What Is PEPFAR?
The President's Emergency Plan for AIDS Relief (PEPFAR) is America's commitment to fighting the global HIV/AIDS, tuberculosis and malaria epidemics, and 2013 marks it's ten-year anniversary. PEPFAR is the largest commitment by any nation to combat a single disease in history. The funds under PEPFAR total approximately $46 billion. PEPFAR will now focus on transitioning from an emergency response to promoting sustainable country programs. PEPFAR funds have helped people in more than 30 countries in Africa, Asia, the Caribbean, and Eastern Europe. More information on participating countries can be found at www.pepfar.gov/countries/index.htm.
The program goals through 2013 include TREATMENT, PREVENTION and CARE. In addition, PEPFAR is building health systems to continue their work under PEPFAR and be accountable for results.
TREATMENT includes commitment by government and community leaders; national HIV/AIDS policy and clinical guidelines; training programs for clinical and laboratory staff; laboratory supplies and staffing support; and community outreach to promote adherence to antiviral treatment.
PREVENTION activities are based on the specific HIV epidemic in each country. These include reducing sexual transmission with the ABC Strategy (Abstain, Be Faithful, use Condoms), the prevention of infections from mothers to children, preventing infections due to unsafe blood and medical injections, and male circumcision, and HIV counseling and testing.
CARE includes care for orphans and vulnerable children, and care and support for people infected with or affected by HIV/AIDS. PEPFAR focuses on strengthening the capacity of families to protect and care for orphans and vulnerable children by extending the lives of parents and caregivers. PEPFAR also provides prevention and treatment of AIDS-related infections and cancers, pain and symptom management, psychological, social, spiritual, and preventive services.
Improving HIV testing can help link people to prevention, treatment, and care. PEPFAR targets counseling and testing for people at high risk of HIV infection. This includes tuberculosis patients and women who might transmit HIV to their children.
To support PEPFAR, the US Food and Drug Administration (FDA) developed a way to ensure that medications are safe and effective. Products "tentatively approved" under PEPFAR cannot be sold in the US if that would conflict with the patent protections of the original manufacturer.
The FDA encouraged manufacturers to apply for approval of single drugs, combinations of various products in a single pill and versions of approved drugs packaged in convenient combinations. Products are reviewed using normal standards.
PEPFAR can purchase any product with full or tentative approval. The FDA helps manufacturers prepare for FDA approvals and inspections of their clinical trials and manufacturing facilities. Reviews are done quickly; in some cases, within 2 to 6 weeks.
The FDA is also working with foreign drug approval agencies to help them understand the FDA approval process. This encourages local country approvals of PEPFAR drugs. Through October 2012, a total of 154 antiviral products have been approved for use by PEPFAR. A full list of medications available through PEPFAR is available at www.fda.gov/oia/pepfar.htm
Latest PEPFAR Program Results
Reflecting the US commitment to saving lives affected by HIV/AIDS, PEPFAR is supporting countries in providing HIV prevention, treatment and care to their people.
The U.S. directly supported more than 5.1 million men, women and children on life-saving antiretroviral treatment worldwide as of 2012.
PEPFAR directly supported HIV testing and counseling for more than 11 million pregnant women in fiscal year 2012. PEPFAR supported antiretroviral drug prophylaxis to prevent mother-to-child transmission for more than 750,000 of these women who tested positive for HIV, allowing approximately 230,00 infants to be born HIV-free.
PEPFAR also provided care and support for nearly 15 million people, including more than 4.5 million orphans and vulnerable children, and HIV counseling and testing for more than 46.5 million people, providing a critical entry point to prevention, treatment, and care.
The U.S. is the first and largest donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria. To date, the U.S. has provided more than $5.8 billion to the Fund. Of the estimated 6.6 million individuals in low- and middle-income countries who currently receive treatment, nearly 5.6 million receive support through PEPFAR bilateral programs, the Global Fund, or both.
Latest PEPFAR Goals and Funding
PEPFAR is on track to meet the target goal of treating more than 6 million people by the end of 2013. Other new goals include 4.7 million voluntary medical male circumcisions, antiretroviral prophylaxis to prevent vertical transmission for 1.5 million pregnant and breast-feeding women, and provision of a billion condoms.
For the fiscal year (FY) 2013, President Obama requested $6.42 billion, including more than $4.54 billion for bilateral HIV/AIDS programs and $1.65 billion for the Global Fund. For FY 2014, President Obama requested $6.73 billion, including more than $4.88 billion for bilateral HIV/AIDS programs and $1.65 billion for the Global Fund.
The Bottom Line
The President's Emergency Plan for AIDS Relief (PEPFAR) is America's commitment to fighting the global HIV/AIDS, tuberculosis and malaria epidemics. The program goals through 2013 include TREATMENT, PREVENTION and CARE. PEPFAR is the largest commitment in history by any nation to fight a disease. Approximately $46 billion has been committed to PEPFAR.
In addition to treatment, prevention, and care, PEPFAR is investing in HIV interventions targeted at populations at greatest risk and promoting sustainability, efficiency and effectiveness. PEPFAR will now focus on transitioning from an emergency response to promoting sustainable country programs.
More information on the US President's Plan for AIDS Relief is available at the web site www.pepfar.gov/.