Transcript Slide 1

The U.S. President’s
Emergency Plan for
AIDS Relief
HIV/AIDS and the U.S. Government’s Response:
The Power of Partnerships
Effects of HIV/AIDS on Economic
Development and Security
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HIV/AIDS is reversing developing nations’ progress towards
welfare and stability. The serious threat it poses to global
development and security is one reason why the President and
PEPFAR host nations have made addressing it such a priority.
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High HIV prevalence among people in the most productive
years of their lives presents a long-term adverse strain on the
socio-economic structure of these nations.
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Businesses in the developing world are faced with absenteeism,
declines in skilled workers, high rates of turnover, expenses to
train new workers, reduced revenue, and increased health care
costs.
Effects of HIV/AIDS on Economic
Development
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Among those of working age, 11.7 million more people who are
engaged in some form of productive activity are now living with
the virus. Many of these people are women who work in the
home.
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This number is in addition to the 24.6 million labor force
participants living with HIV.
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Between 1992 and 2004, 43 countries heavily affected by
HIV/AIDS lost a yearly average of 0.5 percent in their rate of
economic growth due to the epidemic.
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And, as a result of this decline, they forfeited 0.3 percent per
year in employment growth.
HIV/AIDS Impact on National Security
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Many nations suffer from high HIV prevalence among
defense forces, losing their soldiers—and their
leadership—to AIDS.
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For example, deaths due to HIV/AIDS are estimated to
have reduced the size of Malawi’s armed forces by 40
percent. In Uganda, more soldiers are believed to have
died from AIDS than from the nation’s 20-year insurgency.
The Transformational Power of Partnerships
• PEPFAR is part of a broader renaissance in
partnerships for international development.
• The United States is changing the paradigm for
development, rejecting the flawed “donor-recipient”
mentality and replacing it with an ethic of true
partnership.
• There is a growing consensus that the world’s
response to global HIV/AIDS has undergone a
transformation in recent years—and the new U.S.
partnerships with hard-hit nations have been the
catalyst.
New Way of Doing Business
• One integrated USG bilateral program:
Department of State, Department of Defense, Department of
Commerce, Department of Labor, Department of Health and
Human Services [Including CDC, FDA, NIH, and Health
Resources and Services Administration (HRSA). Substance
Abuse and Mental Health Administration (SAMHSA)], Peace
Corps, U.S. Agency for International Development – and
others
• Results oriented: links performance and funding with
strong strategic information element
• Network model: links prevention, treatment and care
• Three Ones is the guiding principle: success depends
on building in-country ownership, capacity and
leveraging all sectors of society
• Sustainability/New Partners
New Leadership Model:
US Global AIDS Coordinator
• Lead USG international HIV/AIDS efforts
• Ensure USG program and policy coordination
• Pursue coordination with other countries and
international organizations
• Resolve policy, program and funding issues
among USG agencies
• Directly approve all USG HIV/AIDS activities
• Promote accountability and monitor progress
toward meeting Emergency Plan goals
What supports interagency collaboration?
• Deliverables:
– PHASE I: 5 Year Strategies, Annual Country Operational Plans
– PHASE II: Partnership Compact Agreements, Annual Country
Operational Plans
– Final funding approval by Global AIDS Coordinator
• MOAs signed by Coordinator with Agencies
• Structures:
– HQ: Principles, Deputy Principles, Core Teams, TWGs, PAWG
– Field: In-country cross-agency structure lead by Ambassador
• Processes:
– HQ: interagency reviews COP, compacts, joint TA to field
– Field: Joint planning, portfolio reviews, site visits, Staffing for Results
PEPFAR Washington Structure - OGAC
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Coordinator
Policy Advisor
Program Services
Management and Budget
Strategic Information
Multilateral Diplomacy
Public Affairs
Congressional Relations
New Partner Outreach
Public Private Partnerships
Management Services
HQ Interagency Leadership Structures
• Policy Group/Principals
• Deputy Principals
• Core Teams
• Technical Working Groups
• Scientific Steering Committee
• PHE Subcommittee
• Care and Treatment Coordinating Committee (CC),
Prevention CC, and Strategic Information CC
• Ad hoc task forces (e.g. gender, male circ, etc.)
In-Country Team
• Led by the U.S. Ambassador
• Multiple U.S. agency representation incountry
• One program, one reporting system
• Collaboration with country leadership and
other donors/partners, support for “Three
Ones”
Overall Coordination
Host Government
In-Country Partners
International Partners
Implementing partners
Other stakeholders
USG Team
U.S. Ambassador
PEPFAR Coordinator
Embassy Staff
USAID
Peace Corps
HHS
DoD
DoL
DoC
Headquarters
Global AIDS Coordinator
Principals
Deputy Principals
Core Teams
Technical Working Groups
Agency Support
Recent USG Spending on Global HIV/AIDS
Under PEPFAR, the U.S. Government has committed $18.8 billion to the fight
against global HIV/AIDS, exceeding its original commitment of $15 billion over five
years.
