In 2019 approximately 38 million people worldwide were living with HIV, including 1.8 million children under the age of 15. During 2019, 1.7 million adults and 150,000 children were newly infected with the disease. At the same time, the number of deaths from the disease has declined by more than 60% since its peak in 2004.
More than 12.6 million people — a third of those living with HIV — are still not able to access the antiretroviral therapy they need to survive and thrive. Only half of HIV-positive children currently access treatment, which is especially disturbing, because half of them will die before their second birthday if they remain untreated. 
Women represent more than half of all people living with HIV. Young women and adolescent girls are only 10% of the world’s population, yet make up 25% (1 in 4) of new infections, with 5,500 young women acquiring HIV every week. [1, 2] 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, discrimination, legal barriers and violations of human rights pose major obstacles for women, young people and children seeking access to HIV treatment, prevention and other health care services. This is also the case for other key populations, including adolescents, men who have sex with men, sex workers, transgender people and people who use drugs. New HIV infections are essentially flat and accelerated action is needed to drive down new infections.
Maintain strong funding levels for global HIV/AIDS programs, including PEPFAR. Global HIV/AIDS programs funded by the United States have shown a consistently high return on investment, measured in lives saved, infections prevented, subsequent costs avoided, and goodwill generated among global partners. Strong support from Congress for global health programs without harmful policy riders is necessary to meet the global targets and accelerate the end of AIDS. 
Continue to support the Global Fund to Fight AIDS, Tuberculosis and Malaria. Multilateral funding complements bilateral funding by leveraging investments from other donors, building country-level commitments, and strengthening capacity at all levels to implement programs. U.S. leadership is the most important tool for making investments from other countries available to the Global Fund.
Support scientific advancement toward the eradication of HIV/AIDS. Despite the strides taken toward ending the global AIDS crisis, many challenges remain. A vaccine or a cure could be on the horizon. New technologies, prevention methods and treatment options could also be game changers. U.S. support for HIV/AIDS research is crucial, not just for those suffering from and at risk for HIV/AIDS around the world, but also for the 1.2 million people currently living with HIV in the United States.
Photo Credit: World Vision Giving children the best possible start in life through Go-Baby-Go 23-year-old Hasnat, spends some time playing and interacting with her son, Mohammed, at the World Vision nutrition centre
Photo Credit: Humana People – Planet Aid
U.S. support of global HIV/AIDS programming is leading the world toward remarkable progress. Linking people living with HIV to care and treatment services is essential for continuing this progress, 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 represents the largest commitment ever made by a single nation to combat a specific disease on a global scale. Since its establishment in 2003, the United States has invested more than $70 billion in bilateral HIV/AIDS programs. As of September 2020, U.S. assistance supported more than 17.2 million patients on lifesaving ART and, in fiscal year 2020, the PEPFAR program supported 50 million people with counseling and testing programs.
The U.S. and international partners have greatly scaled up services to help HIV-positive women to have HIV-negative children: 80% of HIV-positive women received the treatment and services necessary to reduce transmission from mother to child, resulting in 60% fewer new infections since 2000. PEPFAR-provided resources and funding for the prevention of mother-to-child HIV transmission has led a cumulative 2.8 million children to be born HIV-free.
A recent study showed that countries where PEPFAR operates have seen greater growth in worker productivity and economic development than other countries. Positive effects also spill over into other areas, such as improvements in government effectiveness, regulatory quality and the rule of law. Additionally, current and former U.S. ambassadors report that these investments allowed for greater U.S. engagement with partner countries and strengthened diplomatic relationships.
The sustainable, long-term approach to laboratory infrastructure and human capacity development has enabled governments and the public to better respond to other disease outbreaks. Recipient countries are also increasing their investments for HIV/AIDS and other health programs, resulting in greater sustainability in fighting their own epidemics.
The COVID-19 pandemic is not only directly affecting the health of millions globally, it is disrupting essential health services, leading to secondary impacts of the disease. This is especially evident with access to HIV care and treatment and prevention services in many countries, resulting in missed clinic visits to pick up ART and restricted access to prevention services. Global efforts to end HIV, like those funded through the U.S. President’s Emergency Plan For AIDS Relief, or PEPFAR, must ensure programmatic gains are maintained during the pandemic or there will be backsliding on years of progress toward ending HIV and AIDS.
PEPFAR Funding Results 2019 http://bit.ly/1DyH90S
PEPFAR Dashboards https://data.pepfar.net
Global Fund 2019 Results: 32 Million Lives https://www.theglobalfund.org/media/8752/corporate_2019resultsreport_report_en.pdf
 “Global HIV & AIDS statistics — 2020 fact sheet,” UNAIDS. https://www.unaids.org/en/resources/fact-sheet
 “Global AIDS Update 2018: Miles to Go,” UNAIDS. http://bit.ly/2JgiZCJ.
 “Fast-Track: Ending the AIDS Epidemic by 2030,” UNAIDS. https://www.unaids.org/sites/default/files/media_asset/JC2686_WAD2014report_en.pdf
HEADER PHOTO CREDIT: International Medical Corps Burundi Training Of Trainers