- Key US and African leaders advocate for reauthorization of PEPFAR, an aid program that has played a crucial role in the global response to the HIV epidemic.
- US lawmakers call for a politically clean reauthorisation to ensure the program’s resiliency in dealing with shocks like Ebola and COVID.
- Delegates included representatives from various organizations and decision-makers from the US government and Africa, as well as UNAIDS, USAID, Microsoft AI for Health, and Friends of the Global Fight Against AIDS, Tuberculosis and Malaria.
Leaders from various corners of the world recently convened at the National Press Club in Washington, D.C., hosted by BroadReach Group, to commemorate the 20-year journey of the US President’s Emergency Plan for AIDS Relief (PEPFAR).
Their collective message was clear: PEPFAR must contine and empower local partners, especially in Africa, to ultimately defeat HIV as a public health threat by 2030.
PEPFAR – most impactful foreign aid programme
PEPFAR stands as the largest and most impactful commitment by any nation to combat a single disease in history. Currently, it supports over 20 million adults and children in Africa and beyond with life-saving antiretroviral treatment, contributing to saving 25 million lives globally over two decades.
Chris LeGrand, CEO of BroadReach Group, a South African PEPFAR implementation partner, lauded PEPFAR while calling for its reauthorisation.
“As a local South Africa organisation, we hosted this event to both express our gratitude to PEPFAR for their ongoing support and to also put a tangible, human face to the programme as we join the global development community in advocating for reauthorisation,” said Chris LeGrand, CEO BroadReach Group.
PEPFAR acting leader, Dr. Rebecca Bunnell, and co-founder of BroadReach, Dr. Ernest Darkoh, reflected on the transformation the program brought, from the dire early days of the HIV epidemic to today’s availability of life-saving treatment.
“People were coming to hospitals by the thousand, thin, emaciated and with no hope, and today thanks to empowered and funded local programmes this is no longer the case. Life-saving treatment is readily available and people can lead long and healthy lives,” noted Dr. Rebecca Bunnell.
Goal of ending HIV as a global public health threat
Key figures, including Ambassador Dr. Deborah Birx, highlighted PEPFAR’s role in building resilient health systems. They equally backed calls for PEPFAR’s reauthorization to achieve the goal of ending HIV as a global public health threat by 2030. Additionally, they underscored the importance of including vulnerable populations in HIV programs and sustaining the gains made in the past two decades under PEPFAR.
Former House Foreign Affairs Committee Chairman Ed Royce, who chaired the Africa subcommittee when PEPFAR was last authorised, called the program “the most consequential and successful foreign aid program in history.”
He highlighted that global health systems have become more resilient to shocks as a result of the networks and training established under PEPFAR: “Thanks to this programme we knew how to deal with Ebola (and COVID), and therefore we also know what the consequences will be if we don’t move forward with this reauthorisation,” Royce, a Republican, said.
Democratic Congresswoman Barbara Lee of the US House of Representatives, a staunch supporter of PEPFAR, who has authored or co-authored all recent critical HIV legislation in the US and has visited several African countries over the last 20 years to ensure that local needs are met and local capacity is built by PEPFAR, has called for a politically clean reauthorisation. “Let’s get it done and get it to the President’s desk.”
Ambassador Dr Deborah Birx, who directed PEPFAR for more than eight years, said PEPFAR’s resources and influence were vital in enabling the world to meet its goal of ending HIV transmission by 2030.
PEPFAR on building sustainable health systems
She highlighted PEPFAR’s successes in building sustainable health systems in developing countries, such as when US staff left the continent when COVID struck and local partners, like as BroadReach, stayed on the ground to provide patients with prevention, treatment, and care.
“We have no time to waste and must push to achieve the goal of ending HIV as a global public health threat by 2030,” she said passionately.
Senior representatives from PEPFAR, the South African AIDS Council, UNAIDS, USAID, Microsoft AI for Health, Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria, as well as several US government decision-makers, were also there.
