The President’s Emergency Plan for AIDS Relief (PEPFAR), which President George W. Bush proposed as part of his State of the Union Address, Congress enacted with near-unanimous support in 2003, and program implementation began in 2004, is arguably one of history’s most successful global health programs - investing more than $100 billion in the global HIV/AIDS campaign, saving 25 million lives, and preventing millions of infections over the past 20 years. It is, according to the State Department, the largest commitment by any nation to address a single disease. When President Bush announced the program, 5 million people around the world were contracting HIV annually, and the virus was costing vulnerable countries, particularly across Africa, a generation of their people. Two decades later, through the extraordinary commitment of the United States’ leaders and people - and through partnerships with such multilateral institutions as the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis, and Malaria - PEPFAR has changed the course of the HIV pandemic, turning despair into hope across the globe. The Bipartisan Policy Center has extensively studied the impact of PEPFAR, issuing reports in 2015 and 2018 that demonstrated the rippling effects of the program that go beyond improved HIV/AIDS health outcomes. Our most recent analysis indicates that by reauthorizing this program, members of Congress will further PEPFAR’s impact on the HIV pandemic, while also nourishing even more goodwill for the United States. PEPFAR has supported life-saving HIV treatment for more than 20 million people in more than 50 countries across the Americas, Africa, Europe, and Asia. It has provided HIV testing to some 65 million people and other services to millions more. In addition, the program has spurred other public, private, and multinational efforts, helping to significantly drive down new infections. PEPFAR is nimble, enabling the program to respond to changing conditions and emerging challenges. Even amid the COVID-19 pandemic, PEPFAR continued to operate at a high level. Presidents and Congress have reauthorized PEPFAR three times with strong bipartisan support since 2003a enabling the program to plan for the future. In January 2023, the Biden administration released its five-year strategy for PEPFAR: Fulfilling America’s Promise to End the HIV/AIDS Pandemic by 2030. Under that strategy, PEPFAR will focus on: (1) Developing strong public health systems; (2) Focusing on a data-driven, science-based implementation; (3) Ensuring a sustainable response; (4) Ensuring the development of partnerships (with the faith-based community, local organizations, philanthropic entities, and the private sector); and (5) Addressing health equity gaps. The Biden administration’s new PEPFAR strategy provides a clear road forward to continue building the capacity and sustainability of PEPFAR-supported HIV responses, which will drive long-term health and development benefits for our partner countries and continue to offer a host of other benefits for the United States.
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