HIV/AIDS, PEPFAR and the Global Fund

FY2016 Funding Recommendation:  
$6.738 billion


Funding History


       President's FY2016 Request   

       InterAction's FY2016 Recommendation


 Key Facts

  • Since 2001, new HIV infections have decreased by 38%, and new HIV infections among children have declined by 58%.

  • In FY2014, PEPFAR supported HIV testing and counseling for more than 14.2 million pregnant women. Of the women who tested positive, PEPFAR provided antiretroviral medications to prevent mother-to-child transmission, resulting in 95% of these babies being born HIV-free. 

  • The Global Fund is the world’s largest global health financier and has approved more than $30 billion in grants to programs serving women, men, and children in more than 140 low and middle-income countries.   

Since its outbreak in the early 1980s, HIV/AIDS has killed approximately 36 million individuals worldwide. In 2013, there were 35 million people living with HIV/AIDS. This pandemic has affected men and women of every race, and in every country. Thankfully, as the world has answered the rallying call to “get to zero,” the end of this pandemic may be within reach. The science, research, tools, technology, and methods for testing, treatment, and behavior change are in place to bring about an end to this debilitating disease. The United States has played a crucial role in getting the world to this point: USAID, the State Department, Centers for Disease Control and Prevention, the National Institutes of Health and the Global Fund to Fight AIDS, Tuberculosis and Malaria have been key contributors in the fight against HIV/AIDS, and their integrated programing has advanced the effort to “get to zero.” InterAction recommends $6.738 billion for HIV/AIDS programming within USAID and the State Department. This funding recommendation is broken down into three components:

USAID - HIV/AIDS: $350 million

USAID is one of the leading implementers of the President’s Emergency Plan for AIDS Relief (PEPFAR). Through this and other programs, USAID provides HIV testing and counseling, works with pregnant women to prevent the transmission of HIV to their children, promotes voluntary medical male circumcision and the use of condoms, works to ensure safe and reliable access to medication, and supports research on products to prevent the spread of HIV. USAID’s HIV/AIDS programs work to scale up proven interventions, while promoting newly-developed innovations and best practices. Funding for two essential partnerships – the Commodity Fund and the International AIDS Vaccine Initiative – help increase condom availability and promote the development of an effective HIV vaccine.

PEPFAR: $5.038 billion

PEPFAR is the United States’ leading program to combat HIV/AIDS through prevention, treatment, care, and the strengthening of health systems through bilateral and multilateral programs. As of September 30, 2014, PEPFAR was supporting antiretroviral treatment for 7.7 million people. It has also ensured that over 1 million babies have been born HIV free. Scientific advances since the beginning of PEPFAR have improved how we respond to the global HIV/AIDS epidemic, and in turn have made U.S.-funded programming more efficient and effective. Building on over a decade’s worth of investment, PEPFAR is now refocusing its programmatic efforts on controlling the epidemic – prioritizing high-impact interventions and using data to determine where and how they are used in the field. For instance, PEPFAR is using district and site-level data to help determine which geographic areas within a country have the most HIV-burden and directing investment to those so-called “hot spots” in order to maximize programmatic and epidemiological impact. PEPFAR is also committed to principles of sound science, focusing on good public health, as well as promoting sustainability and shared responsibility with the host countries in which PEPFAR works.

Global Fund to Fight AIDS, Tuberculosis and Malaria: $1.35 billion

The Global Fund is a 21st-century organization designed to accelerate the end of AIDS, tuberculosis, and malaria as epidemics. Founded in 2002, the Global Fund is a partnership between governments, civil society, the private sector, and people affected by the diseases. The Global Fund raises and invests nearly $4 billion a year to support programs run by local experts in more than 140 countries, and regularly seeks out technical guidance from PEPFAR and the President’s Malaria Initiative. As of December 2014, the Global Fund had provided HIV/AIDS treatment to 7.3 million people. In addition, 2.7 million HIV-positive pregnant women received care to prevent mother-to-child transmission. The Global Fund has distributed 450 million insecticide-treated bed nets, treated 470 million cases of malaria, and detected and treated 12.3 million cases of tuberculosis. The Global Fund held its 4th Voluntary Replenishment Conference in Washington, DC, on December 2-3, 2013 where it raised $12.01 billion, which includes funding from 25 countries and represents a 30% increase from the 2010-2013 pledging period. To date, the Global Fund has successfully raised $12.32 billion in pledges for the 2014-2016 period. The U.S. committed up to $5 billion to the organization for Fiscal Years 2014-2016.

The global fight against HIV/AIDS is at a critical juncture: investments in the global AIDS response are working, and the pace of progress is accelerating. Twenty-seven countries have seen a 50% or greater drop in new HIV infections since 2001, and there are 12.9 million people accessing antiretroviral treatment worldwide, up from just 300,000 in 2002. We are also seeing new partnerships based on the principles of shared responsibility and global solidarity. In 2013, domestic investment made by low and middle-income countries totaled $9.65 billion.

The knowledge and innovations acquired over the last 10 years have led us to reach the global tipping point on AIDS– meaning more people are now on treatment than becoming newly infected. But this milestone is fragile – the United States must not let current budgetary constraints undo the success of the past few years. If we do not act, we may lose our best chance to end this epidemic.

Success Story:

Creating a sense of belonging for vulnerable children in Ethiopia

After losing her parents seven years ago, Rhobot moved to live with her ailing grandmother in Shawshamenee, central Ethiopia. Rhobot’s academics began to suffer both because of her new household and care responsibilities. When her grandmother’s condition worsened, Rhobot went to live with her aunt and enrolled in Halaba Edget Primary School.

Like many schools in Ethiopia, Halaba Edget has a large population of students that have lost one or both parents to AIDS. After enrolling, Rhobot began to receive support from World Learning’s School-Community Partnership Serving Orphans and Vulnerable Children Affected by HIV/AIDS (SCOPSO) project, a USAID initiative funded by PEPFAR. It provided her with vital resources to thrive in school. This assistance helped change her attitude about school and her academic performance significantly improved.

“Before, I was not happy to come to school because I did not have clothing and stationery material,” Rhobot said. “Now I receive a uniform, school supplies, and food support and I am very happy to attend school.”

Rhobot has also become an active member of Aflatoun, an after-school program sponsored by SCOPSO that emphasizes financial literacy, responsibility, and citizenship while building friendships among participants.

“We learn about saving and spending,” Rhobot said. “We learn how to develop ideas and implement them practically.”

SCOPSO provides children with the basic materials they need to attend school – a uniform, school supplies and a full stomach. But more importantly, the project builds strong communities and promotes a sense of belonging.

Rhobot said there were no students like her in her old school, but at Halaba she says there are students with similar backgrounds.  They encourage and support one another, which has helped shape Rhobot’s future plans. Now in seventh grade, she says, “I want to stay in school and become a doctor so I can help my community.”

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