The U.S. Program That Brought H.I.V. Treatment to 20 Million People


Within the 20 years since its inception, the President’s Emergency Plan for AIDS Reduction has delivered lifesaving remedy to greater than 20 million folks in 54 international locations, essentially the most profitable international well being marketing campaign of its variety, in response to a report launched on Tuesday.

The $7.5 billion program, housed within the State Division, is due for reauthorization by Congress this 12 months. Up to now, it has obtained robust bipartisan assist.

President George W. Bush introduced the institution of Pepfar in January 2003, when remedy for H.I.V. was unavailable in lots of components of the world. In 2004, this system started offering antiretroviral medication to folks in Africa.

The preliminary objective was to deal with two million folks with H.I.V. over 5 years. Now, Pepfar is estimated to have saved as many as 25 million lives.

“I knew it was going to be huge, however I feel it turned out to be even greater and higher than we thought,” Dr. Anthony S. Fauci, this system’s architect, mentioned in an interview. “It ought to function a mannequin of what could be accomplished while you make a significant dedication.”

About 38 million folks were living with H.I.V. in 2021, and about 29 million of them have been receiving remedy. About 650,000 folks died from an H.I.V.-related trigger that 12 months, and about 1.5 million folks grew to become newly contaminated with the virus.

Antiretroviral medication can suppress H.I.V. ranges, stop transmission of the virus to sexual companions and lower the danger of transmission from contaminated pregnant girls to their infants.

Pepfar “was making an attempt to do one thing that had by no means been accomplished earlier than, to offer remedy to tens of millions of individuals with H.I.V. in Africa the place there was no care infrastructure,” mentioned Dr. Carlos del Rio, an infectious-disease knowledgeable at Emory College in Atlanta and chair of Pepfar’s scientific advisory board.

“People must be happy with this superb program,” Dr. del Rio mentioned.

To evaluate Pepfar’s success, researchers from the Facilities for Illness Management and Prevention analyzed information from six international locations that obtained funding from this system. Between January 2004 and September 2022, this system elevated the variety of folks receiving remedy by 300 instances, the group discovered.

“Pepfar’s efforts have dramatically altered the course of the worldwide H.I.V. epidemic,” the C.D.C.’s chief medical officer, Dr. Debra Houry, mentioned in a press release.

In Uganda, one of many first international locations supported by Pepfar, this system has prevented almost half one million H.I.V. infections since 2004 and saved greater than 600,000 lives. In Eswatini, the speed of recent H.I.V. infections fell by half from 2011 to 2016.

In Nigeria, the variety of folks newly identified with H.I.V. who began remedy elevated by eight instances in 18 months.

Nonetheless, H.I.V. remedy is patchy amongst some susceptible teams, together with younger youngsters, pregnant girls, males who’ve intercourse with males and transgender folks. “Eliminating H.I.V. as a worldwide public well being risk calls for that we perceive and handle the basis causes of well being disparities, together with stigma, discrimination and social inequities,” Hank Tomlinson, director of the Division of International H.I.V. & Tuberculosis on the C.D.C., mentioned in a name with reporters on Tuesday.

The C.D.C. is a key implementing company of Pepfar and has offered remedy to 62 p.c of those that have obtained it. The company additionally helps greater than 10,000 labs or testing websites worldwide, trains well being care staff and strengthens surveillance to detect areas of excessive want.

The infrastructure Pepfar constructed “has been crucial to confront different infections like Covid and now shall be used to sort out different main issues like hypertension and diabetes,” Dr. del Rio mentioned.

The Biden administration named Dr. John Nkengasong to steer this system in 2021, about 18 months after Dr. Deborah Birx, this system’s earlier director, left to hitch the White Home coronavirus process power. Dr. Nkengasong is the primary individual of African origin to go this system.

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