PEPFAR Reauthorization Recommendations
The advocacy community has identified a number of issues that need to be addressed in order to strengthen the second phase of the President's Emergency Plan for AIDS Relief. These include ensuring adequate funding to achieve universal access to HIV/AIDS prevention, treatment, and care by 2010, and shifting from an emergency response to one that builds long-term, sustainable programs. In addition, it will be essential to ensure that the second phase of PEPFAR advances a truly comprehensive prevention strategy. It will also be important to assess how PEPFAR's shift away from targeting funding to specific focus countries will impact implementation and the ability of civil-society organizations to watchdog the program's effectiveness.African Civil-Society Recommendations
For the most part, the voices of African stakeholders—including local service providers, advocacy organizations, and individuals affected by HIV/AIDS in focus countries—have not been effectively engaged in the PEPFAR reauthorization debate. This reflects a major gap in understanding how PEPFAR can and should be improved, both in terms of effective implementation, as well as its impact and influence on national and international AIDS policies and programs. To help fill this gap, on December 10-11, 2007, the Kenya Treatment Access Movement (KETAM), Global AIDS Alliance, and Health GAP co-sponsored a two-day meeting in Nairobi, Kenya, that produced a series of specific recommendations for strengthening the US global AIDS initiative.
Click here to read the recommendations issued by KETAM.
Global AIDS Alliance Recommendations
GAA has identified several key priorities for strengthening the US global AIDS response:
- Allocate at least $50 billion by 2013 and provide increased support for the Global Fund to Fight AIDS, TB and Malaria.
- Shift focus from emergency response to building long-term sustainability and strengthening local capacity.
- Dedicate increased resources to strengthening health systems and health workforce capacity.
- Eliminate the requirement that PEPFAR spend one-third of its prevention budget on abstinence-until-marriage programs, and promote comprehensive, evidence-based HIV prevention strategies.
- Integrate targeted AIDS funding with more multisectoral development programs, including food and nutrition and microcredit funding.
- Preserve the 10% earmark for programs that serve orphans and vulnerable children and prioritize pediatric treatment, prevention of mother-to-child transmission, and youth HIV prevention.
- Set more ambitious targets for supporting progress toward universal treatment access by 2010.
Please click here to read GAA's priorities for PEPFAR reauthorization.
Other Civil-Society Recommendations
A number of advocacy groups, including GAA, are engaging in the PEPFAR reauthorization debate through the Global AIDS Roundtable (GAR), a coalition of groups working to improve HIV/AIDS policies. Following are links to recommendations issued by GAR and several other respected civil-society organizations.
Global AIDS Roundtable (GAR)
GAR PEPFAR Recommendations
Center for Health and Gender Equity (CHANGE)
CHANGE Press Release on PEPFAR Reauthorization
Center for Strategic and International Studies (CSIS) Task Force on HIV/AIDS
CSIS Recommendations on Prevention
CSIS Recommendations on Injection Drug Users (IDUs)
CSIS Recommendations on Health Workers and Health Systems
CSIS Recommendations on Gender
Friends of the Global Fight Against HIV, Tuberculosis and Malaria
Factsheet on PEPFAR Reauthorization and the Global Fund
Guttmacher Institute
Voluntary Contraceptive Services Key to Global AIDS Prevention Efforts
Physicians for Human Rights (PHR)
Recommendations for US Funding to Fight AIDS
Other Analysis of PEPFAR
Several studies have focused on PEPFAR's requirement that one-third of all funding to prevent the sexual transmission of HIV/AIDS be used to promote abstinence and fidelity, rather than access to condoms and other prevention methods. In April 2006, the US Government Accountability Office released a report that found this requirement is causing confusion in many countries and eroding other prevention efforts, including prevention of mother-to-child transmission programs. On the eve of World AIDS Day 2006, the Center for Public Integrity released "Divine Intervention," a year-long investigation that highlighted a number of problems with the US global AIDS initiative. And in March 2007, a report from the Institute of Medicine concluded that PEPFAR's abstinence-until-marriage earmark greatly limits the ability of countries to respond to local needs.Please click below to access these reports:
PEPFAR Implementation: Progress and Promise, Institute of Medicine, March 2007
Spending Requirement Presents Challenges for Allocating Prevention Funding Under PEPFAR, US Government Accountability Office, April 2006
Divine Intervention, Center for Public Integrity, November 30, 2006
Click here to access the official PEPFAR website.
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