The Foreign Service Journal, May 2017

THE FOREIGN SERVICE JOURNAL | MAY 2017 27 During the last three years, PEPFAR has completely realigned and refocused the program in every country with business process improvements that increased its impact in a budget-neutral environment. These include targeting investments using granular, site-level data; rig- orous partner management to increase performance and efficiency; and intensive quarterly monitoring of the entire program. Our use of data to drive accountability, find efficiencies and leverage partnerships has made PEPFAR a cost-effective model for foreign assistance programs everywhere. Through the PEPFAR platform, the U.S. government has accelerated the progress toward a world more secure from infectious disease threats. PEPFAR’s investments in countries with sizable HIV/AIDS burdens bolster their ability to swiftly address Ebola, avian flu, cholera and other outbreaks, which ultimately enhances global health security and protects America’s borders. These lessons and experiences will continue to inform and improve our response, and those of our partners, to unforeseen health crises. Ending the global public health and security threat posed by the HIV/AIDS epidemic is doable, although it will not happen easily or automatically. One of the most critical areas for action is reducing new HIV infections among adolescent girls and young women. Every year, 390,000 adolescent girls and young women are infected with HIV—more than 1,000 a day. In sub-Saharan Africa the numbers are even more staggering: nearly 3 out of 4 adolescents newly infected with HIV are female, and in some countries young women are up to 14 times more likely to contract HIV than young men. Address- ing girls’ vulnerability is especially urgent because the population of young women and men in sub-Saharan Africa has doubled since the epi- demic began, from 100 million to 200 million. One of the reasons for girls’ vulnerability is the stag- geringly high rate of sexual assault: from 25 to 45 percent of young women experience sexual assault before the age of 25. In our partner countries, PEPFAR is calling on com- munities of faith—which are a healing presence in areas affected by gender-based violence—to once again stand with us, and support the campaign to protect girls and women from sexual assault. This will put us on the path to upholding the dignity and autonomy of all women and girls and overcoming one of the most horrific obstacles to finally ending the epidemic. Each day we are motivated by the memory of the 35 million men, women and children who have died from AIDS-related illnesses. We are driven to work harder and smarter for the nearly 37 million people who are still liv- ing with HIV. The promise of controlling and ultimately ending the AIDS epidemic is now within reach. What once seemed impossible is now possible, but it will continue to take data-driven action and focus to get the job done. n Young women receive PEPFAR support in Mozambique. PEPFAR/SARAHDAYSMITH U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy Ambassador-at-Large Deborah L. Birx oversees the implementation of the U.S. President’s Emergency Plan for AIDS Relief, as well as all U.S. government engagement with the Global Fund to Fight AIDS, Tuberculosis and Malaria. An M.D., Ambassador Birx is a world-renowned medical expert and leader in the field of HIV/AIDS, with a three-decades-long career focusing on HIV/AIDS immunology, vaccine research and global health.