A number of United States government agencies have come together in the common cause of turning the tide against the HIV/AIDS pandemic. They support a range of activities from research to technical assistance and financial support to other nations to combat the global HIV/AIDS pandemic. These global activities are coordinated with PEPFAR.
Department of State
The U.S. Global AIDS Coordinator reports directly to the Secretary of State. At the direction of the Secretary, the Department of State's (DoS) support for the Office of the Global AIDS Coordinator (OGAC) includes:
- Providing human resources services;
- Tracking budgets within its accounting system;
- Transferring funds to other implementing agencies; and
- Providing office space, communication, and information technology services.
Chiefs of Mission provide essential leadership to interagency HIV/AIDS teams and, along with other U.S. officials, engage in policy discussions with host-country leaders to generate additional attention and resources for the pandemic and ensure strong partner coordination. Learn more about DoS's role in Emergency Plan HIV/AIDS programs.
USAID
The U.S. Agency for International Development (USAID) is an independent Federal government agency that receives overall foreign policy guidance from the Secretary of State. USAID implemented its first HIV/AIDS programs in 1986 and currently supports the implementation of PEPFAR programs in nearly 100 countries, through direct in-country presence in 50 countries and through seven regional programs in the remaining countries. As a development agency, USAID has focused for many years on strengthening primary health care systems in order to prevent, and more recently to treat and care for, a number of communicable diseases, including HIV/AIDS. Learn more about USAID’s role in implementing PEPFAR programs.
Department of Defense
The Department of Defense (DoD) implements PEPFAR programs by supporting HIV/AIDS prevention, treatment, and care, strategic information, human capacity development, and program and policy development in host militaries and civilian communities of 73 countries around the world. These activities are accomplished through direct military-to-military assistance, support to nongovernmental organizations and universities, and collaboration with other U.S. Government agencies in country. Members of the defense forces in 13 PEPFAR focus countries have been the recipients of DoD military-specific HIV/AIDS prevention programs designed to address their unique risk factors, in addition to treatment and care programs for their personnel. Learn more about DoD’s role in implementing PEPFAR programs.
Department of Commerce
The Department of Commerce (DoC) has provided and continues to provide in-kind support to PEPFAR, aimed at furthering private sector engagement by fostering public-private partnerships. The U.S. Census Bureau, within the DoC, is also an important partner in PEPFAR. Activities include assisting with data management and analysis, survey support, estimating infections averted, and supporting mapping of country-level activities. Learn more about DoC’s role in implementing PEPFAR programs.
Department of Labor
The Department of Labor (DoL) implements PEPFAR workplace-targeted projects that focus on prevention and reduction of HIV/AIDS-related stigma and discrimination. DoL has programs in over 23 countries and has received PEPFAR funding for projects in Guyana, Haiti, India, Nigeria, and Vietnam. As of March 2006, DoL programs that work with the International Labor Organization and the Academy for Educational Development have helped 415 enterprises adopt policies that promote worker retention and access to treatment. These programs have reached more than 2,500,000 workers now covered under protective HIV/AIDS workplace policies. DoL brings to all these endeavors its unique experience in building strategic alliances with employers, unions, and Ministries of Labor, which are often overlooked and difficult to target. Learn more about DoL’s role in implementing PEPFAR programs.
Department of Health and Human Services
The Department of Health and Human Services (HHS) has a long history of HIV/AIDS work within the United States and internationally. Under PEPFAR, HHS implements prevention, treatment, and care programs in developing countries and conducts HIV/AIDS research through these HHS agencies and programs:
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention’s (CDC) Division of Global HIV & TB (DGHT) works side by side with Ministries of Health, leveraging the agency’s scientific and technical expertise to help deliver high impact, sustainable prevention, care and treatment to millions of people in countries most affected by HIV. Specifically, DGHT is working with country partners to:
- Scale up the use of antiretroviral treatment (ART) among people living with HIV
- Strengthen the ability of national governments to provide top-notch, sustainable HIV services
- Deliver the most effective prevention tools to individuals at high risk for HIV infection
- Use data to reach high-risk groups, inform public health policies and strategies, and measure our impact
Food and Drug Administration
The Food and Drug Administration (FDA) ensures the availability of safe and effective antiretroviral drugs (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 antiretroviral medicines (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.
Health Resources and Services Administration
The Health Resources and Services Administration (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 25 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 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.
National Institutes of Health
The National Institutes of Health (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/AIDS, 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 HIV and AIDS.
Office of Global Affairs
The Office of Global Affairs (OGA) in the Office of the HHS Secretary coordinates all of the HHS agencies to be sure the Department's resources are working effectively and efficiently under the leadership of the U.S. Global AIDS Coordinator at the State Department.
Substance Abuse and Mental Health Services Administration
HHS’s Substance Abuse and Mental Health Services Administration (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 PEPFAR to assist other countries with serious substance use—including opioid-related disorders--and mental disorders, which make the treatment and prevention of HIV more complicated.
Peace Corps
As a grassroots capacity-building organization, the Peace Corps contributes to the PEPFAR transition to sustainable, country-led responses to HIV by providing long-term capacity development support to non-governmental, community-based, and faith-based organizations, with particular emphasis on ensuring that community-initiated projects and programs provide holistic support to people living with and affected by HIV/AIDS. Peace Corps volunteers also aim to develop the necessary management and programmatic expertise at recipient and beneficiary organizations to ensure long-lasting support, particularly in rural communities. All of this is possible in large part because Peace Corps volunteers receive language and cultural training that enables them to become members of the communities in which they live and work.
Department of the Treasury
The Department of the Treasury is working to promote financial effectiveness and fiscal sustainability of the HIV/AIDS response in partner countries, primarily in Africa. The goal of Treasury’s work is to: increase awareness and understanding of the economic and financial dimensions of HIV/AIDS, especially among finance ministries; include the disease response as part of national economic strategies; strengthen financial resource mobilization and efficient utilization; and build capacity to implement policy improvements. Treasury’s work entails both policy engagement and technical assistance to support implementation of improved policies, generally in partnership with finance ministries. Illustrative examples include supporting HIV expenditure oversight committees, strengthening budget systems and execution in health and finance ministries, and developing capacity for health cost analysis.