PDF _ RL34192 - PEPFAR: From Emergency to Sustainability
28-Sep-2007; Tiaji Salaam-Blyther ; 24 p.

Abstract: The Joint United Nations Program on HIV/AIDS (UNAIDS) estimates that HIV/AIDS, tuberculosis (TB), and malaria kill more than 6 million people each year. At the end of 2006, about 39.5 million people were living with HIV/AIDS, 2.3 million (6%) of whom were children under 15 years. Nearly 90% of all children infected with HIV are African. On each day of 2005, some 1,500 children around the world contracted HIV, due in large part to inadequate access to drugs that prevent mother-to-child HIV transmission (PMTCT). In that year, 8% of pregnant women in low- and middle-income countries had access to PMTCT services.

In January 2003, President George Bush proposed that the United States spend $15 billion over five years to combat the three diseases and established the President’s Emergency Plan for AIDS Relief (PEPFAR). The President proposed concentrating most of the resources ($9 billion) in 15 Focus Countries, where the Administration estimated 50% of all HIV-positive people lived. The proposal allotted $5 billion of the funds to research and other bilateral HIV/AIDS, TB, and malaria programs, and $1 billion for contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund). The President estimated that from FY2004 to FY2008, PEPFAR would support the provision of anti-retroviral treatment (ARV) to 2 million HIV-infected people; prevent 7 million new HIV infections; and care for 10 million people affected by HIV/AIDS, including children orphaned by AIDS.

In May 2003, Congress passed the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (P.L.108-25) to authorize funds for PEPFAR and create the Office of the Global AIDS Coordinator (OGAC). The newly created office was responsible for managing the flow of U.S. funds aimed at addressing the three diseases in 15 Focus Countries. As of March 31, 2007, PEPFAR has supported the treatment of 1.1 billion people; and as of September 30, 2006, supported the prevention of mother-to-child HIV transmission during more than 6 million pregnancies and facilitated care for nearly 4.5 million people, including more than 2 million orphans and vulnerable children. From FY2004 to FY2007, Congress provided nearly $13.5 billion for U.S. global HIV/AIDS, TB, and malaria programs. In FY2008, the President requested $5.8 billion for global HIV/AIDS, TB, and malaria efforts; the House proposed spending almost $6.2 billion; and the Senate proposed nearly $6.1 billion.

On May 30, 2007, President Bush requested that Congress authorize $30 billion to extend PEPFAR an additional five years. The President anticipates that from FY2009 to FY2013, the plan would support treatment for 2.5 million people, prevent more than 12 million new infections, and care for more than 12 million people, including 5 million orphans and vulnerable children. Supporters of the Administration’s plan applauded the President and congratulated him for leading global efforts to address HIV/AIDS. Critics asserted that the target of treating 2.5 million HIV-infected people was not ambitious enough and that the next five years of PEPFAR should build on the progress already made. This report focuses on some of the key issues that Congress might consider as it faces the issue of whether, and at what level, to reauthorize PEPFAR.

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Topics: International, Population, Information

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