“More than 100 million condoms will be distributed annually to sex workers, men who have sex with men, and other groups vulnerable to HIV as part of a new five-year program to be run by the Ethiopian government and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR),” PlusNews reports. “Dubbed MULU, the Amharic word for comprehensive, the $70 million program — implemented by the NGOs Population Services International and World Learning — will also target day laborers in the booming construction industry, migrant workers and their partners,” the news service notes.
“Ten years ago today President Bush stepped into the Rose Garden to announce a $500 million program to stop the transmission of HIV passed from mothers to children during birth,” an announcement that “led the way to PEPFAR,” which Bush announced in his 2003 State of the Union address, John Donnelly, correspondent for GlobalPost’s “Global Pulse” blog, writes in this commentary in the blog. “In the years since, PEPFAR has been credited for saving millions of lives, most of them in Africa,” he continues, adding, “For anyone who cares about the global AIDS fight, today should be a day to celebrate the saving of millions of lives in the developing world.”
U.S. Global AIDS Coordinator Ambassador Eric Goosby “discussed lessons learned from the U.S. response to the global HIV/AIDS epidemic over the past decade at an event hosted by the Brookings Institute Monday morning,” the Center for Global Health Policy’s “Science Speaks” blog reports. “While calling recent scientific advances in HIV prevention ‘game changers’ that have offered hope of an AIDS-free generation, [Goosby said] that the successful fight against the epidemic relies on recognizing AIDS-specific efforts so far as a foundation for further health gains, on country ownership, and on continuing to build ‘the shared responsibility’ of a multi-donor response,” the blog adds.
“Government assurances that the scaling back of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program in South Africa (SA) will be carefully managed to protect patients are welcome, but … [t]he reality is that the Department of Health is struggling to cope with severe medical staff shortages, financial resources that never seem to stretch far enough, inadequate infrastructure and maintenance programs, and administrative bottlenecks,” a Business Day editorial states. Though the reworking of PEPFAR funding will take place over five years “and does not entail the complete loss” of funding, “the shortfall will have to come from somewhere,” the editorial says, adding, “It will be tragic if, just as we are starting to see light at the end of the long, dark tunnel of the HIV/AIDS epidemic in SA, the gains of the past few years were to be reversed due to the loss of critical foreign funding and the government’s lack of capacity to plug the gap.”
U.S. Global AIDS Coordinator Ambassador Eric Goosby “was named to lead a new Office of Global Health Diplomacy on Friday, the State Department said,” the New York Times reports, noting, “Goosby will continue to head PEPFAR” (McNeil, 12/15). “The Global Health Diplomacy office was announced last July as the successor to President Obama’s Global Health Initiative,” the Center for Global Health Policy’s “Science Speaks” blog writes. “Goosby will be joined in creating the Global Health Diplomacy office by Leslie Rowe, previously U.S. ambassador to Mozambique, who will be in charge of its day to day operations,” the blog notes (Barton, 12/14).
Noting “PEPFAR has been criticized for its vertical or ‘stove-piping’ structure, with resources targeting a specific disease rather than working to strengthen the underlying health system,” a study published in the Journal of Acquired Immune Deficiency Syndromes “aimed to evaluate whether PEPFAR activities were associated with system-wide improvements in both proximal and distal indicators of health systems strengthening.” According to the abstract, “[t]he progressive scale-up of PEPFAR-supported activities was associated with consistent improvements in proximal indicators of health systems strengthening” and “was also associated with improvements in broader measures of health system strength, most clearly life expectancy” (Cohen et al., 12/18).
This report (.pdf) from the Center for Strategic & International Studies (CSIS), titled “Competing Pressures for U.S. PEPFAR In Botswana: Rising Ambitions, Declining Resources,” examines how the “partnership will be tested as the United States and Botswana negotiate a complex, multiyear handoff of PEPFAR-supported HIV/AIDS activities and as U.S. financial assistance is reduced,” the report summary states. The summary continues, “Botswana is a good setting in which to see whether an AIDS-free Generation is achievable and to better understand what success might require in terms of policy and programmatic innovations, health planning and management capacity, and costs” (Stash et al., 11/30).
PEPFAR will purchase up to 150 rapid tuberculosis (TB) Xpert testing devices and cartridges to test about 450,000 people for TB, “addressing a need to improve diagnoses of drug-resistant strains of disease, and to identify the disease in HIV-positive people in sub-Saharan Africa and Myanmar, the Office of the Global AIDS Coordinator announced” Tuesday, the Center for Global Health Policy’s “Science Speaks” blog reports. “The investment is part of an ongoing effort,” according to the blog, which notes, “The announcement of the program’s added investment in the Cepheid Xpert tests, following the pre-World AIDS Day release last week of PEPFAR’s blueprint for creating an AIDS-free generation backs the plan’s stated purpose of applying evidence-based approaches and scientific advances to confront the global HIV epidemic” (Barton, 12/4).
Devex’s “Pennsylvania Ave.” blog reports on reaction from the international development community to the release last week of the “President’s Emergency Plan for AIDS Relief (PEPFAR) Blueprint: Creating an AIDS-free Generation” (.pdf). “In general, aid groups welcomed the release of the blueprint and urged other donors to follow the United States’ lead,” the news service writes, adding, “There are, however, some groups that were disappointed with the lack of concrete funding commitments, among other details.” Devex provides reaction from DAI, Management Sciences for Health, and World Vision and quotes representatives of Save the Children, Abt Associates, and UNAIDS (Mungcal/Valdez, 12/4).
Last week, the U.S. government announced up to $7.5 million in grants over the next two years to fund “implementation science projects exploring how to achieve the goal of eliminating new pediatric HIV infections while keeping mothers alive,” the Center for Global Health Policy’s “Science Speaks” blog reports (Barton, 12/5). According to a State Department press release, “Implementation science is critical to ensure that evidence-based and scalable interventions address current barriers to effective PMTCT programs. The results from successful operational and implementation science research are essential to improved program and health system performance” (11/28).