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

In the 20 years since its inception, the President’s Emergency Plan for AIDS Relief has saved more than 20 million lives in 54 countries, making it the most successful global health campaign of its kind, according to a report published on Tuesday.

The $7.5 billion program, which sits within the State Department, will be re-authorised by Congress this year. In the past, it has received strong bipartisan support.

President George W. Bush announced the creation of Pepfar in January 2003, when HIV treatment was not available in many parts of the world. In 2004, the program began providing antiretroviral drugs to people in Africa.

The initial goal is to treat two million people living with HIV within five years. Now, Pepfar is estimated to have saved around 25 million lives.

Dr. Anthony S. Fauci, the program’s architect, said in an interview: “I knew it was going to be huge, but I think it turned out to be bigger and better than we thought. “It will serve as a model of what can be done when you make a big commitment.”

About 38 million people living with HIV in 2021 and about 29 million of them are being treated. About 650,000 people died from HIV-related causes that year, and about 1.5 million people were newly infected with the virus.

Antiretroviral drugs can suppress HIV levels, prevent transmission of the virus to sexual partners, and reduce the risk of transmission from infected pregnant women to their babies.

Dr Carlos del Rio, an infectious disease expert at Emory University in Atlanta, said: “Pepfar is “trying to do something that has never been done before, which is to provide a treatment for millions of people living with HIV in Africa, where there is no infrastructure for care.” and chairman of Pepfar’s scientific advisory board.

“Americans should be proud of this amazing program,” said Dr. del Rio.

To gauge Pepfar’s success, researchers from the Centers for Disease Control and Prevention analyzed data from six countries that received funding from the program. The team found that from January 2004 to September 2022, the program increased the number of people receiving treatment 300-fold.

CDC chief medical officer, Dr Debra Houry, said: “Pepfar’s efforts have dramatically changed the course of the global HIV pandemic.

In Uganda, one of the first countries to be supported by Pepfar, the program has prevented nearly half a million HIV infections since 2004 and saved more than 600,000 lives. In Eswatini, the rate of new HIV infections halved between 2011 and 2016.

In Nigeria, the number of people newly diagnosed with HIV starting treatment increased eightfold in 18 months.

However, HIV treatment is patchy for some vulnerable groups, including young children, pregnant women, men who have sex with men, and transgender people. “Removing HIV as a global public health threat requires us to understand and address the root causes of disparities,” said Hank Tomlinson, Director of the Global HIV & TB Division at the CDC. health disparities, including stigma, discrimination and social inequality. call with reporters on Tuesday.

The CDC is the main implementing agency for Pepfar and has provided the treatment to 62% of those who have received it. The agency also supports more than 10,000 labs or testing sites around the world, trains healthcare workers, and ramps up surveillance to spot areas of high demand.

Dr del Rio said the infrastructure Pepfar built “was crucial to dealing with other infectious diseases like Covid and will now be used to tackle other big problems like hypertension and diabetes.” road”.

Biden administration named Dr. John Nkengasong to lead the program in 2021, about 18 months after Dr. Deborah Birx, the program’s previous director, left to join the White House coronavirus task force. Dr. Nkengasong was the first person of African descent to head the program.


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