Reauthorizing PEPFAR (August 2008)

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U.S. President's Emergency Plan for AIDS Relief 

Reauthorizing PEPFAR 

“Defeating HIV/AIDS once and for all will require an unprecedented investment over generations. But it is an investment that yields the best possible return: saved lives.”

-President George W. Bush, July 30, 2008      

On July 30, 2008, President George W. Bush signed into law H.R. 5501, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008. This legislation responds to the President’s call last year to expand the U.S. Government commitment to this successful program for five additional years, from 2009 through 2013.

In 2003, President Bush launched the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to combat global HIV/AIDS – the largest commitment by any nation to combat a single disease in history. This legislation will increase the U.S. financial commitment to the fight against global HIV/AIDS, tuberculosis, and malaria, authorizing up to $48 billion to combat the three diseases, including:

$39 billion for:

  • PEPFAR bilateral HIV/AIDS programs
  • U.S. contributions to the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria

$5 billion to:

  • The President’s Malaria Initiative to fight malaria through bilateral programs around the world

$4 billion for:

  • Bilateral programs to fight tuberculosis, which is the leading killer of Africans living with HIV

When the President launched PEPFAR in 2003, approximately 50,000 people in sub-Saharan Africa were receiving antiretroviral treatment. Today, PEPFAR supports lifesaving treatment for over 1.7 million people worldwide, the vast majority of them in sub-Saharan Africa.

PEPFAR has also supported care for more than 6.6 million people, including 2.7 million orphans and vulnerable children. To date, PEPFAR has allowed nearly 200,000 children to be born HIV free. These statistics are promising, yet there is no way to quantify PEPFAR’s greatest achievement – the spread of hope.

The Power of Partnerships

PEPFAR’s success is rooted in support for country-owned strategies and national programs with commitment of resources and dedication to results, achieved through the power of partnerships with governments, non-governmental, faith- and community-based organizations, the private sector, and groups of people living with HIV/AIDS. In 2007, 87 percent of PEPFAR partners were indigenous organizations, and nearly a quarter were faith-based.

10-Year Program Goals:

Working in partnership with host nations, PEPFAR will support:

  • Treatment for at least 3 million people
  • Prevention of 12 million new infections
  • Care for 12 million people, including 5 million orphans and vulnerable children

To meet these goals, PEPFAR will support training of at least 140,000 new health care workers in HIV/AIDS prevention, treatment and care.

PEPFAR Reauthorization 

The New Plan Emphasizes Continuation And Expansion


  • HIV/AIDS treatment, prevention and care are life-long needs, and the American people will continue to support those served during PEPFAR’s first five years.


  • PEPFAR will further expand efforts to strengthen health systems and to collaborate with programs that address malaria, tuberculosis, child and maternal health, clean water, food and nutrition, education, and other needs.

Bilateral Partnership Compacts

The U.S. Government will pursue Partnership Compacts by which PEPFAR resources and other commitments will increase in partnership with countries dedicated to fighting their HIV epidemics. Through these compacts, host nations will strengthen their collaboration with the U.S. Government by:

  • Increasing their own resources, according to economic ability, for HIV/AIDS and health systems so that the combined resources can achieve clear goals.
  • Implementing policies and practices to optimize effectiveness of resources in key areas, e.g. health workforce expansion, gender equity, protection of the rights of orphans, effective HIV counseling and testing, and others to be identified as Partnership Compacts are developed.

Multilateral Partnerships

The U.S. Government, through PEPFAR, will help to bolster multilateral efforts by continuing to engage international organizations as partners and to put accessibility, quality and sustainability at the center of all HIV/AIDS work. This complex effort requires close cooperation with the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Joint United Nations Programme on HIV/AIDS (UNAIDS); and other international partners. The U.S. is the first and largest contributor to the Global Fund to Fight AIDS, Tuberculosis and Malaria. To date, the U.S. has contributed more than $2.5 billion to the Global Fund.

Inspiring a Global Response

Responding to President Bush’s call for PEPFAR reauthorization, in June 2007 the United States and other G8 nations set ambitious goals to collectively support treatment for a total of 5 million HIV-infected individuals, prevent 24 million new infections, and care for 24 million people, including 10 million orphans and vulnerable children, as well as to cut malaria-related deaths by 50 percent in 30 countries. At the 2008 G8 meeting and in other fora, the U.S. has reported publicly on its programs’ contributions to meeting these goals. U.S. Government interagency website managed by the Office of U.S. Global AIDS Coordinator and the Bureau of Public Affairs, U.S. State Department.
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