Briefs

WHAT YOU SHOULD KNOW

In 2015 approximately 37.6 million people worldwide were living with HIV, including 1.8 million children under the age of 15. Additionally 1.9 million adults and 190,000 children were newly infected with the disease.[1] At the same time, the number of deaths from the disease has declined by almost 50% since its peak in 2005.

Almost 20 million people – over half of the people living with HIV – are still not accessing the antiretroviral therapy (ART) they need to survive and thrive. Only about half of HIV positive children are accessing treatment, which is especially troubling since half will die by their second birthday without treatment.[2]

Women represent more than half of all people living with HIV, and young women and adolescent girls make up almost 60% of new infections among young people aged 15-24.[3] Persistent gender inequality means that women often have less power in relationships and during sexual encounters, leaving them vulnerable to coercion and gender-based violence.

Stigma and discrimination, legal barriers, and violations of human rights pose major obstacles for women, young people, and children, as well as key populations – including adolescents, men who have sex with men, sex workers, transgender people, and people who use drugs – seeking to access HIV prevention, treatment, and care services in many countries across the world.

A man in Turkana, Kenya, learns that he is HIV-negative after a rapid test in a mobile clinic. Credit: Eric Bond, Elizabeth Glaser Pediatric AIDS Foundation, 2016

37.6 million

people worldwide were living with HIV in 2015

20 million

people – over half of the people living with HIV – are still not accessing the antiretroviral therapy (ART) they need to survive and thrive

almost 60%

of new infections among young people aged 15-24 are young women and adolescent girls

RECOMMENDATIONS FOR CONGRESS

Maintain strong funding levels for global HIV/AIDS programs, including the President’s Emergency Plan for AIDS Relief (PEPFAR). U.S.-funded global HIV/AIDS programs have shown a consistent return on investment measured in lives saved, costs avoided through infections prevented, and the generation of goodwill among global partners. UNAIDS is urging a “fast-track” approach to the AIDS response in Fast-Track Commitments to End AIDS. If the Fast Track targets[4] are met, it would result in a reduction to fewer than 500,000 infections and 500,000 AIDS-related deaths by 2020. Strong support for global health programs from Congress without harmful policy riders is critical to meeting the global Fast Track targets.

Continue to support the Global Fund to Fight AIDS, Tuberculosis, and Malaria. Multilateral funding complements bilateral funding by leveraging investments from other donors, helping build country-level commitment, and strengthening capacity at all levels to deliver programs. U.S. leadership has been and remains the most important leveraging tool available to the Global Fund.

Support scientific advances toward the end of HIV/AIDS. Even with amazing strides towards ending the global AIDS crisis, many scientific challenges remain. A vaccine and a cure could be on the horizon. New technologies and prevention and treatment options could be game changers. U.S. support for HIV/AIDS research is critical, not just for those suffering from and at risk for HIV/AIDS around the world, but also for the more than 1 million people living with HIV in the United States.

WHY IS THIS INVESTMENT IMPORTANT?

U.S. support of global HIV/AIDS programming is leading the world toward continued remarkable progress against the epidemic. Linking people living with HIV to care and treatment services is critical to reaching those goals, as scientific research has conclusively shown that putting individuals on treatment is not only good for their own health, but also reduces the likelihood of transmission to others.

PEPFAR is the largest commitment by a single nation to combat a single disease globally. Since President Bush’s announcement of PEPFAR in 2003, the U.S. has invested more than $54 billion in bilateral HIV/AIDS programs as well as provided over $12 billion to the Global Fund. As of the end of Fiscal Year (FY) 2015, U.S. assistance supported more than 9.5 million patients on lifesaving antiretroviral treatment and more than 68.2 million people with counseling and testing programs.[5]

