Why HIV Treatment Is Becoming A Reality For People Everywhere
Just last year, it was announced that, for the first time in history, 50 percent of those infected with HIV/AIDS were receiving treatment. This landmark achievement is a massive process with different factors worldwide, but it’s all an interconnected humanitarian struggle against this life-threatening disease. 
As the year moves closer to 2019, it’s important to evaluate the measures being taken to keep the epidemic at bay and to take a closer look at the future of HIV/AIDS treatment worldwide.

A Survey of The World

The Joint United Nations Programme on HIV/AIDS, known as UNAIDS, reported in 2017 that, of the 36.7 million people living with HIV/AIDS, 19.5 million are now receiving life-saving treatment in the form of anti-retroviral drugs (ARVs).

This trend has risen steadily since 2014 when UNAIDS announced that, if countries could meet the following goals for 2030, the global HIV/AIDS epidemic would be eliminated. Some of these goals are:

  • 90 percent of those with HIV are aware they carry the virus
  • 90 percent of the previous group begins using ARVs for treatment
  • 90 percent of those receiving treatment continue their treatment and reduce the levels of the virus in their system to levels below standard testing baselines.

These goals may seem as though it sets the bar high. However, after calculating the data from 168 countries in 2017, the world was already at 75-79-81. Several countries are doing exceedingly well: Iceland, Singapore, Sweden, Botswana, Cambodia, Denmark and the United Kingdom.

These nations have managed to keep the virus in 73 percent of the carrying population suppressed. This means that, after receiving HIV/AIDS treatment, 73 percent of individuals have such low levels of the virus in their blood that the disease is no longer transferable by them to another person.

An Uncertain Future

Though the world has made tremendous progress in recent years in controlling the number of HIV patients, much of this progress has to do with aid provided by the U.S. In 2018, the Trump Administration has been proposing cuts to the U.S. Emergency Plan for AIDS Relief (PEPFAR) program. As one of America’s major global health initiatives, PEPFAR is responsible for HIV/AIDS treatment to millions of patients around the world.

President Trump’s budget proposal would strip PEPFAR’s funding from $6 billion to $5 billionThis is significant, as this program benefits those living along east and southern Africa. This area contains the highest concentration of those living with HIV/AIDS worldwide. The $1 billion cut would result in 1.8 million deaths over the next ten years in South Africa and The Ivory Coast alone. Those currently receiving ARV treatment will not lose their access to the life-saving medications they need because of the budget cuts.

Though the outcome for the future is uncertain, currently the world has been succeeding in the fight against HIV/AIDS, and HIV/AIDS treatment is becoming a reality worldwide. If countries worldwide can stay on track in meeting UNAIDS guidelines, then the global community may see this notorious virus eliminated by 2030.

Jason Crosby
Photo: Flickr

The President’s Emergency Plan for AIDS Relief (PEPFAR) was created in 2003 as a cornerstone of the global HIV/AIDS response. In the 14 years since its inception, PEPFAR has helped 13 million people receive counseling and antiretroviral therapy.

PEPFAR has gone through multiple iterations and been managed by three U.S. presidents. The program is currently managed by the Trump administration, which, on December 1, launched the PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control.

PEPFAR’s accelerated strategy includes putting a focus on 13 countries with an exceptional HIV/AIDS burden. The countries, Kenya, Zambia, Côte d’Ivoire, the United Republic of Tanzania, Uganda, Zimbabwe, Malawi, Lesotho, Botswana, Namibia, Swaziland, Haiti and Rwanda, will be receiving widespread and much-needed antiretroviral therapy coverage. The strategy also includes a strong focus on young girls and women with HIV and AIDS.

The ultimate goal of PEPFAR’s accelerated strategy is to gain control of the epidemic in these 13 countries by the year 2020. Though the prospective outcome is bright, this change could bring about more issues than anticipated.

In May, President Trump announced his plan to restructure the federal budget. Approximately 19 percent of the HIV/AIDS global care and prevention budget is proposed to be cut in 2018. Prior to PEPFAR’s accelerated strategy, the program was providing assistance to 50 countries around the world. The plan is to continue providing assistance to those countries while also providing extra provisions to the 13 focus countries.

While it is important, of course, to increase assistance where the burden is heavier, it is also important that other vulnerable communities aren’t left behind. With a lowered budget and the focus of PEPFAR being shifted, worldwide HIV/AIDS prevention and recovery programs are at risk.

