U.S. Cites "ABC" of Success in World AIDS Fight

On Monday, the acting U.S. Global AIDS Coordinator said the President's Emergency Plan for AIDS Relief (PEPFAR) will likely surpass its $15 billion, five-year funding target by 2008 and is the beginning of a sustained U.S. commitment to fight AIDS globally.

"It's the first step of a quantum leap," Dr. Mark Dybul said in South Africa during an interview at the start of the initiative's annual meeting of HIV/AIDS program specialists. "We are pleased with what has been accomplished, but we're a long way from reaching our goal yet."

Halfway through its five-year term, PEPFAR now has some 561,000 patients in 15 target countries on antiretrovirals, and it has prevented an estimated 65,100 mother-to-child transmissions through interventions with pregnant women. Providing treatment has consumed about 50 percent of PEPFAR's spending, estimated to total around $4 billion in 2007.

Dybul said some of the program's most exciting results have been in prevention. "ABC is bringing results," he said of campaigns that urge people to prevent the disease through Abstinence, Being faithful, and using a Condom. Dybul linked ABC programs to reported declines in HIV prevalence in a number of African countries such as Botswana, Ethiopia, Kenya, and Zimbabwe.

But some health experts are critical of PEPFAR's reliance on the ABC model and its use of faith-based groups to implement AIDS programs. Dybul rejected such criticism, saying clear messages on reducing the number of sexual partners and delaying sexual debut are bringing obvious results.

"We don't differentiate between saving a life and saving a soul," said Dybul. "We are trying to save as many lives as possible in as quick a time as possible." "We're seeing a dramatic decline in [sexual] partnerships, particularly among young men," he noted. "And my guess is we're seeing prevalence decline in even more countries, we just don't have the demographic data for it yet."

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