Tag: HIV

Obama's Global Health Initiative

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Though PEPFAR under Bush certainly made progress in the prevention and treatment of HIV/AIDS, it is important to remember that epidemics such as these do not exist in a vacuum.  Rather, the cycle of poverty and illness is one that is self-sustaining, and aid efforts must focus relief on both sides of the equation.

The Obama administration has recognized this and developed something called the Global Health Initiative, which “adopts a more integrated approach to fighting diseases, improving health, and strengthening health systems.”  Obama’s 2010 budget brings continued awareness to broader global health issues such as child and maternal health, family planning, neglected tropical diseases, and HIV/AIDS.

Obama’s statement says, “the budget invests $63 billion cumulatively over six years (2009-2014) for global health programs. PEPFAR… will constitute more than 70 percent of global health funding.”

It seems that Bush’s plans neglected an important part of global health and poverty: family planning.  Family planning is a difficult topic in much of Africa, where a man’s wealth is measured partly by the size of his family.

Condoms are associated with STDs and with infidelity, so they are very rarely used within a marriage for family planning. Other family planning techniques, such as birth control pills and contraceptive injections, are being promoted.

Another issue that must be addressed is that there is also still some opposition within African governments to the family planning measures.

It is absolutely vital to look at the AIDS crisis in the greater sphere of global health.  Hopefully policymakers will continue to take this into consideration when they decide how aid money is spent.

Porche, a Furman student, with an AIDS orphan during Furman's study abroad program to Namibia, South Africa, and Botswana.
Porche Warren, a Furman student, with an AIDS orphan in Namibia. (Photo taken by Liz Lineback.)

Listen Listen to an interview with a Furman student about her own experiences learning about AIDS while in Africa.

View a slideshow of images showing materials brought back from Porche’s trip to Namibia, South Africa, and Botswana.


PEPFAR's Future Plans

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Though they were not the biggest focus under the Bush administration, condom programs are vital to the AIDS prevention efforts of PEPFAR.
Though they were not the biggest focus under the Bush administration, condom programs are vital to the AIDS prevention efforts of PEPFAR. (All photos taken by Liz Lineback.)

My last few posts have focused on PEPFAR’s past, for it is vital to understand an initiative’s history before realizing its next steps.  It is only through analyzing strengths and weaknesses that policymakers can create the best plan for the future.  Thus, PEPFAR was reauthorized by Congress in July 2008 to provide $48 billion in funds from FY 2009 to FY 2013.

According to the PEPFAR website, “as PEPFAR works to build upon its successes, it will focus on transitioning from an emergency response to promoting sustainable country programs.”

The goals for PEPFAR’s future are as follows:

  • Transition from an emergency response to promotion of sustainable country programs.
  • Strengthen partner government capacity to lead the response to this epidemic and other health demands.
  • Expand prevention, care, and treatment in both concentrated and generalized epidemics.
  • Integrate and coordinate HIV/AIDS programs with broader global health and development programs to maximize impact on health systems.

While these goals are lofty, these trying economics times are making foreign aid promises harder and harder to keep.  Furthermore, limited funding is creating rifts between those who think the focus should be on prevention and those who want to focus on treatment.

Some claim, “while treatment of HIV/AIDS has gained funding support, funding of prevention has lagged behind.”  Bill Gates, founder of the philanthropic Gates Foundation, said, “The harsh mathematics of this epidemic prove that prevention is essential to expanding treatment, and that stressing treatment without paying adequate attention to prevention is simply unsustainable.”

While distribution of funds is never an uncomplicated task, it is certainly an important one for Obama to keep in mind as PEPFAR progresses.  In my next post I will update you on more of Obama’s developments.

Bush's Positive Legacy

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President Bush signing PEPFAR
President Bush signing PEPFAR

There are many who consider the most significant positive legacy of George W. Bush’s eight years as President of the US to be his implementation of PEPFAR: the President’s Emergency Plan for AIDS Relief.  Developed in 2003, the initiative designated $15 billion dollars to be spent on AIDS relief efforts.  $9 billion of this was allocated to 15 focus countries that are most harshly affected by the disease, 12 of which are in sub-Saharan Africa.  The goals of the effort were lofty:

  • Provide treatment to 2 million people with HIV infection
  • Prevent 7 million new HIV cases
  • Provide care to a further 10 million people affected by AIDS

Reporting directly to the Secretary of State, OGAC (the Office of the Global AIDS Coordinator) managed the implementation and realization of the initial “2-7-10 by 2008” goal.

In November of 2008, President Bush announced that both the treatment and the care goals had been met.  Yet prevention of a disease is much harder to gauge because it is difficult to measure a non-event.  For example, the distribution of one condom could be counted as one case of AIDS prevented, when no foreign aid worker can truly know whether or not that condom was used.

PEPFAR has certainly done a lot of good on the African continent, especially in sub-Saharan Africa where AIDS relief is so needed.  Yet Bush’s program was not without stipulations, many of which clashed with traditional African social norms.  Many think that even though PEPFAR has done great things, more significant results could have been achieved.  In my next posts, I will go into more detail about how the PEPFAR funds were divided and allocated.