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President's Emergency Plan for AIDS Relief

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 President's Emergency Plan For AIDS Relief (PEPFAR/Emergency Plan) is President Bush's pledge of $15 billion over the next five years (2003-2008) to fight the HIV/AIDS pandemic. As the largest international health initiative in history initiated by one nation to address a single disease, the program hopes to reach over 120 countries in the world, providing anti-retroviral treatment (ART) for 2 million, preventing 7 million new infections, and supporting care for 10 million (the "2-7-10 goals"). See the Five Year Strategy Fact Sheet, the Funding Fact Sheet, and also Funding Information for FY2006

Focus Countries

The President's Emergency Plan for AIDS Relief starts by addressing countries with especially high HIV/AIDS prevalence rates. These countries account for approximately one-half of the world's 40 million HIV infections. Current focus countries include Botswana, Cote d'Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Vietnam, and Zambia. While most of the $10 billion for this program will be spent on these focus countries, $4 billion is allocated for programs other PEPFAR countries and HIV/AIDS research. (The other $1 billion is contributed to the Global Fund, see below). See the PEPFAR World Wide Activities Map

Prevention

The number of people living with HIV has never been higher - over 40 million people worldwide are living with HIV, and there were approximately 5 million new infections in 2005. To slow the spread of the epidemic, PEPFAR implements programs catered toward the conditions in each focus country. As HIV can be transmitted by both sexual and non-sexual means, there are a variety of prevention programs: the ABC approach (Abstain, Be faithful, and correct and consistent use of Condoms); prevention of mother to child transmission (PMTCT) treatments; and education programs focusing on blood safety, intravenous drug use, alcohol abuse, etc.

In 2005, to clarify the ABC approach, the Office of the Global AIDS Coordinator issued the policy directive the ABC Guidance.

Treatment

In addition to providing anti-retroviral treatment (ART)], the Emergency Plan coordinates with host nations and other partners to provide trained clinical and laboratory personnel and counselors for adherence, updated laboratory equipment and distribution systems, logistics and management for drugs and other commodities, treatment for opportunistic infections, and more. This ensures the sustainability of PEPFAR goals in host countries, enabling long-term management of HIV/AIDS.

Care

For those who have already been infected with HIV/AIDS, the Emergency Plan provides HIV counseling, resources for maintaining financial stability, etc. Special care is given to orphans and vulnerable children (OVCs) and services are provided that meet the unique needs of women and girls, including victims of sex trafficking, rape, abuse, and exploitation (see fact sheet on Gender and HIV/AIDS). Finally, the Emergency Plan works closely with country leaders, military groups, faith-based organizations, etc. to eliminate stigma.

Programs

Recognizing that the HIV/AIDS pandemic is an issue that cannot be addressed single-handedly, the Emergency Plan not only establishes bilateral programs in host countries, but also works closely with multilateral partners, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria, for which the United States is the first and largest donor; the World Health Organization (WHO); as well as local Faith-Based Organizations. The New Partners Initiative is another U.S. government program that provides $200 million in grants to new partners to provide HIV/AIDS prevention and care services. The competitive process for applying for these grants encourages community groups to continuously improve their programs and bring leadership to individual communities in the host countries. Finally, to make sure that partners are working together efficiently, the "Three Ones" principles were established: - one national plan, one national coordinating authority, and one national monitoring and evaluation system in each of the host countries in which organizations work. Rather than mandating that all contributors do the same things in the same ways, the Three Ones facilitate complementary and efficient action in support of host nations.

Accountability

The Emergency Plan is carefully monitored and statistics collected to ensure the adaptability of the program to change. To read about the achievements of the program made in the first two years, consult The Second Annual Report to Congress on the President's Emergency Plan for AIDS Relief.

A breakdown of financial contributions/allocations can also be found in the report.

Note: The President's Emergency Plan For AIDS Relief is exempt from the Mexico City Policy. [1]

Criticism

Naturally, with any large-scale initiative, criticism regarding foreign policy, funding, and overall approach can be expected. One must be careful, however, to avoid misinformation. PEPFAR is working against the circulating rumors by launching a website to make its program more transparent to the public. On the other hand, there are legitimate concerns being raised about PEPFAR, but hopefully, through open communication and cooperation, a sustainable, effective plan of action can be employed to combat the HIV/AIDS epidemic. An example of an open forum held to discuss controverial issues can be found at the Center for Strategic and International Studies, where Ambassador Mark Dybul, M.D. discusses the controversy over the ABC prevention approach, misinformation, etc.

"Watchdogs"

There are several PEPFAR Watchdogs. The following are few examples:

PEPFAR Watch

AIDSmap, an organization based in the UK.

Advocates for Youth, criticism on the ABC Guidance

Global AIDS Alliance

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