Important programs like safe needle exchange, counseling for sex workers and homosexual men and care for children living with HIV and AIDS could potentially lose funding. Without these and other programs, there’s a high chance that infection rates will increase rather than decrease.

The general notion of the focus shift is a positive one. By gaining epidemic control in the focus countries, PEPFAR would be creating a roadmap for further epidemic control and prevention in other countries.

However, in order to gain epidemic control, infection rates need to be lower. Before making an attempt at an AIDS-free generation, PEPFAR needs to focus on providing prevention as well as treatment to all affected communities.

– Anna Sheps

Photo: Flickr

Trump's HIV Foreign Aid CutsIn May 2017, President Donald Trump unveiled his “skinny budget” plan that would be implemented in the upcoming fiscal year. President Trump’s plan is particularly worrisome for foreign countries that are plagued by HIV, as the plan cuts $1 billion from the President’s Emergency Plan for AIDS Relief (PEPAR) program.

It has been estimated that President Trump’s HIV foreign aid cuts would result in nine million life years lost in South Africa and Ivory Coast, which are two countries that have a predominant problem with the spread of HIV. Specifically, according to humanitarian writer Sebastien Malo, “South Africa has the highest prevalence of HIV worldwide, with 19 percent of its adult population carrying the virus in 2015.”

The U.S. Department of State reported that HIV-infected patients who currently receive antiretroviral therapy funded by U.S. foreign aid would not stop getting treatments. On the other hand, however, it is estimated that 1.8 million people would die from HIV in South Africa and Ivory Coast within 10 years due to President Trump’s HIV foreign aid cuts.

According to the Kaiser Family Foundation, if the Trump administration continues to cut funding for HIV-related programs and research, HIV could transform into a pandemic and affect the world. Jacqueline Alemany, White House reporter, indicated that the foreign aid cuts are due to the Trump administration’s partiality toward defense and military spending.

Thus, a small reduction of $1 billion from the current $6 billion PEPFAR program would potentially cause catastrophic effects around the world. Furthermore, adding to South Africa’s estimated seven million HIV-infected people, Ivory Coast is home to approximately 460,000 HIV-infected people. All in all, as Malo questions, “would the relatively small savings realized by currently proposed budget reductions be worth these large humanitarian costs?”

Now, the U.S. government is left to determine whether or not the budget cuts are worth the potential humanitarian crisis caused by an enormous loss of life and the spread of HIV.

Emily Santora

Photo: Flickr


A U.S. global initiative has made significant strides in helping with the HIV/AIDS epidemic in South Africa. The President’s Emergency Plan for AIDS Relief, or PEPFAR, has provided substantial support programs to the African nation including clinical services, HIV counseling and testing and various programs emphasizing treatment to adolescent girls and young women.

The PEPFAR initiative came into effect during the Bush administration, providing the president with declarative powers to help fight HIV/AIDS and other diseases. The program was renewed and expanded in 2008, and its funding was tripled.

In an article published by the Christian Science Monitor, Sharonann Lynch, the HIV and TB policy advisor for Doctors Without Borders, notes PEPFAR as one of the most significant AIDS relief programs in the region.

“It’s not every day in global health where a program gets to essentially say they’ve turned the tide on an epidemic, and that’s what PEPFAR has done,” Lynch said.

Lynch believes that PEPFAR is integral in bringing awareness to the disease and to the possibility of its future eradication across the globe.

“When PEPFAR was announced, you didn’t have anyone talking about ending AIDS – and now that’s exactly what the US and other governments have committed to. They can see it in sight,” Lynch said.

According to a report published on the PEPFAR website, seven million people of all ages were living with HIV in 2015. Approximately 180,000 deaths were attributed to AIDS the same year.

In 2016, the plan and various other partners and organizations contributed HIV testing and counseling to more than 10.4 million people. These programs have also been integral to providing life-saving antiretroviral treatment to more than 3.4 million people.

PEPFAR focuses heavily on women and children affected by HIV/AIDS. The organization provided antiretroviral treatment to 220,626 expectant mothers to reduce the risk of mother-to-child HIV transmission in 2016. The plan has also provided care and support for 407,056 orphans and vulnerable children affected by HIV/AIDS by providing funding to the health and social welfare systems of South Africa.

