Today is a remarkable day. Today, we come together, as a global community, across continents, faiths and cultures, to renew our commitment to ending the AIDS pandemic - once and for all.
--President Obama, December 1, 2011
Combating a Global Pandemic
Since AIDS was identified 30 years ago, the United States has played a leading role in achieving scientific progress, and in translating science into programs. The President’s Emergency Plan for AIDS Relief (PEPFAR), established by President George W. Bush and a bipartisan Congress and expanded by President Obama, has put that science into action to save the lives of millions in the developing world. Today, President Obama announced new prevention goals for PEPFAR.
The President’s Emergency Plan for AIDS Relief
Under the Obama Administration, PEPFAR has continued to achieve extraordinary results. In Fiscal Year 2011 alone, the United States supported:
These results, along with encouraging scientific advances, create an exciting moment on global AIDS, with an opportunity to use existing tools to push the rate of new infections downward dramatically. To do so, the United States is working to support an optimal mix of combination prevention tools in each country in which PEPFAR works. This means prioritizing combinations of activities based on sound scientific evidence that will have the maximum impact on reducing new HIV infections and saving lives.
Expanded efforts in the areas described below will dramatically reduce new HIV infections and save lives. This expansion will occur in concert with other proven interventions, such as HIV testing and counseling, programs focused on people living with HIV and populations at higher risk for infection, and behavioral supports.
Prevention of Mother-to-Child Transmission (PMTCT): Pediatric HIV can be eliminated worldwide. No scientific or technical barriers stand in the way. PEPFAR has been the global leader in the effort to prevent mother to child transmission, and the prevention of 200,000 infant infections in FY 2011 by PEPFAR programs represents accelerating progress toward this goal. In June, PEPFAR and UNAIDS led an effort that outlined a path for achieving virtual global elimination of new pediatric HIV infections by 2015, assuming a continuing and shared commitment among donor and partner countries. To capitalize on this opportunity, over the next two years the United States will reach more than 1.5 million HIV-positive pregnant women with antiretroviral drugs to prevent them from passing the virus to their children.
Voluntary Medical Male Circumcision (VMMC): PEPFAR is leading the world in support for a rapid expansion of voluntary medical male circumcision. In the past few years, research has proven that this low-cost procedure reduces the risk of female-to-male transmission by more than 60 percent—and the benefit is life-long. Approximately one million male circumcisions for HIV prevention have been done in recent years, with the United States providing the support for three-quarters of them. Building on this, over the next two years, PEPFAR will support more than 4.7 million voluntary medical male circumcisions in Eastern and Southern Africa.
Treatment as Prevention: The effect of antiretroviral treatment in saving lives has long been known. Recent science has shown that treatment is also highly effective in preventing transmission to others. A study published in May 2011 showed that effective treatment of a person living with HIV reduced the risk of transmission to partners by 96%, on par with a vaccine. In FY 2011, PEPFAR reached 3.9 million with treatment, laying a foundation for heightened efforts. By the end of 2013, PEPFAR will directly support more than 6 million people on antiretroviral treatment – two million more than our previous goal.
Condoms: When used consistently and correctly, male and female condoms are highly effective in preventing sexual transmission of HIV. In heterosexual relationships where one partner is HIV-positive and the other is HIV-negative, when condoms were consistently used, HIV- negative partners were 80% less likely to become infected than persons in similar relationships in which condoms were not used. For this reason, the United States has long been a leading provider of condoms for HIV prevention in the developing world, and over the next two years will distribute more than 1 billion condoms.
The President believes that we must make smart investments with each dollar available. Using our wealth of scientific evidence and programmatic experience, we must support the interventions that have the largest impact and deliver them effectively and efficiently. With this focus, U.S. investments through PEPFAR have delivered exceptional and increasing results. In the area of treatment, PEPFAR has driven down its cost per year per patient on treatment from over $1100 to $335 in FY 2011. This translates into more lives being saved, and this continued focus on lowering costs and finding efficiencies will allow us to achieve these ambitious targets with existing resources. Some of the ways we’ve lowered costs include:
PEPFAR is one of the key platforms upon which the Obama Administration is building the Global Health Initiative, which supports one-stop clinics offering an array of health services while driving down costs, driving up impact, and saving more lives. Through PEPFAR investments, we have put systems of care in place that countries are leveraging to improve their citizens’ overall health.
Investments in global health are a pillar of American leadership – advancing our national interests, making other countries more stable and the U.S. more secure. They are also an expression of our values. The global AIDS response is a shared responsibility that cannot be met by one nation alone and today President Obama called on the global community to join the United States in this undertaking. The President has written to leaders of other nations that have demonstrated notable leadership on HIV/AIDS, expressing his desire to work together to meet the shared global responsibility.
PEPFAR is working with partner countries to build their capacity to lead their national responses and increase their own AIDS funding. Progress toward country ownership is essential for AIDS programs to be sustainable for the long term. In addition to governments, country ownership means embracing the efforts of civil society, including faith-based groups and groups of people affected by our programs. The U.S. is calling on other donors (including governments, foundations, and the private sector) to join us in increasing their investments. This includes supporting and strengthening the Global Fund to Fight AIDS, Tuberculosis, and Malaria. The U.S. is the largest donor to the Fund, providing more than $5.8 billion through 2011. In 2010, the U.S. made its first-ever multi-year pledge to the Fund, and the U.S. stands by this historic pledge. The U.S. is also a strong supporter of the Fund’s efforts to transform its operations at both the country and headquarters levels, in order to become more efficient and effective and save as many lives as possible.
The International AIDS Conference, returning to U.S. soil for the first time in over 20 years in July 2012, will provide an important platform at which the United States will communicate this shared responsibility message.
Fighting the Domestic HIV/AIDS Epidemic
In the United States, roughly 1.2 million Americans are living with HIV and about 50,000 become newly infected each year. Since the beginning of the epidemic, more than 600,000 Americans have lost their lives to HIV and AIDS. The Obama Administration has mounted a comprehensive and aggressive response to refocus our collective efforts to respond to the domestic HIV epidemic:
Creating a Coordinated National Response to the HIV Epidemic
National HIV/AIDS Strategy: The National HIV/AIDS Strategy is the Nation’s first comprehensive plan to fight the domestic epidemic. The Strategy provides a roadmap for moving the nation forward in addressing the domestic HIV/AIDS epidemic with clear and measurable targets to be achieved by 2015. The development of the NHAS is an important effort to reflect on what is and is not working in order to improve the outcomes that we receive for our public and private investments.
Increasing Access to Care
Today, President Obama announced he is directing $50 million in increased funding for domestic HIV/AIDS treatment and care because every American with HIV should have access to the highest quality of care available.
This is part of the broader effort to ensure all people with HIV get the maximum benefit from the latest treatments:
Focusing on Reducing New HIV Infections
Making Significant Policy Changes