The Foreign Service Journal, May 2017

26 MAY 2017 | THE FOREIGN SERVICE JOURNAL W e can control and ultimately end the global HIV/AIDS epidemic as a public health threat. Fifteen years ago, this was unimaginable. At that time, reports from the front lines, particularly in sub-Saharan Africa, were dire. In many countries, an HIV diagnosis was a death sen- tence. The prior gains in global health and development were being lost. In the hardest-hit regions of sub-Saharan Africa infant mortality had doubled, child mortality had tripled and life expectancy had dropped by 20 years. The rate of new HIV infections in the highest-burden regions was exploding, and people were getting sick and dying during the most productive years of their lives. The virus was devastating families, communities and countries as moms, dads, teachers, nurses and doctors all succumbed to the new plague. Today, the global HIV/AIDS landscape has been dramatically transformed, thanks in large part to the U.S. President’s Emergency Plan for AIDS Relief and its partners. Using the best science, often provided by the National Institutes of Health, and with strong bipartisan support in Congress and across administrations, PEPFAR has helped replace despair and death with hope, life and stability. PEPFAR was launched by President George W. Bush in 2003 as an “act of mercy beyond all current interna- tional efforts to help the people of Africa.” PEPFAR is led and coordinated by the Department of State’s Office of the Global AIDS Coordinator and Health Diplomacy, and implemented on the ground through an interagency model that draws on the critical contributions of the U.S. Agency for International Development; the U.S. Depart- ment of Health and Human Services and its agencies; the Department of Defense; the Peace Corps; the Department of Labor and the Department of the Treasury. Supported by appropriations from the U.S. Congress, the program has demonstrated the value of a whole-of-government approach focused on achieving clearly defined and mea- surable targets. It is also an expression of the compassion and generosity of the American people. In the countries that PEPFAR supports, our ambas- sadors and deputy chiefs of mission have been essential in moving policies forward that increase the program’s effectiveness and mobilize host countries’ resources year over year to expand services. PEPFAR also benefits greatly from our close collaboration with partner govern- ments and global partners, including multilateral institu- tions, civil society, faith-based organizations, the private sector, philanthropic organizations and people living with HIV. The results have been breathtaking. As of Sept. 30, 2016, PEPFAR was supporting nearly 11.5 million people with life-saving antiretroviral treatment—a 50-percent increase since 2014 and up from the fewer than 50,000 people who were on treatment in sub-Saharan Africa when PEPFAR and the Global Fund to Fight AIDS, Tuber- culosis and Malaria began. With PEPFAR support, nearly two million babies have been born HIV-free to pregnant women living with the virus—almost twice as many as in 2013—and their mothers have been kept healthy and alive to protect and nurture them. Recent public health impact assessments in three African countries show that the HIV/ AIDS epidemic is becoming controlled there, and evidence suggests that we are poised to control the epidemic in 10 African countries over the next four years. Eunice (right) is HIV-positive but, thanks to PEPFAR-supported programs that help prevent transmission of the disease from mother to child, her baby was born HIV-negative. USAID PEPFAR: Making the Impossible Possible BY DEBORAH L . B I RX