UNAIDS representative Angeli Achrekar lauded PEPFAR for contributing to real progress in achieving the UN Sustainable Development Goals, particularly in combatting communicable diseases and driving advancements in gender equality and economic growth.
“We need to keep up a multisectoral partnership approach and maintain the gains of the past 20 years, especially the locally led ones. This includes scaling innovations and community outreaches. It was a long road to reach truly global development and advocacy for HIV, and we must keep up the good work.”
Dr. Rebecca Bunnell, who has been appointed by Dr. John Nkengasong to oversee PEPFAR, outlined the initiative’s five-pillar strategy for ending HIV as a public health catastrophe by 2030, resulting in a more secure world.
PEPFAR critical in responding to new HIV outbreaks
Dr. Bunnell believes HIV can be contained if funded programs in partner countries, particularly in Africa, can maintain viral load suppression, prevent, detect, and respond to new cases and outbreaks, and if all nations cease or lessen the disparities that drive HIV.
The role of technology was also underscored, with Microsoft’s AI for Health program noting its vital capacity-building role.
Dr. Bill Weeks, who oversees Microsoft’s AI for Health effort as part of the larger AI for Good initiative, stated that technology has played and will continue to play a critical role in increasing capacity for overburdened health systems and healthcare professionals. Importantly, technology need ethical safeguards to ensure that patient confidentiality, privacy, and security are always preserved when AI is employed.
“One of our greatest joint achievements (of BroadReach, PEPFAR, and USAID) was turning around the Ugu District in KwaZulu-Natal, which at one point had the highest HIV prevalence in the world,” said Dr Ernest Darkoh, BroadReach co-founder who served on President Obama’s Presidential Advisory Council on HIV/AIDS and is now based in Cape Town. Our health staff, whose capacity was expanded with the use of artificial intelligence (AI), saved millions of lives.”
Dhirisha Naidoo, leading BroadReach’s HIV treatment and care program in South Africa, shared the remarkable progress achieved thanks to PEPFAR and USAID.
She recalled on her early job as a nurse in a PEPFAR-funded HIV clinic in KwaZulu Natal 20 years ago, where people were malnourished and dying until ARV therapies were available.
Advocating for universal healthcare access
“Ugu became the first district in SA to reach the 90-90-90 UNAID care and treatment goals. We are proud that just last week two more of our districts have also reached this milestone! We currently support 555 000 people on sustained treatment across four rural, high prevalence districts in Kwa Zulu-Natal and Mpumalanga. Thanks to PEPFAR and USAID, you have given people like me the opportunity to make a difference in my country.”
Chris Collins, President and CEO of Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria, emphasized the need to continue advocating for universal healthcare access and greater diversity, equity, and inclusion in global healthcare.
“We must continue to advocate for universal access to healthcare and the achievement of greater diversity, equity and inclusion in global healthcare. This will be possible if PEPFAR is reauthorised and given the green light to scale its innovations and networks to reach more people,” noted Chris Collins.
At the end, the consensus among leaders was clear: PEPFAR’s reauthorisation is not just a commitment to saving lives but a stride toward ending the HIV epidemic by 2030 and fostering a healthier, more equitable world.
State of HIV in Africa
According to the World Health Organization (WHO), Africa remains the most heavily affected by HIV, with over 25.6 million people living with the virus, accounting for 65 percent of the global total of 39 million cases.
Statista data reveals that countries such as Eswatini, Lesotho, and South Africa have the highest HIV prevalence rates. In 2022, Eswatini had the highest HIV prevalence at nearly 26 percent. Last year, HIV-related causes claimed the lives of 630,000 people, and 1.3 million individuals contracted the virus.
Despite the high prevalence of HIV in Africa, substantial progress has been made in the past decade. New infections have dropped by 44 percent, and AIDS-related deaths have declined by 55 percent.
This progress is a result of collaborative efforts by various development partners who have advocated for and supported the expansion of new HIV prevention and treatment technologies, provided guidance on combination HIV prevention, testing, and treatment, and enhanced data availability and quality in countries.