Founded in 2002, the Global Fund is a partnership between governments, civil society, the private sector, and people affected by HIV/AIDS, tuberculosis, and malaria. The Global Fund partnership has saved 20 million lives since 2002 and is on track to reach 22 million lives saved by the end of 2016. The Global Fund raises and invests nearly $4 billion a year to support programs run by local experts in countries and communities most in need. Since 2002, in countries where the Global Fund invests, there has been a decline of one-third in the number of people dying from these three diseases. The U.S. government’s financial contribution to the Global Fund continues to be one of the most effective tools for leveraging additional resources for the fight against HIV/AIDS, tuberculosis, and malaria. The U.S. has historically pledged to contribute $1 for every $2 provided by other donors. For the Global Fund’s Fifth Replenishment period – 2017-2019 – the U.S. pledged to contribute $1 for every $2 provided by other donors worldwide through September 30, 2017, up to $4.3 billion.[6]

The U.S. and international partners have greatly scaled up the services to help HIV-positive women to have HIV-negative children: over 75% of HIV-positive women received the necessary treatment and services to reduce transmission from mother to child, resulting in a 70% reduction in new infections since 2000.[7] PEPFAR provided resources and funding for the prevention of mother-to-child HIV transmission for more than 14.7 million HIV-positive pregnant women, allowing more than 267,000 infants to be born HIV-free in FY2015, cumulating in over 1.5 million infections averted in children due to PEPFAR support.[8] And as of the end of 2015, programs supported by the Global Fund provided antiretroviral HIV treatment to 9.2 million people. The number of HIV-positive women who have received services since 2002 to prevent transmission of HIV to their unborn children has reached 3.6 million.[9]

U.S. investment in HIV/AIDS and global health programs strengthens our national security and helps safeguard the health of Americans. A recent study showed that because PEPFAR is “targeted, sustained, effective, and visible,” it has significantly improved public perceptions of the U.S. across many developing countries.[10] The sustainable, long-term approach to laboratory infrastructure and human capacity development has enabled governments and the public to respond to other diseases, such as Ebola in West Africa and the Democratic Republic of Congo. We are seeing recipient countries increase their investments for HIV/AIDS and other health programs, resulting in increased sustainability in fighting their own epidemics. In 2014, domestic investment from low- and middle-income countries accounted for over half of all HIV-related spending. [11]

Resources

  1. PEPFAR http://www.pepfar.gov/funding/results/index.htm
  2. PEPFAR Dashboard https://data.pepfar.net/
  3. The Global Fund Results Report 2016 http://www.theglobalfund.org/en/blog/2016-09-01_20_Million_Lives/

Contributors

Kevin Fisher, AVAC, kevin@avac.org
Katie Lapides Coester, Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), kcoester@pedaids.org


Citations

[1] “AIDS by the Numbers.” http://bit.ly/2ambo2P.

[2] “AIDS by the Numbers.”

[3] “Prevention Gap Report.” http://bit.ly/29AURHq.

[4] “Fast-Track: Ending the AIDS Epidemic by 2030,” UNAIDS, 2014. http://bit.ly/1AeRosU.

[5] “PEPFAR 2016 Annual Report to Congress, U.S. Department of State.” http://bit.ly/2aHEZ8t.

[6] “Friends of the Global Fight.” http://bit.ly/2hyNWqm.

[7] “How AIDS Changed Everything – MDG6: 15 Years, 15 Lessons of Hope from the AIDS Response.” http://bit.ly/1CBLaGG.

[8] “PEPFAR 2016 Annual Report to Congress, U.S. Department of State.”

[9] “Friends of the Global Fight.”

[10] Goldsmith, Hirochi, and Wood. “Doing Well by Doing Good: The Impact of Foreign Aid on Foreign Public Opinion,” Quarterly Journal of Political Science, Vol 9, Issue 1, March 2014 pp. 87-114. http://bit.ly/1bD7oEE.

[11] “How AIDS Changed Everything – MDG6: 15 Years, 15 Lessons of Hope from the AIDS Response.”

©2017 Global Health Council