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October 2010
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Even With Budget Constraints, U.S. Response to Global HIV/AIDS Is Powerful
Annual Meeting Coverage

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has faced budget pressures in recent years, but nevertheless has made a tremendous impact on the lives of people with HIV/AIDS, according to Eric Goosby, MD, U.S. Global AIDS Coordinator, speaking at the opening plenary session of the 48th Annual Meeting of IDSA in Vancouver.

In 2009, 29 million people were tested for HIV through PEPFAR; 3.6 million orphans and vulnerable children were cared for; 340,000 babies of HIV-positive mothers were born free of HIV; and nearly 2.5 million people received antiretroviral therapy (ART).

With 2010 data still to come, Dr. Goosby estimated the updated figures would put the program well on its way to reaching more than 4 million people with lifesaving treatment by 2014, its current goal.

Dr. Goosby acknowledged the difficult fiscal context and noted that finding efficiencies had allowed PEPFAR to expand access to services. Savings from the cost of antiretroviral drugs have been exhausted, with the program now purchasing 92 percent of medications as generics. The focus has shifted to making improvements in supply management and procurement that will free up more resources, he said.

Moving forward, male circumcision as a one-time intervention has the potential to save millions of lives with a scaled implementation, noted Dr. Goosby, who announced that PEPFAR was poised to do country-level scale up of male circumcision in Swaziland, Lesotho, and several key provinces in South Africa. “The pilot projects that have been done are very promising,” Dr. Goosby said, with significant potential cost savings as well.

In the prevention of mother to child transmission, PEPFAR also has targeted six countries for major investment over the next year with the goal of testing at least 80 percent of pregnant women for HIV infection and ensuring that at least 85 percent of those who test positive are offered ART.

Dr. Goosby also described an aggressive effort to ensure the most effective use of PEPFAR’s resources through an analysis of program expenditures that has already been completed in 14 countries and will now be expanded to 30 countries. “It’s not to point a finger at who is able to do it cheaper, it’s really to allow us to transform those more expensive efforts into cheaper efforts, and use that as a technical assistance tool that moves our costs down.”

For more coverage of Dr. Goosby’s presentation and other global health related sessions at the Annual Meeting, visit the Center for Global Health Policy’s blog, Science Speaks.  Audio and synchronized speaker slides from sessions are available for purchase online.
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