Posted by Deborah L. Birx
Right things. Right places. Right now. Six simple words that are strategically guiding the largest U.S. foreign assistance program -- PEPFAR -- the U.S. President's Emergency Plan for AIDS Relief.
I've been privileged to lead PEPFAR for a year now, working with countries to achieve the potential of an AIDS-free generation, together.
A program never known for taking baby steps, we are making great strides forward, together with all of our partners, focusing on:
- Adolescent girls and young women
- Life-saving treatment for children living with HIV/AIDS
- Data-driven decision-making
- Strengthening community engagement
- Ending stigma and discrimination
- Adolescent Girls and Young Women
Every year, 380,000 adolescent girls and young women are infected with HIV, 7,300 every week, over 1,000 everyday. And in sub-Saharan Africa, they are more likely than their male counterparts to be living with HIV. That is why PEPFAR joined with the Bill & Melinda Gates Foundation and theNike Foundation to launch the $210 million DREAMS Partnership to ensure that adolescent girls and young women have an opportunity to live Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe lives. DREAMS will provide a core package of evidence-based interventions that have successfully addressed HIV risk behaviors, HIV transmission, and gender-based violence combined with intense ongoing evaluation to measure impact and ensure the ability to continually improve programs.
Children and HIV/AIDS
In 2013, 3.2 million children under the age of 15 were living with HIV/AIDS -- more than 90 percent in sub-Saharan Africa. Tragically, only one-fourth has access to treatment. Children living with HIV are one-third less likely to receive antiretroviral treatment (ART) compared to adults. Without ART, half of the children living with HIV will die before their second birthday, and 80 percent will die before their fifth birthday. To help change this situation, PEPFAR and the Children's Investment Fund Foundation created the Accelerating Children's HIV/AIDS Treatment (ACT) Initiative. This $200 million initiative will reach 300,000 more children living with HIV across high priority countries in sub-Saharan Africa by the end of 2016.
PEPFAR is using data in unprecedented ways, strategically targeting geographic areas and populations with the highest HIV burden to achieve the greatest impact for our investments. We are examining data down to the most granular site level to reach those most in need and prevent new infections. Globally, we are heading towards 28 million new infections in the next 15 years. But, as UNAIDS has laid out in its bold Fast-Track report, by achieving the 90/90/90 global goals and focusing our efforts, we can change the very course of the epidemic if we seize the moment now. Ministries of Health are leading the way in using data to understand where the HIV epidemic is and where to expand critical services. Kenya launched itsHIV Prevention Revolution Road Map in August 2014 -- signaling a new way to address its HIV epidemic, and other high burden countries around the globe are taking this innovative approach.
Data is only as useful as it is accessible, understandable, and actionable. That is why PEPFAR is opening its data to optimize program effectiveness and foster mutual accountability. We have posted on our website the first-everPEPFAR Dashboards, enabling all to view, download and utilize PEPFAR data. We invite all stakeholders to examine the Dashboards, analyze our progress, and let us know if you have ideas for how to make this information or our program better. That is the value of transparency.
HIV/AIDS interventions must be tailored to the unique needs of the communities they serve. We also know that the long-term sustainability of these programs is dependent on the full engagement of civil society at every point in their development and implementation. To cement this into all of PEPFAR planning, I have instructed each of our PEPFAR countries to involve civil society throughout the development of their annual Country Operational Plans -- from day one. No longer will civil society simply hear about our actions, they will be meaningfully involved in discussing what needs to be done to best control their local epidemics.
Stigma and Discrimination
Stigma and discrimination as well as harmful laws and policies reduce access to essential health services and undermine efforts toward effective responses to HIV/AIDS. The principles of good public health demand that we strive to reach all affected populations with core HIV services even when facing difficult cultural contexts, severe stigma and discrimination, or challenging security environments.
I believe I speak for the entire PEPFAR team when I say it is an honor to wake up every day and work for a program whose mission is to save lives. I am grateful to the countries for their leadership, their willingness to focus and change the way we all have been doing business together. I am thankful for the voices of the community and innovative partnerships that bring their insights and ideas to make us more effective day-by-day. While the epidemic is not yet over, we can see an AIDS-free generation on the horizon, but we must run toward it with the focus to succeed. And what better reason is there than that to keep us all moving forward.
About the Author: Deborah L. Birx, M.D., serves as the U.S. Global AIDS Coordinator and U.S. Representative for Global Health Diplomacy.
Editor's Note: This blog entry also appears on the Huffington Post's Impact Blog.