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Changing Lives |
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Compassion Spotlight
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The Need
The HIV/AIDS pandemic is among the worst tragedies the world has seen.
More than 20 million people have died from AIDS, and more than 40 million people live with HIV worldwide.
More than 5,700 individuals lose their lives to AIDS around the world each day.
Five years ago, many wondered whether HIV prevention, treatment, and care could ever successfully be provided in resource-limited settings where HIV was a death sentence.
Prior to PEPFAR, it is estimated that only 50,000 people living with HIV in all of Sub-Saharan Africa were receiving antiretroviral treatment.
The Response
Announced in 2003, the President’s Emergency Plan for AIDS Relief (PEPFAR) is the largest commitment by a single nation toward an international health initiative — combating HIV/AIDS around the world, with a special emphasis on 15 focus countries that together account for approximately half of the world’s HIV infections. PEPFAR has set the goals of treating two million people, preventing seven million new infections, and providing care to 10 million people, including orphans and vulnerable children, for the program’s first 5 years.
PEPFAR embodies the principles of the Faith-Based and Community Initiative on a massive, international scale, with faith-based and other community organizations (FBCOs) operating as central partners in achieving its expansive prevention, treatment, and care objectives.
These partners possess cultural know-how, dedicated volunteers, strong trust relationships, social networks, buildings, and other key resources critical to effective service. In addition, the compassion of the individuals who serve through them brings a caring touch government alone rarely offers. Faith-based organizations are an essential part of this sector — providing between 30 and 70% of healthcare in sub-Saharan Africa, according to estimates by the World Health Organization. Perhaps most importantly, when well trained and equipped, indigenous organizations can provide sustainability for ongoing response.
In fiscal year (FY) 2007, PEPFAR partnered with 2,217 local organizations — up from 1,588 in 2004 — and more than 80 percent of partners were local.
Faith-based organizations were welcomed as a vital part of this work, representing nearly a quarter of all local partners.
With a heavy emphasis on building long-term local response capabilities, PEPFAR estimates its investment in network development, human resources, and local organization capacity development in FY 2007 at roughly $640 million.
From FY 2004 through FY 2007, PEPFAR supported nearly 2.6 million training and retraining encounters for health care workers. In FYs 2006 and 2007, PEPFAR provided approximately $281 million to support training activities.
To promote expansion of partnerships and sustainability, PEPFAR country programs may devote no more than eight percent of funding to a single partner (with exceptions made for host government partners, commodity procurement, and “umbrella contractors” for smaller organizations). This requirement helps to expand and diversify PEPFAR’s base of partners and to facilitate efforts to reach out to new partners, particularly local partners — a key to sustainability. The exception for umbrella contracts is based on a desire to support mentoring of smaller local organizations by larger organizations, supporting capacity- building in challenging areas such as management and reporting. PEPFAR also works with its international implementing partners to ensure that they have strategies to hand over programs to local organizations as those groups develop the capacity to work directly with the U.S. Government.
New Partners Initiative
On World AIDS Day 2005, President Bush launched the $200 million New Partners Initiative (NPI), part of PEPFAR’s broader effort to increase the number of local organizations, including faith-based and other community organizations (FBCOs), that work with the Emergency Plan. The first 23 NPI grants were awarded on World AIDS Day 2006; a second round of 14 grants was announced on World AIDS Day 2007; and a third round will be announced in 2008.
Through NPI, PEPFAR is enhancing the technical and organizational capacity of local partners, and is working to ensure sustainable, high-quality HIV/AIDS programs by building community ownership. NPI supports organizations that have previously worked as PEPFAR sub-partners— receiving PEPFAR funds through larger organizations — in graduating to prime partner status. Nearly half of NPI’s direct grantees to date had previously been PEPFAR sub-partners. Each grantee receives comprehensive technical and organizational support through NPI, including increasing financial and reporting capacity, enabling them to compete not only for PEPFAR resources but also for grants and contracts from other sources of funding.
Results
PEPFAR is on track to meet its ambitious goals. As of March 31, 2008:
Globally, PEPFAR supported life-saving antiretroviral treatment for approximately 1.73 million men, women and children.
In sub-Saharan Africa alone, PEPFAR supported antiretroviral treatment for nearly 1.68 million individuals.
PEPFAR has also supported in the 15 focus countries:
Prevention of mother-to-child HIV transmission services for women during more than 12.7 million pregnancies.
Antiretroviral prophylaxis for women in more than 1 million pregnancies.
Prevention of an estimated 194,000 infant infections.
In addition, as of September 2007, the initiative supported:
Care for nearly 6.6 million people, including care for more than 2.7 million orphans and vulnerable children.
Over 33 million counseling and testing sessions for men, women and children.
President Bush has called on Congress to reauthorize PEPFAR and double its funding, consistent with the program’s founding and successful principles and practices.
