HTB

Dozens of countries left out of new PEPFAR strategy, threatening the global AIDS response

1 October 2017. Related: Treatment access.

Health GAP

Secretary of State Rex Tillerson yesterday unveiled the President’s Emergency Plan for AIDS Relief (PEPFAR) “Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020)” at the United Nations General Assembly. The plan includes a greater push toward epidemic control in 13 target countries, but takes the foot off the gas for more than 37 countries PEPFAR does not designate as ‘priority,’ leaving behind millions of people living with HIV due to a lack of resources and a waning commitment to evidence-based strategies.  

Health GAP Executive Director Asia Russell said: “The strategy announced today is the kind of global AIDS response policymakers craft when they have one hand tied behind their backs. An ambitious strategy wouldn’t limit efforts toward epidemic control in just 13 of PEPFAR’s more than 50 countries, but would aggressively map out a plan for ending AIDS as an epidemic in all countries, including those with the highest burden and greatest need such as Mozambique, South Sudan, the Democratic Republic of Congo and other parts of West Africa

“This strategy makes the right moves in too few places, at the expense of saving lives everywhere else,” said Russell. “PEPFAR leadership should sound the alarm about the risks of committing too few resources to the global AIDS response and the dangers of using scarce resources for anything other than evidence-based strategies.”

The plan announced today is remarkable in that:

  • It does not include support for rapid treatment scale-up in all PEPFAR countries, including high-burden countries like Mozambique and impoverished countries like South Sudan.
  • It fails to name the costs of not scaling-up efforts in all PEPFAR countries, which will include preventable deaths, new infections, and a more expensive future global AIDS response.
  • It does not include an aggressive strategy for reaching key populations, including LGBT people, sex workers, or women and girls.
  • It does not highlight the dangerous impact of expanding the Global Gag Rule to PEPFAR.
  • It does not call on Congress to increase funding for the global AIDS response.
  • It does not include a human rights component.
  • It calls for increasing engagement with faith-based organisations, which have historically rejected evidence-based strategies.

During his campaign, President Trump responded to a question about whether he would commit to doubling the number of people receiving treatment through PEPFAR to 230 million by 2020, saying: “The answer is yes. I believe strongly in that and we are going to lead the way.” Trump reiterated his support for PEPFAR during the United Nations General Assembly today, but has proposed $1 billion in cuts to the U.S. global AIDS response, including PEPFAR.

While Congress has so far rejected those cuts, it has also failed to increase funding for life-saving global HIV treatment and prevention. Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said in a recent speech that additional resources will be necessary to achieve epidemic control targets.

Congress must add $700 million for PEPFAR during the upcoming budget reconciliation process in order to fund a truly ambitious and effective strategy for achieving epidemic control in all PEPFAR countries and not just a chosen few,” concluded Russell.

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