping more than one million Americans living with HIV/AIDS in various states. In dramatically expanding HIV counseling and testing services, PEPFAR supports counseling and testing based on international standards where full consent is obtained before testing. Usually, client-initiated or self-referred counseling and testing is requested by an individual, while in a medical setting, provider-initiated counseling and testing occurs where health care workers recommend an HIV test and the patient chooses to accept. PEPFAR also continues to support HIV tests becoming a routine part of care so that all Americans know their status. The HHS Centers for Disease Control and Prevention (CDC) have already released guidelines to physicians recommending routine voluntary HIV testing as a part of regular medical care for all people between the ages of 13-64, and annual screening for those at high risk. HHS continues to do extensive outreach to help states put these guidelines into practice.

The administration is working to compassionately address the needs of people living with HIV/AIDS and to prevent new HIV infections within the United States. Each year, about half of new transmissions are spread by individuals unaware they are infecting others. The number of AIDS cases is especially high in the African-American, Hispanic, and gay communities, as well as among injecting drug users and prisoners. Few Americans know that since 2001, the US Administration has devoted more than $89 billion to treatment and care for people living with HIV/AIDS in the United States, increasing annual treatment funding by 47 percent. In addition, the Administration has devoted approximately $18 billion to HIV/AIDS research to help develop new methods of treatment and prevention, increasing research funding by 20 percent during this same time period. According to a recent White House press bulletin, the US administration is also successfully implementing the Ryan White Care Act helping ensure that AIDS patients can receive treatment, including lifesaving drugs. system.

Every leader in the world, particularly if their country is devastated by AIDS, knows that this disease is atypical of other health issues since it is mostly transmitted through sex. It's not just one of many infectious diseases and belongs in the league of climate change, nuclear threats and so on. AIDS is now the precursor to an existing disaster in many developing countries of the world, which if unchecked, will challenge global human development and economic growth. For America, the fight against HIV/AIDS is therefore a universal fight.

UNAIDS projects that of 33.2 million people living with HIV where by there are 6,800 new infections and over 5,700 people die of AIDS every day, there is growing awareness of the infection particularly among the developing countries, where prevention messages have to be developed more effectively. Incidentally 2008 marks a new two-year UNAIDS rollout theme "Stop AIDS: Keep the Promise" whichis head Dr. Peter Piot strongly believes all leaders of the world need to commit their time to . President Bush has already been fulfilling his part by keeping the global leadership promise alive in helping those communities infected by HIV/AIDS in pursuing a future that is based on hope and courage in defeating future AIDS infections.