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PEPFAR's Vital Role in the Fight Against AIDS


U.S. foreign assistance programs like the President's Emergency Plan for AIDS Relief has helped reverse the growth of HIV/AIDS in many developing countries and could provide tactics for reducing the epidemic in the United States. Photo courtesy The Bill and & Melinda Gates Foundation.

To a large degree, the International AIDS Conference under way in Washington, DC, is a celebration of life. Yes, the deadly disease continues to loom over our world, with no known cure, but HIV/AIDS is no longer a death sentence—for those who realize that they have the disease and have access to life saving medicines. After doctors began treating HIV with powerful combinations of antiretroviral drugs in 1996, life expectancies for those infected changed from months to a full, normal spans.

Around the world, the number of people newly infected has steadily declined in recent years as has the number of AIDS-related deaths. According to Dr. Diane Havlir, U.S. Co-Chair of AIDS 2012, new scientific breakthroughs have given leaders in the AIDS movement hope that we may be beginning to see an end to the epidemic.

Progress against HIV/AIDS has been a remarkable achievement in which diverse communities worked together to apply political pressure, find funding, conduct research, and share tactics. U.S. foreign assistance programs like the Presidents Emergency Plan for AIDS Relief (PEPFAR) has provided support to tens of millions of people through prevention, treatment, and care. Bread for the World members have advocated for funding for PEPFAR since it was launched in 2003.

In 2009, Bread for the World shared the story of Florence Chakulya, a midwife in Zambia who is preventing the transmission of HIV from mother to child, one pregnancy at a time—with resources provided by PEPFAR. Although she often must work by candlelight, Chakulya is able to give each of her clients an HIV test and adminster Nevirapine, a drug that helps to prevent transmission of the HIV virus from a mother to her baby during delivery. In this way, the battle against AIDS is being won.


Yet, even as we rightfully celebrate the lives spared, HIV/AIDS continues to ravage segments of the population here in the United States. Three percent of residents of our nation’s capital are HIV-positive. That number rises to 7 percent among African-American men. In fact, the infection rate in the AIDS Conference’s sponsoring city is higher than in African countries like Ethiopia, Nigeria and Rwanda. And the problem is not confined to the District of Columbia. According to the Centers for Disease Control, infection rates are at an all-time high across the United States, particularly in urban centers: nearly 1.2 million people in the United States are infected with HIV, with a thousand new cases every week.

Dr. Gregory Pappas, director of HIV/AIDS treatment with the District of Columbia Department of Health has identified poverty and poor education as the main causes of new infections in the United States. In a recent PBS News segment, Ray Suarez, spoke with Pappas and other people working on the front lines of the epidemic to see what lessons the United States could learn from successes in less developed countries.

One of the panelists was Dr. Wafaa El-Sadr , director of the International Center for AIDS Care and Treatment. According to El-Sadr, PEPFAR has been a prime factor in slowing the transmission of HIV/AIDS in Africa. “I realize, sometimes, when we say that the epidemic in parts of the United States is similar to epidemics in parts of Africa that this is a quite alarming statement,” said El-Sadr. But she added that U.S. programs of prevention and treatment could be improved by examining PEPFAR programs.

El-Sadr says that the cornerstone of PEPFAR has been community involvement and direct outreach, approaches that she believes could make a big difference in communities in the United States that are still ravaged by the disease. Pappas agreed “There are people, village workers that go from house to house and encourage people to take their medication. That same sort of approach, that community-based approach to helping people stay in care, is what we have got to get to in the United States.”

As the International AIDS Conference continues this week in Washington, DC, it is worth reflecting on the part that Bread for the World members have played in fighting AIDS through their support of U.S. foreign assistance programs like PEPFAR. And it provides a reminder of the importance of keeping such assistance in the federal budget. The support that we give to communities abroad can be like bread upon the waters as strategies developed in African communities find application in here in the United States—perhaps even in our nation's capital.

+ Find out more about foreign assistance programs like PEPFAR.

+ Read "Babies by Candlelight," and watch a digital story about Florence Chakulya and the women of Kampekete, Zambia.

Eric Bond is the managing editor at Bread for the World.

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