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).
“The Global Fund to Fight AIDS, Tuberculosis and Malaria has signed a new grant agreement [with Tanzania] worth $308 million,” Devex’s “Development Newswire” reports. “The grant, signed Dec. 1, will help provide more than 660,000 Tanzanians access to antiretrovirals, HIV testing and counseling, and other health products for the next three years, according to a press release” from the Global Fund, the news service writes (Ravelo, 12/3). The press release states, “The grant will also allow the country to reach 96 percent of pregnant women with HIV testing and counseling, providing treatment for over 346,000 HIV-positive pregnant women to prevent HIV transmission to their babies by 2015.” The press release adds, “These results are being achieved through close collaboration with Tanzanian partners as well as with the U.S. Government’s PEPFAR program and other donors such as Germany through its bilateral cooperation” (12/1).
“Many currently believe that U.S. domestic entitlements are too large, but disregard the fact that the PEPFAR program has created a new class of moral entitlements overseas — in the form of four million and counting people receiving U.S.-supported life-sustaining AIDS treatment in low- and middle-income countries around the world,” Mead Over, a senior fellow at the CGD, writes in the Center for Global Development’s (CGD) “Global Health Policy” blog. He continues, “But I think the U.S. has just as much fiduciary and moral responsibility to anticipate and plan for its current and future AIDS treatment entitlements overseas as it does for its much larger Social Security and Medicare entitlements at home,” and adds, “Moving forward, I suggest that the U.S. should figure out how to convert the moral entitlements it has already granted into credible long-term enforceable commitments which are more analogous to the commitments it makes to Social Security beneficiaries in the U.S.” (11/30).
U.S. Ambassador to Namibia Wanda Nesbitt writes in the State Department’s “DipNote” blog, “Here in Namibia, the United States, through the President’s Emergency Plan for AIDS Relief (PEPFAR), is working closely with the people and Government of Namibia to prevent new HIV infections, provide lifesaving HIV treatment to those who need it, and help put an end to AIDS in the country.” She discusses the recently released Blueprint for an AIDS-free Generation (.pdf), progress in Namibia’s AIDS response, and the transition period in which Namibia will take full responsibility for its HIV program. “We are proud to work with the government and people of Namibia to do our part toward achieving the goal of creating an AIDS-free generation. By investing smarter and working together, we will win this fight,” she writes (12/3).
“After three decades of global emergency responses and a series of scientific breakthroughs in the fight against HIV/AIDS, it is now tempting to ask if we are marching towards the end of AIDS,” an editorial in the Lancet states. Noting the November 29 release of the U.S. Government’s PEPFAR Blueprint: Creating an AIDS-Free Generation, the Lancet writes, “The first and foremost signal the report has sent is that the U.S. commitment to the global AIDS response will continue to be ‘strong, comprehensive and driven by science,'” and the report “calls on partner countries, civil society, donors, foundations, multilateral institutions, and people living with HIV to step up together and make concrete commitments.” The editorial continues, “The vision of ‘an AIDS-free generation’ in the blueprint relies heavily on scientific and technological feasibility … However, eradicating a disease goes far beyond scientific advances, which will go unrealized without strong social support and public health actions as well as substantial and sustainable investments.”
In this White House blog post, Samantha Power, special assistant to the President and senior director for multilateral affairs and human rights at the National Security Council, highlights progress made across the U.S. government in implementing “the first-ever Presidential Memorandum to advance the human rights of [lesbian, gay, bisexual, transgender (LGBT)] persons.” The memorandum “require[s] all U.S. agencies engaged abroad to ‘ensure that U.S. diplomacy and foreign assistance promote and protect the human rights of LGBT persons,’ and to report annually on their progress,” she notes. Power discusses efforts undertaken by the State Department, USAID, the Peace Corps, PEPFAR, the Millennium Challenge Corporation, the Department of Health and Human Services and other departments, as well as multilateral engagements. She writes, “We will continue to build on this foundation to identify new opportunities to advance and protect the human rights of LGBT persons” (12/13).