Why PEPFAR’s Accelerated Strategy Needs Reevaluation
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