Department of Health and Human Services (HHS)

HHS has a long history of HIV/AIDS work within the United States and at the global level. Under the Emergency Plan, HHS implements prevention, treatment, and care programs in developing countries and conducts HIV/AIDS research through its:

• Centers for Disease Control and Prevention (CDC);
• National Institutes of Health (NIH);
• Health Resources and Services Administration (HRSA);
• Food and Drug Administration (FDA); and
• Substance Abuse and Mental Health Services Administration (SAMHSA).

HHS field staff also work with the country coordinating mechanisms of the Global Fund to improve implementation of Global Fund grants and programs and their coordination with USG programs.

Examples of HHS programs and activities include:

• HHS/CDC's Global AIDS Program (GAP) works through highly trained physicians, epidemiologists, public health advisors, behavioral scientists, and laboratory scientists in 29 countries (including the 15 focus countries), who are part of USG teams implementing the Emergency Plan. GAP supports more than 25 additional countries through its headquarters and regional offices. Through partnerships with host governments, Ministries of Health, NGOs, international organizations, U.S.-based universities, and the private sector, GAP assists with HIV prevention, treatment, and care; laboratory capacity building; surveillance; monitoring and evaluation; and public health evaluation research. It is uniquely positioned to coordinate with HHS's other global health programs, such as global disease detection, public health training, and prevention and control of other infectious diseases such as malaria and tuberculosis, as well as with HHS's domestic HIV/AIDS prevention programs in the United States.
   
• HHS/NIH supports a comprehensive program of basic, clinical, and behavioral research on HIV infection and its associated opportunistic infections, co-infections, and malignancies. This research will lead to a better understanding of the basic biology of HIV and the development of effective therapies to treat it. It also will foster the design of better counter-measures to prevent new infections, including vaccines and prophylaxis with antiretroviral drugs (ARVs) and microbicides. NIH supports an international research and training portfolio that encompasses more than 90 countries; it also is the lead federal agency for biomedical research on AIDS.
   
• HHS/HRSA builds human and institutional capacity for scaling up HIV treatment and care, based on its experience in providing quality comprehensive HIV/AIDS care to underserved communities in the United States for more than 20 years. HRSA's Global HIV/AIDS Program implements its strategies through rapid roll-out of ARVs and clinical services, training and technical assistance, nursing leadership development, and promotion of the continuum of palliative care. Supporting education and training in more than 25 countries, thousands of health care workers are able to provide care and services in order to help PEPFAR meet its 2-7-10 goals. HRSA also is providing HIV quality improvement models, as well as supplying patient, provider, and population-level software to PEPFAR countries in order to improve the quality of care.
   
• HHS/FDA ensures the availability of safe and effective ARVs to meet the in-country treatment goals of global agencies and governments engaged in the treatment and care of patients living with HIV/AIDS. As of January 2007, using a process that combines focused engagement with companies prior to submitting authorization packages with a priority assessment of the submitted packages, the FDA has approved or tentatively approved 34 single-entity, fixed-dose combination, and co-packaged versions of previously-approved ARVs (most of which are still protected in the United States by patent and/or exclusivity) to increase the arsenal of low-cost, high-quality HIV/AIDS therapies available for purchase under PEPFAR. By making these much-needed, high-quality generic products available for registration and marketing in the 15 PEPFAR focus countries, the FDA has helped save lives and has significantly reduced the cost of treatment.
   
• HHS/SAMHSA works through state and tribal governments and faith- and community-based programs to support substance abuse and dependence and mental illness prevention, treatment and recovery, including support of an educational and training center network that disseminates state-of-the-art information and best practices. This technical expertise and program experience is being applied to the Emergency Plan within the program areas of drug and alcohol abuse, with an emphasis on the use of medication-assisted treatment as an HIV prevention intervention.

The Office of Global Health Affairs in the Office of the Secretary coordinates all of the HHS agencies to be sure the Department's resources are working effectively and efficiently under the leadership of the Coordinator.