Recently the President´s Emergency Fund for AIDS Relief(PEPFAR) and Warner Bros. Entertainment proudly unveiled a trailer "Saving Lives Creating Hope." Developed through a public-private partnership between PEPFAR and Warner Bros., the engaging new trailer gives audiences a sneak peek of PEPFAR's "Saving Lives Creating Hope" documentary. For those working with PEPFAR, a bold US foreign policy initiative in helping developing countries in the fight against global AIDS, it is an unforgettable tale of the human spirit, of bold leadership and the transformational power of partnerships. In the documentary, government, faith, community and private sector leaders from Haiti, Rwanda and Tanzania share inspiring stories of the impact of PEPFAR in their daily lives.
In 2007, the world saw much positive global coverage on AIDS and fulfilling the leadership challenge in broaching the development and health crises. One of the good intervention models that was mentioned repeatedly by the global media was the President´s Emergency Fund for AIDS Relief (PEPFAR) which has got distinctive global goals and priorities, some of which can be considered ambitious but still achievable. In its recent results, PEPFAR mentioned it was quite on target to achieve the ambitious goals of supporting treatment for two million people, prevention of seven million new infections, and care for 10 million people infected and affected by HIV/AIDS globally, including orphans and vulnerable children.
On February 28, 2008, US House leaders from both the Republican and Democratic parties and the White House reached an important agreement to introduce a new US bill that authorizes $50 billion worth of funding for five years to prevent infection, treat people already suffering from HIV/AIDS, provide clinical and home based care, and support to mothers and children orphaned by the epidemic. The bill is already being raved globally as a genuine US leadership initiative in stopping AIDS.
On March 11, 2008, Ambassador Mark Dybul, US Global AIDS Coordinator, stated before the United States House, "When the history of public health is written, the global HIV/AIDS action of the American people will be remembered for its size, but also for its scope: the insistence that prevention, treatment and care -- all three components, with goals for each -- are all required to turn the tide against HIV/AIDS." While advocating a program balance and stressing prevention, Mr. Dybul mentioned," PEPFAR is well on the way to achieving its ambitious five-year targets of supporting treatment for two million people, prevention of seven million new infections, and care for 10 million people infected and affected by HIV/AIDS, including orphans and vulnerable children. PEPFAR-supported programs have reached tens of millions of people with prevention messages. Since 2004 the U.S. Government has shipped more than 1.9 billion condoms worldwide – as Dr. Piot of UNAIDS has said, more than all other developed countries combined. PEPFAR has supported antiretroviral prophylaxis in more than 827,000 pregnancies, preventing an estimated 157,000 infant HIV infections." Five of the focus countries have greater than 50 percent coverage of pregnant women – the goal of the President´s International Mother and Child Prevention Initiative (which preceded the Emergency Plan) – and Botswana has achieved a 4 percent national mother-to child transmission rate, which approximates that of the U.S. and Europe.
According to Mr. Dybul, with PEPFAR support, focus countries have scaled up their safe blood programs, and 11 of them can now meet fifty percent of their annual demand for safe blood. Through September 2007, PEPFAR supported antiretroviral treatment for approximately 1.45 million men, women, and children worldwide. Of these, approximately 1.36 million are in the 15 focus countries, and more than 1.33 million are in Sub-Saharan Africa.
PEPFAR´s major concentration still happens to be the 15 individual countries having the world´s highest infection rates. Earlier this year, President George W. Bush, First Lady Laura Bush and daughter Jena Bush, who has been active in youth involvement in global AIDS prevention, visited some of the African countries that had suffered from the impact of prolonged AIDS crises.
According to PEPFAR, some of the countries such as Botswana, Nigeria, Rwanda, South Africa, Tanzania and Zambia have been able to make real achievements in their antiretroviral treatment programs due to timely program support from PEPFAR. Most PEPFAR results have also consistently proven reliable and in consonance with targets set by the countries and global experts, including UNAIDS and WHO. However there is also requirement to accelerate Public-Private Partnerships with the developing countries in the spirit of what Richard Holbrooke, a prime advocate, often describes as catalyzing effective solutions that come from the AIDS affected countries themselves. It would still mean encompassing newer forms of health information dissemination using strategic and behavior change communications, active local community mobilization, and pro-active partnership development with the global private sector which has shown much interest in President Bush´s initiatives to date.
Why do the US´s AIDS initiatives work so well? The answer might be, under PEPFAR, all US government bilateral HIV/AIDS programs are developed and implemented within the context of multi-sectoral national HIV/AIDS strategies under the host country´s own national authority and governance. The local health authorities implement, own and evaluate their own programs which assures an element of inborn success. It seems PEPFAR´s assistance is usually geared toward program innovation and sustenance, reflecting the comparative advantage of its involvement in national strategy development, and extending to other partnerships with international and private-sector resources.
At the beginning of 2008, UNAIDS mentioned there was still urgent need to deal with the risk of program duplication, overlap and fragmentation of response due to heavy involvement of international donors. In these initiatives, Dr. Peter Piot, head of UNAIDS has personally praised PEPFAR´s global role, its easily verifiable interventions, data indicators and results outputs. PEPFAR has been solely credited by many developing countries leaders, in helping them develop a nationally owned and led AIDS response. President Bush´s leadership role in helping PEPFAR assist the poorer countries on a compassionate basis, has also been widely appreciated in both developing and developed countries. For developing countries' leaders, curbing AIDS rates us important to sustaining national progress. It is now also a well appreciated aspect of the US State Department´s foreign assistance goals to lesser advantaged countries.
While some have mentioned in the American media that PEPFAR has become synonymous for concrete foreign policy gains for the Bush administration, to the developing countries leaders, it is also a doable venture where effective American AIDS intervention strategies are helping them on a daily basis and in a realistic manner. For instance, in the sub-Saharan region, PEPFAR has been targeting government, public-private sector initiatives, church and other religious groups, women and children´s groups and youth through active behavioral change communications and community mobilization programs which were prior absent to US involvement.
Many developing countries media have considered it praiseworthy that fighting AIDS is now a major focus of US foreign policy and multilateral assistance, including through the UN. During the recent visit to Africa, particularly in Tanzania, President Bush got to see first hand many programs under PEPFAR. Many African leaders pointed out to US administration officials that though PEPFAR looked huge to them, it was still like the tip of an ant hill with many more mountains to be climbed for people living with AIDS and their affected family members throughout the continent. President Bush stated, "We don't want people guessing on the continent of Africa whether the generosity of the American people will continue." Now, President Bush has received not only a resounding bi-partisan endorsement to his message of hope for Africa and the rest of the world, he has received global appreciation for this important effort in American diplomacy. PEPFAR definitely has got many successes in focusing on saving lives and creating hope globally in its fight against AIDS; these efforts must continue consistently in the future enveloping innovative program development and the continuity of its excellent public-private partnerships. Nepal too is receiving generous US aid in helping fight AIDS.
(Surya B. Prasai is a global strategic communications, media and interantional development consultant based in Maryland, whose views reguarly appear in some eminant global media on a regular basis, including Google and Yahoo Global News networks on international affairs.)
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