Tag: treatment

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.

Treatment or Prevention- What Should We Buy Into?

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Since the AIDS outbreak in the 1980s, people have been scrambling to treat those already infected and prevent further infections.  In Africa, especially, there are major obstacles to overcome.  This could explain why “two-thirds of the world’s 40 million HIV/AIDS cases are in… sub-Saharan Africa… and 72 percent of the 3 million people who died from AIDS in 2006 were Africans” (Bristol).  So how should we as global citizens try to help?  To figure out the solution one must recognize the myriad and endlessly complex obstacles getting in the way:

Obstacles to treatment:

  • Weak health systems— many African countries suffer from a “brain drain,” meaning medical students leave for school then never return to practice medicine

    Antiretroviral pills (ARVs) used to treat AIDS
    Antiretroviral pills (ARVs) used to treat AIDS
  • Lack of medial workers— “Africa… bears 24 percent of the world’s burden of disease but has only 3 percent of the global health workforce and 1 percent of its physicians” (Bristol)
  • Limited funding— most of the people who need antiretroviral (ARV) treatment are not receiving it consistently or even at all
  • Stigma of the disease— AIDS carries with it a harsh stigma, causing many to refuse to recognize it for the deadly disease that it is

Obstacles to prevention:

  • Cultural norms— many social norms stimulate the spread of AIDS, including objection to male circumcision, prevalence of male-dominated culture,  and the tendency of concurrent sexual partners
  • Misinformation & lack of education— myths are widely circulated, such as the belief that having sex with a virgin will cure a man of AIDS
  • No AIDS vaccine in sight— it will be many years until we even begin to see a cure

While there are differing opinions as to the main obstacle, ultimately we must focus on both prevention and treatment to be successful.  So where has the US contributed its funds?  Next time I will focus on some of our government’s efforts in Africa.