As PEPFAR Nears its Two-Decade Mark, New Analysis Finds That Mortality Declined Substantially in PEPFAR Countries Over the Course of the Program

A new KFF analysis finds the President’s Emergency Plan for AIDS Relief (PEPFAR) program was associated with large declines in mortality in PEPFAR recipient countries since its creation in 2003. The new analysis takes a closer look at PEPFAR’s health impact by assessing the all-cause mortality rate in 90 PEPFAR recipient countries compared to similar low-and middle-income countries. The all-cause mortality rate was 20% lower than expected had PEPFAR been absent.

PEPFAR countries with higher levels of investment saw the greatest decline in mortality, with an all-case mortality rate reduction of 27% over 2004-2018. Comparatively, countries who received low investment involvement saw a reduction of 16%, showing even with lower levels of investment, the PEPFAR program contributed to a decline in mortality.

Mortality continued to decline throughout all three PEPFAR phases, with the first two phases seeing the biggest drop (2004-2013), according to the new analysis, conducted by researchers at KFF and Brandeis University.

The PEPFAR program is the largest commitment by any nation to address not only HIV/AIDS, but any single disease in history. As the program approaches its two-decade mark and begins the process of developing the next five-year strategy, this new analysis finds promising results suggesting that future investments would likely continue to yield significant health impacts.