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Celebrating U.S. Global Health Leadership on the 15th Anniversary of PEPFAR

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Porter DeLaney

By Porter DeLaney, Kyle House Group

On December 1st, we celebrated World AIDS Day, and this year we also recognized the 15-year anniversary of the President’s Emergency Plan for AIDS Relief (PEPFAR). PEPFAR is a tremendous success story, and perhaps the best example of how U.S. leadership in global health can achieve transformational change and progress.

When PEPFAR was announced during President George W. Bush’s 2003 State of the Union Address, there were only 50,000 people on the entire continent of Africa on the life-saving anti-retroviral (ARV) treatment. Fifteen years later, PEFPFAR has supported treatment for nearly 15 million people across the globe, including more than 11 million in Africa. PEPFAR also has prevented the mother-to-child transmission of HIV/AIDS for more than 2 million children and successfully cared for nearly 7 million orphans and vulnerable children. Alongside the PEPFAR program, the reach and impact of U.S. leadership on HIV/AIDS has been substantially expanded through U.S. support for the Global Fund to Fight AIDS, TB and Malaria, which has mobilized more than $40 billion from international donors, providing significant leverage to U.S. investments.

While President Bush deserves credit for his bold leadership in creating the PEPFAR program, which is the largest global health initiative focused on a single disease ever undertaken, it could not have been launched, nor sustained over time, if it were not for the strong bipartisan leadership of key Members of Congress, such as Senators Bill Frist, John Kerry, Dick Durbin and Rick Santorum, and Representatives Henry Hyde and Tom Lantos.

The bipartisan support for PEPFAR was on full display again last week when Congress approved another five-year reauthorization of the program, this time behind the leadership of Senators Bob Corker and Robert Menendez and Representatives Ed Royce, Eliot Engel, Chris Smith and Barbara Lee. PEPFAR’s success also is due in large part to the program’s focus on partnerships with other key stakeholders, including the private sector, faith community, and academic and research institutions.

The PEPFAR success story is a tremendous example of how U.S. leadership in global health can save the lives of millions and positively change the world for generations to come. PEPFAR is, however, just one of many global health success stories over the last two decades. Thanks in large part to U.S. leadership, the deaths of children under five have been cut in half—from 12 million to less than 6 million per year over the last twenty-five years—and malaria deaths have been reduced by nearly 75 percent in the hardest hit countries. At the same time, a super-charged global immunization campaign, led by the Global Alliance for Vaccines and Immunization (GAVI), has saved millions of lives through the rapid development and delivery of vaccines for diseases such as rotavirus, pneumococcal, polio, and measles.

A lot of work remains in the global fight against HIV/AIDS, and as the U.S. continues to lead in this global effort, there are several lessons that can be applied to our broader global health work. First, in order to achieve the type of impact that we’ve seen with the PEPFAR program, there needs to be Presidential leadership coupled with strong bipartisan support in Congress. Second, it is vital to develop a partnership platform that pulls in the competencies and capabilities from the private sector and civil society. Finally, the ultimate measure for success and sustainability rests with the ability to track and demonstrate results, and to develop true country ownership of these health programs.

As a new Congress comes together at the beginning of 2019, the need for U.S. leadership in global health is greater than ever. While the remarkable progress that has been achieved over the last two decades should be recognized and celebrated, the challenges that lie ahead across the full portfolio of global health, from infectious disease to maternal and child health and nutrition to health security, will require clear and bold leadership from the U.S. government.


Kyle House Group is a Georgia Global Health Alliance partner.

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