PEPFAR Funding Flow
International HIV/AIDS Commitments, by
Donor, 2007
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In 2007, the United States was the largest donor in the world, accounting for
approximately 55% of commitments by governments.
Among resources available in 2007 for the fight against AIDS in low-and middleincome countries from all sources (domestic and international), the U.S. accounted for
20%, the largest share.
*Source: http://www.pepfar.gov/documents/organization/107828.pdf
The Focus Countries
• Under the first phase of PEPFAR, the program has been
working around the world, with a special emphasis on 15
focus countries. These countries are home to
approximately half of all the world’s HIV infections.
• These countries were picked because, with U.S. support,
they should be able to achieve national scale-up of
HIV/AIDS prevention, treatment and care by 2009.
PEPFAR Worldwide Activities
FY 2008 Spending for Prevention, Treatment
and Care in Focus Countries
Progress in PEPFAR Support for Treatment Coverage in
Select Focus Countries, FY2004-FY2007
2004
2006
2005
2007
Latest Program Results
PEPFAR has supported in the 15 focus countries
Through March 31, 2008:
– Prevention of mother-to-child HIV transmission services for women
during nearly 12.7 million pregnancies
– Antiretroviral prophylaxis for women in more than 1 million
pregnancies
– Prevention of an estimated 194,000 infant infections
– Antiretroviral treatment for more than 1.64 million people
Through September 30, 2007:
– Care for more than 6.6 million, including care for more than 2.7
million orphans and vulnerable children
– Over 33 million counseling and testing sessions for men, women
and children
Beyond 2008: The Next Phase of PEPFAR
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The American people will continue to stand with our global sisters
and brothers as they take control of the pandemic and their lives
and restore hope to individuals, families, communities and nations.
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This legislation will increase the U.S. financial commitment to the fight
against global HIV/AIDS, tuberculosis, and malaria, authorizing up to
$48 billion to combat the three diseases, including:
• $39 billion for:
– PEPFAR bilateral HIV/AIDS programs
– U.S. contributions to the Global Fund to Fight HIV/AIDS,
Tuberculosis and Malaria
• $5 billion to:
– The President’s Malaria Initiative to fight malaria through bilateral
programs around the world
• $4 billion for:
– Bilateral programs to fight tuberculosis, which is the leading killer
of Africans living with HIV
Beyond 2008: 10-Year Program Goals
Working in partnership with host nations, PEPFAR will
support:
– Treatment for at least 3 million people
– Prevention of 12 million new infections
– Care for 12 million people, including 5 million
orphans and vulnerable children
• To meet these goals, PEPFAR will support training of
at least 140,000 new health care workers in
HIV/AIDS prevention, treatment and care.
Beyond 2008: Emphasizing Continuation
and Expansion
• Continuation: HIV/AIDS treatment, prevention and
care are life-long needs, and the American people
will continue to support those served during
PEPFAR’s first five years.
• Expansion: PEPFAR will further expand efforts to
strengthen health systems and to collaborate with
programs that address malaria, tuberculosis, child
and maternal health, clean water, food and nutrition,
education, and other needs.
Beyond 2008: Bilateral Partnership
Compacts
• PEPFAR resources and other commitments will increase
in partnership with countries dedicated to fighting their HIV
epidemics.
• Through these compacts, host nations will strengthen their
collaboration with the U.S. Government by:
– Increasing their own resources, according to economic
ability, for HIV/AIDS and health systems so that the
combined resources can achieve clear goals.
– Implementing policies and practices to optimize
effectiveness of resources in key areas
Beyond 2008: Multilateral Partnerships
• The U.S. Government, through PEPFAR, will help to bolster
multilateral efforts by continuing to engage international
organizations as partners and to put accessibility, quality and
sustainability at the center of all HIV/AIDS work.
• This complex effort requires close cooperation with the Global
Fund to Fight AIDS, Tuberculosis and Malaria; the Joint United
Nations Programme on HIV/AIDS (UNAIDS); and other
international partners.
• The U.S. is the first and largest contributor to the Global Fund to
Fight AIDS, Tuberculosis and Malaria. To date, the U.S. has
contributed more than $2.5 billion to the Global Fund.
Inspiring a Global Response
• Responding to President Bush’s call for PEPFAR
reauthorization, in June 2007 the United States and
other G8 nations set ambitious goals to collectively
support:
– Treatment for a total of 5 million HIV-infected
individuals
– Prevention of 24 million new infections, and
– Care for 24 million people, including 10 million
orphans and vulnerable children
Thank you
For further information, please visit:
www.PEPFAR.gov