President Obama and Secretary Kerry have committed PEPFAR to supporting countries in achieving an AIDS-free generation as a core pillar of the United States global health agenda. Together, we have made extraordinary progress toward this ambitious goal, saving millions of lives, and bringing hope and healing to communities and nations. Dozens of countries, many in sub-Saharan Africa, have realized steep declines in new HIV infections and AIDS-related deaths – gains that would have been unthinkable just a decade ago.
Around the world, progress has been greatest when a nationally-tailored combination of high-impact HIV inventions is brought to scale and sustained. The core interventions in this package include: prevention of mother-to-child transmission, treatment, voluntary medical male circumcision, condoms, targeted outreach to key populations (i.e., men who have sex with men, sex workers, and people who inject drugs), and testing and counseling combined with effective targeted prevention interventions. As outlined in the PEPFAR Blueprint, we are committed to rapidly scaling up the HIV prevention, treatment, and care services that science shows will have the greatest impact on controlling the epidemic in each country context.
Last November, passage of the PEPFAR Stewardship and Oversight Act of 2013 was an extraordinary reaffirmation of bipartisan U.S. commitment to this program and the global fight against HIV/AIDS. Congress made clear that PEPFAR should follow the best science and use its resources in the most efficient and effective manner possible to achieve an AIDS-free generation. We are deeply committed to do just that – in full compliance with all legislative provisions and mandates – so that all our investments support expanded access to lifesaving HIV services and the ability of countries to sustain them.
Our continued success requires that we strengthen core elements of health systems essential to service delivery and sustainability (e.g., supply chain, human resources for health, and health information systems). We must also target comprehensive HIV services to those most at risk and in need, including key populations, women and girls, and orphans and vulnerable children. And we must continue our close collaboration and partnerships with host-country governments, civil society – including faith-based and women’s organizations, networks of key populations and people living with HIV – multilateral institutions, the private sector, and other stakeholders. Only by working together will we get the job done.
We are currently conducting our annual comprehensive programmatic review of PEPFAR Country Operational Plans (COP) to ensure all our investments align with what science has shown us and are tailored to address the epidemic in each country. Particularly in an environment of limited resources and substantial unmet need, this process allows us to allocate our efforts optimally. Over the past year, a number of PEPFAR country teams – including in Ethiopia, Nigeria, and Uganda – have already followed this approach to adjust their program portfolios for maximum impact. In so doing, they also naturally reached Congressionally-mandated directives – including the 50 percent care and treatment, and the 10 percent orphans and vulnerable children requirements – with which PEPFAR must comply across its entire portfolio for 2014 COP.
Looking forward, our vision is to achieve an AIDS-free generation through impact, accountability, transparency, shared responsibility, and a commitment to human rights. Together, with all hands on deck, I believe we can get there.