Evaluation of PEPFAR (2013) / Chapter Skim
Currently Skimming:
1 Background
1 Background
Pages 19-38
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 19... ...
Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 P.L. 110-293 110th Cong., 2nd sess.
|
From page 20... ...
. Although HIV continues to affect all regions of the world, the greatest burden of HIV falls on sub-Saharan Africa, which is home to 69 percent of people living with HIV and, in 2011, had the highest number of new HIV infections.
|
From page 21... ...
. The authorizing legislation clearly articulated the urgent need to scale up and rapidly implement HIV services and interventions for prevention, care, and treatment in countries most affected by the HIV pandemic.3 Even 2 United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003, P.L.
|
From page 22... ...
. shall be expended for assistance for orphans and vulnerable children affected by HIV/AIDS."12 PEPFAR's goals, budgetary allocations, and targets are summarized later in this chapter in Table 1-2.
|
From page 23... ...
The President's Emergency Plan for AIDS Relief: First Five-Year Strategy The first U.S. Five-Year Global HIV/AIDS Strategy, instituted in response to the legislation's mandate, was titled "The U.S.
|
From page 24... ...
The initial strategy also specified several principles to guide these goals, including respond urgently to the HIV/AIDS crisis; seek novel approaches; devise ways in which to measure goals and ensure accountability; develop and implement programs that align with the objectives of partner countries; integrate prevention, care, and treatment programs; and build and strengthen national capacity. The strategy also laid out the following specific targets for PEPFAR: prevent 7 million new HIV infections by 2010, provide treatment with antiretroviral (ARV)
|
From page 25... ...
. The first IOM evaluation centered on the idea of "harmonization" and focused on PEPFAR's contribution to capacity building in partner countries to address HIV/AIDS (IOM, 2007)
|
From page 26... ...
26 EVALUATION OF PEPFAR TABLE 1-1 PEPFAR HIV/AIDS Programs in 2004 Region/Country USAID HHS DoD DoL Peace Corps Sub-Saharan Africa 1 Angola B B B 2 Benin B B B V 3 Botswana R B B B V 4 Burkina Faso R B V 5 Burundi R B 6 Cameroon R B V 7 Cape Verde R 8 Chad R B V 9 Congo, D.R. of B B B 10 Côte d'Ivoire R B 11 Djibouti R 12 Eritrea B B 13 Ethiopia B B B B 14 Gabon B V 15 Gambia, The R 16 Ghana B B B V 17 Guinea Bissau R 18 Kenya B B B B V 19 Lesotho R B B V 20 Liberia R 21 Madagascar B B V 22 Malawi B B B B V 23 Mali B B V 24 Mauritania B 25 Mozambique B B B B V 26 Namibia B B B B V 27 Niger R V 28 Nigeria B B B B 29 Rwanda B B 30 Senegal B B B V 31 Sierra Leone R B 32 Somalia R 33 South Africa B B B B V 34 Sudan R 35 Swaziland R B B V 36 Tanzania B B B B V 37 Togo R B B V 38 Uganda B B B B V 39 Zambia B B B B V 40 Zimbabwe B B B B
|
From page 27... ...
BACKGROUND 27 TABLE 1-1 Continued Region/Country USAID HHS DoD DoL Peace Corps Asia and Near East 41 Bangladesh B 42 Burma R 43 Cambodia B B B B 44 China R B 45 East Timor R 46 Egypt B B 47 India B B B B 48 Indonesia B B B 49 Jordan B 50 Laos R B 51 Nepal B B V 52 Papua New Guinea R 53 Philippines B 54 Thailand R B B 55 Vietnam R B B B 56 West Bank/Gaza B Europe and Eurasia 57 Albania B V 58 Armenia B 59 Azerbaijan B 60 Belarus B 61 Bosnia R 62 Bulgaria R 63 Croatia R 64 Estonia R 65 Georgia B B 66 Kazakhstan B B V 67 Kosovo B 68 Kyrgyzstan R B 69 Latvia R 70 Lithuania R 71 Macedonia R 72 Moldova B 73 Romania B B B V 74 Russia B B 75 Serbia R 76 Tajikistan R B 77 Turkmenistan R V 78 Ukraine B B B V continued
|
From page 28... ...
The 14 focus countries named in the original authorizing legislation are italicized. SOURCE: Appendix F from PEPFAR's First Five-Year Strategy (OGAC, 2004)
|
From page 29... ...
Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 The U.S. Congress passed the Tom Lantos and Henry J
|
From page 30... ...
The reauthorization legislation also established the goal of supporting the provision of ART to people with HIV/AIDS, beyond the initial goal of 2 million under the Leadership Act of 2003, and set new programmatic requirements, many of which were related to prevention activities.25 In addition, it removed almost all of the highly specific fiscal benchmarks that were instituted in the original legislation. The benchmarks remaining were a preservation of the earmark to use 10 percent of funding for orphans and vulnerable children26 and a revision to now require that more than half of the funds be spent on ART and other care and treatment services.27 For prevention, the Lantos-Hyde Act of 2008 required the Coordinator to establish a balanced HIV sexual transmission prevention strategy to govern expenditures for prevention activities in countries with 21 Supra, note 1.
|
From page 31... ...
. based on objective epidemiological evidence as to the source of infections and in consultation with the government of each host country involved in HIV/ AIDS prevention activities."28 Second PEPFAR Five-Year Strategy In December 2009, Ambassador Goosby released a new legislatively required PEPFAR Five-Year Strategy, which included the targets written into the reauthorization legislation, but specified that the treatment target should provide direct support for more than 4 million people (OGAC, 2009a)
|
From page 32... ...
Invest in innovation and operations research to evaluate impact, improve service delivery, and maximize outcomes PEPFAR Budgetary Allocation Requirements Authorizing Legislationa Reauthorization Legislationb 2003 2008 Therapeutic medical care: Not less than 55 percent, Care and Treatment: More than 50 of which at least 75 percent for the purchase and percent for antiretroviral treatment distribution of antiretrovirals and at least 25 percent for HIV/AIDS; clinical monitoring for related care of HIV-seropositive people not in need of antiretroviral treatment; care for associated opportunistic infections; nutrition and food support for people living with HIV/ AIDS; and other essential HIV/ AIDS-related medical care for people living with HIV/AIDS Palliative care: 15 percent Prevention: 20 percent, of which not less than 33 Prevention: Balanced funding for percent for abstinence-until-marriage programs prevention activities for sexual transmission of HIV/AIDS, based on objective epidemiological evidence and in consultation with the governments of partner countries involved in HIV/AIDS prevention activities. For countries with a generalized epidemic, justification is required if less than 50 percent of this funding is allocated for promoting abstinence, delay of sexual debut, monogamy, fidelity, and partner reductionc Orphans and vulnerable children: Not less than 10 Orphans and vulnerable children: percent Not less than 10 percent
|
From page 33... ...
(Through 2013) Treatment for 2 Treatment for at Treatment for more than 4 Treatment for 6 million least 3 million million million Prevention of Prevention of Prevention of more than 12 7 million new 12 million new million new infections infections infections Reduce the rate 80 percent access 80 percent coverage of of maternal- to counseling, testing for pregnant women; to-child testing, and 85 percent coverage of transmission by treatment to antiretroviral prophylaxis, and 20 percent by prevent the treatment as indicated, for 2005 and 50 transmission of HIV-positive pregnant women; percent by 2010 HIV from mother 480,000 babies of HIV-positive to child mothers born HIV-negative 65 percent coverage of early infant diagnosis and 80 percent coverage of testing for older children of HIV-positive mothers Provision Provision of care Provision of care to more than of care to to 12 million, 12 million, including 5 million 10 million, including 5 orphans and vulnerable children including million orphans orphans and and vulnerable vulnerable children children Care and treatment services to children with HIV in proportion to their percentage within the HIV-infected population Training and Training and retention of more retention of than 140,000 new health care 140,000 new workers health care workers continued
|
From page 34... ...
Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, P.L. 110-293, 110th Cong., 2nd sess.
|
From page 35... ...
. At the meeting of the International AIDS Society in July 2012, PEPFAR announced several new investments, including $80 million to support innovative approaches to ensure treatment for HIV-positive pregnant women; $40 million to support voluntary medical male circumcision in South Africa; $15 million for implementation research to identify the specific interventions that are most effective for reaching key populations; $20 million for a challenge fund to support country-led expansion of services for their key populations; and $2 million to bolster civil society efforts to address key populations (Clinton, 2012)
|
From page 36... ...
Global AIDS Coordinator, Ambassador Eric Goosby, was named to also lead the Office of Global Health Diplomacy (Goosby, 2012; McNeil, 2012)
|
From page 37... ...
Journal of Acquired Immune Deficiency Syndromes 60(Suppl 3)
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.