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Four-year evaluation of PEPFAR concludes

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On 20 February, the Institute of Medicine (IOM) presented the results of a four-year evaluation of the United States President’s Emergency Plan for AIDS Relief (PEPFAR). Led by Dr Robert E. Black, chair of the evaluation committee, the 700-page report is based on an extensive review of data from over 30 countries receiving PEPFAR funding, interviews with partner organizations and stakeholders, and findings from field visits to 13 countries.

The report serves as strong affirmation of PEPFAR’s significant impact on the AIDS epidemic, both in its partner countries and globally. It highlights PEPFAR’s continued relevance and progress in meeting its targets and in its staunch commitment to halting the spread of HIV and saving lives through investments in HIV prevention, treatment and care services.

The report also outlines the significant contribution PEPFAR has made to strengthening partnerships with governments, civil society, development partners and other stakeholders. Its increased attention and commitment to key populations and contribution to addressing the challenging nature of concentrated epidemics, and the overall transformative role in the global HIV response also come out strongly in the report. The report’s conclusions and recommendations for future action, reinforce the strong synergies between UNAIDS vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths and the US goal of creating an AIDS-free generation.

“The United States of America has led a formidable response to the AIDS epidemic. Through PEPFAR the US has actively saved millions of lives and prevented millions of new infections around the world,” said UNAIDS Executive Director Michel Sidibé. “We are also encouraged to see that this report emphasizes our common goals to see more country-owned and sustainable approaches achieved through greater shared responsibility.”

The evaluation also shows the clear need for PEPFAR to sustain its progress and to continue being ambitious in achieving real results to halt the global AIDS epidemic. It urges PEPFAR to transition to new implementation models that enhance systems and build capable leadership in partner countries to sustainably and effectively manage their own responses to HIV. “As the HIV response becomes more country-driven, PEPFAR, like other external donors, will need to focus its contribution on national efforts, rather than direct provision of services and attribution of results,” said Dr Black.

The report concludes that PEPFAR has the potential to further transform the way health assistance is envisioned and implemented, with ultimate long-term positive effects for global health and well-being.

In response to report, the head of PEPFAR, Ambassador Eric Goosby, reiterated the importance of the study in shaping PEPFAR’s efforts to implement the Blueprint for Creating an AIDS-free Generation, "We are proud that the IOM stated that PEPFAR has played a transformative role in the global response to HIV. We stand ready to continue to play this role as we work with our partners across the globe to create an AIDS-free generation," he said. "While our work is far from finished, we believe our best days lie ahead as we work with the global community to help countries reach the tipping point in their epidemics, and sustain their AIDS responses over time." He also announced the formation of a US government committee to follow-up on the report’s recommendations.