According to a report published by the CDC, approximately 52 percent of deaths in South Africa were caused by HIV/AIDS in 2006. With the help of programs such as PEPFAR, the number of fatalities has dropped significantly, from roughly one-half to one-third, in South Africa.

Drew Hazzard

Photo: Flickr


Foreign aid has been a part of American culture ever since the end of World War II. Under this modern international order, the U.S. has been able to successfully flourish and spread its message of democracy. Former Secretary of State John Kerry said, “The money we devote to international programs … amounts to just one percent of the total federal budget.”

The main piece of legislation that authorizes the use of foreign aid is the Foreign Assistance Act (FAA) of 1960. While this act provides an outline and structure for dealing with foreign aid, Congress decides on most budget decisions and distribution of funds through various bills. This year’s proposals for specific financing have already been laid out in the FAA.

In order to properly finance obligations made in the 1960 legislation pursuant to section 476, more than $1 billion is to remain available until the fall of 2018. This specific bill makes $1.7 billion accessible for assistance to foreign countries. Although this seems like a lot of money, this is an $877 million cut in aid compared to the 2016 foreign aid budget. However, aid to Eurasia will remain the same at $930 million in order to combat Russian aggression in countries like Ukraine.

Congress sets the standard and fosters the responsibility of stabilizing funds responsibly. By enforcing specific conditions on the distribution of foreign aid, international goals can be successful. This affords leverage in critical situations of destabilization, like negotiating democracy with countries that erupt into a military coup.

Destabilization of a nation can reduce access to basic health services. Through the effort of international funding, governments can “control pandemics before they reach our shores.” The current budget that the U.S. Congress has agreed on includes $8 billion toward funding worldwide healthcare initiatives. A portion of this money was used to successfully implement the President’s Emergency Plan for Aids Relief (PEPFAR), ultimately ending child and maternal deaths that previously had been unavoidable.

In addition, supporting the international community allows for the stabilization of nations and prevents the spread of terrorist activity. In the current 2017 budget, $71.1 billion is to be distributed in order to combat terrorist networks like the Islamic State of Iraq and the Levant (ISIL) and Al Qaeda.

Through international efforts, nations have been assisted from destabilization and diseases have been contained. The budget plan for foreign assistance this year will be distributed appropriately once budget decisions are finalized and approved.

Nick Katsos

Photo: Flickr

PEPFAR Progresses Toward AIDS-Free Generation
December 1 marked World AIDS Day, which this year brought hopeful news about the 35-year-old epidemic. The President’s Emergency Plan for AIDS Relief (PEPFAR) shared new data demonstrating significant progress in HIV reduction in Zimbabwe, Zambia and Malawi. The announcement revitalized PEPFAR’s resolve to yield an AIDS-free generation by 2030.

In the press release, three countries represented the progress-at-large toward AIDS eradication due to the astonishing prevalence of the disease there. Respectively, Zimbabwe globally ranks fifth in most HIV cases among adults, followed by Zambia at seventh and Malawi at ninth.

Even so, reductions of the disease in these nations is appreciable. The incidence of HIV in adults since 2003 have decreased by 76 percent in Malawi, 51 percent in Zambia, and 67 percent in Zimbabwe. Across the three countries, the community viral load suppression among HIV-positive adults averages 65 percent, indicating HIV transmission is nearly under control. These shocking results are inspiring broader action and reinvigorating the AIDS-free dream.

Surpassing President Obama’s 2015 targets of global AIDS reduction, PEPFAR now provides about 11.5 million people with antiretroviral treatments, has performed 11.7 million voluntary medical male circumcisions, and has facilitated 2 million HIV-free births.

The momentum is gaining. Along with their World AIDS Day press release, PEPFAR announced their $4 million, two-year partnership with the Elizabeth Taylor AIDS Foundation (ETAF). The project will enhance HIV service delivery to men in the Mulanje District of Malawi through mobile clinics and door-to-door household level testing. According to the project’s success, it will serve as a community-based-treatment model for other areas that are difficult to service, improving health care opportunities for hard-to-reach places around the world.

While there is still a long road ahead, PEPFAR’s announcements last week served as reminders that an AIDS-free world is not only possible but well within sight. Now is the time to redouble global efforts to prevent and treat HIV so that a new generation can live completely AIDS-free.

Robin Lee

Photo: Flickr