NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Monday, April 17, 2017

There is much concern about the future of the President’s Emergency Plan for AIDS Relief, or PEPFAR, under the new administration. Since the creation of PEPFAR in 2003, the US has been the global leader in responding to the urgent need for the treatment and prevention of HIV/AIDS, and the care of orphaned and vulnerable children affected by the disease. With bipartisan support in Congress, PEPFAR was initiated under the Bush administration and continued under the Obama administration.

While the initial goals of the program were emergency relief to respond to the devastating consequences of the unfolding AIDS crisis, the program created new aims to strengthen health systems and make country programs more sustainable when it was re-authorized in 2008. In the Institute of Medicine’s evaluation of PEPFAR, released in 2013, Chair of the Committee on the Outcome and Impact Evaluation of Global HIV/AIDS Programs Robert Black cited PEPFAR as a “globally transformative” program that changed the paradigm of global health by achieving ambitious goals while demonstrating humanitarian commitment to a public health crisis.

Health Affairs has published a number of articles on PEPFAR’s impact over the years, and in 2012 we published a theme issue that reviewed the first 10 years of PEPFAR implementation. At a time when the future of the program is in doubt due to possibly severe budget cuts to the US State Department (where PEPFAR is based) proposed by the new administration, we thought it would be an opportune moment to highlight some of the key studies we have published exploring PEPFAR’s role in fighting the HIV/AIDS epidemic.