Bush Administration Releases Fifth Annual PEPFAR Report

The Bush administration on Monday released to Congress the fifth annual report of the President’s Emergency Plan for AIDS Relief, which provided a review of the program’s first five years, before Bush leaves office on Jan. 20, AFP/Google.com reports. U.S. Secretary of State Condoleezza Rice at a press conference to release the report said she does not think that “anything will stand as strongly in the hearts and minds of people around the world, but also in our own consciousness, as the work and achievements of PEPFAR.”

At the time of PEPFAR’s initial launch in 2003, 50,000 people in sub-Saharan Africa were receiving antiretroviral treatment, U.S. officials said (AFP/Google.com, 1/12). According to the report, PEPFAR during its first five years provided antiretroviral treatment to 2.1 million HIV-positive people, exceeding the program’s goal of treating two million people. The government since 2003 has allocated $18.8 billion to PEPFAR for HIV prevention and treatment efforts, which is the largest amount spent by any country to combat a disease, according to the report. The program also provides drugs for about two-thirds of the three million people receiving antiretroviral treatment in Africa, Bloomberg reports (Gienger, Bloomberg, 1/13).

Rice added that PEPFAR has supported services aimed at preventing mother-to-child HIV transmission for almost 16 million pregnant women, which has allowed about 237,000 infants to be born without HIV. In addition, the program supports care for more than 10.1 million people, “including more than four million orphans and vulnerable children who represent the hope for a brighter future,” Rice said (Semnani, CQ HealthBeat, 1/12). She added that although HIV/AIDS once was “thought to be a death sentence,” it “is now a disease that America is helping people to live with and to manage, so that they can be a part of their children’s lives going forward” (AFP/Google.com, 1/12). Although critics assert the program has overemphasized abstinence for HIV prevention, PEPFAR has provided more than 2.2 billion condoms worldwide, according to the State Department.

According to Mark Dybul, U.S. Global AIDS Coordinator who administers PEPFAR, the program has helped to improve overall health systems in its target countries. “The data that are available suggest that this intervention in HIV/AIDS is actually building the health care of other areas and having a spillover effect,” Dybul said (Bloomberg, 1/13). He added that this is “a tremendous shift in development, a philosophical revolution, and we’re pleased to be a part of it” (Dybul, State Department transcript, 1/12).

President Bush in July 2008 signed a bill reauthorizing PEPFAR at $48 billion over the next five years. According to Bloomberg, President-elect Barack Obama voted in favor of the reauthorization and Vice President-elect Joe Biden helped push the bill through the Senate. Dybul said this indicates that the incoming Obama administration supports the program (Bloomberg, 1/13). Dybul in an e-mail to his staff on Friday indicated that he will continue to serve as the U.S. Global AIDS Coordinator during the Obama administration for an undetermined length of time (Connolly, The Trail blog, Washington Post, 1/12).

The report is available online.

Officials, Advocates Respond to President Bush’s Legacy on HIV/AIDS
In related news, AFP/Yahoo! Health on Monday examined the praise President Bush has received from many HIV/AIDS advocates and officials on his efforts to launch PEPFAR and provide treatment for HIV-positive people in developing countries. “Under the Bush administration, there has been an extraordinary increase in resources dedicated to the fight against AIDS in less developed countries,” Michel Kazatchkine, executive director of the Global Fund, said. Peter Piot — former executive director of UNAIDSwho left the agency last month — said PEPFAR has “literally saved millions of lives,” adding that he has “no doubt that Bush’s legacy on AIDS is very positive.” Tachi Yamada, president of the Global Health Program at the Bill & Melinda Gates Foundation, called PEPFAR and the President’s Malaria Initiative “real success stories” that “offer health and opportunity to millions of people around the world.” According to Seth Berkley, head of the International AIDS Vaccine Initiative, many challenges remain in the global fight against HIV/AIDS, but PEPFAR is “a tremendous accomplishment, and one of which the Bush administration should be extremely proud” (Ingham, AFP/Yahoo! Health, 1/12).

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