15 Years of PEPFAR: Past Success and Future Progress

This year marks the 15th anniversary of the President’s Emergency Plan for AIDS Relief, or as it is better known, PEPFAR. In recognition of this milestone, PEPFAR launched a year-long campaign highlighting “15 Years of Saving Lives through American Generosity and Partnerships.” As part of the campaign, the year has been filled with events around the world and personal reflections about the incredible impact of PEPFAR. And for good reason. When then-President George W. Bush first called for the creation of PEPFAR in his 2003 State of the Union Address, more than 5,000 people were dying from AIDS every day. Today, thanks to PEPFAR and other partners, including the Global Fund, that number has been cut in half.

But that progress was far from assured 15 years ago. As discussed at the recent “15 Years of PEPFAR: Past Success and Future Progress” event hosted by Friends and several other organizations, there were serious doubts in the beginning about the impact that U.S. funding could have in the fight against HIV/AIDS internationally and questions about how PEPFAR and the Global Fund would work together. Were it not for strong bipartisan support for PEPFAR and the Global Fund over the past eight Congresses and three Presidential Administrations, then these doubts might have come true.


That sustained support, though, was not just the result of a blind trust in PEPFAR. From the very beginning, the program has used data to measure targets, demonstrate impact and ensure that successful interventions are brought to scale. As Ambassador Deborah Birx remarked, the approach has helped to look beyond what people said cannot be done to see the individuals impacted by HIV/AIDS and understand what must be done to ensure they have access to lifesaving treatment and prevention programs.


While the success of PEPFAR over the last 15 years is undeniable, it is equally true that there is much work still to be done. There were still 36.9 million people” living with HIV in 2017, and over 15 million are not yet on treatment. Addressing this and other challenges will require even stronger partnerships and increased resources from donors, the private sector and implementing countries.

At the Capitol Hill event, Dr. Mark Dybul, the first United States Global AIDS Coordinator and former Executive Director of the Global Fund, explained that PEPFAR and the Global Fund form the cornerstone of the U.S. global health portfolio. Their relationship has evolved over time, with each providing unique advantages to ensure a more sustainable response to the epidemic. The PEPFAR/Global Fund partnership and others will be crucial to ending the HIV/AIDS epidemic.


As Ambassador Birx highlighted, countries that have reached some level of epidemic control have done so through a combination of community engagement, political leadership and financing. Working together, PEPFAR, the Global Fund, implementing countries and others can ensure that the past 15 years of success are the foundation for ending the HIV epidemic for good.