http://blogs.state.gov/index.php/site/index/ en U.S. Department of State 2012-05-20T23:11:38+00:00
As we celebrate Mother's Day and think about mothers around the world, the American people are working through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) to make every day Mother's Day. This program is quietly saving lives every day, restoring the health and hope of mothers and children.

Each year, nearly 400,000 children are born with HIV around the world, with sub-Saharan Africa being the most challenged region. In June of last year PEPFAR and UNAIDS joined with other partners to launch the Global Plan, an initiative to eliminate new HIV infections among children and keep their mothers alive. Its central goal is to reduce the number of new pediatric infections by 90 percent by 2015 in 22 countries which carry 90 percent of the global burden. The goal is daunting, but achievable.

Science has long established that we have the tools to push the rate of new infections of children downward dramatically. In each PEPFAR country, we prioritize a strategic combination of activities based on sound scientific evidence to maximize impact on reducing new HIV infections among children and saving lives. It is working: in 2011 alone, we supported programs that tested nearly 10 million pregnant women. Of these, more than 660,000 pregnant women were found to be living with HIV, and provision of antiretroviral drugs (ARVs) to these women allowed more than 200,000 infants to be born HIV-free. It's hard to get a grip on such large numbers -- 200,000 babies who now have an opportunity to live long and healthy lives. What better gift can a mother receive than giving birth to a healthy child?

Throughout my travels with PEPFAR, I've met incredibly inspiring women who are so grateful for this gift. In Rwanda, I learned of Theresa and how she discovered she and her husband were HIV-positive during her third pregnancy. She immediately started on ARVs, accessed through a PEPFAR program integrated with maternal and child health services. As a result, her third and fourth children have been born HIV-free. Over this past year in Rwanda alone, we have supported these services for more than 150,000 women, and now about 90 percent of HIV-positive women deliver healthy babies in health facilities -- real progress.

Our programs offer an opportunity to improve the coverage of HIV-positive women on antiretroviral treatment -- keeping them healthy, while also significantly decreasing their risk of transmitting the virus to their unborn children and uninfected partners. When an HIV-positive pregnant woman enters the health care system, it provides an opportunity to link the rest of her family with highly effective prevention interventions, such as HIV counseling and testing for other family members, treatment for eligible male partners, voluntary male medical circumcision, and other life saving health services.

The science is clear, and though the road ahead will not be easy, the opportunity before us is extraordinary. We can now say, as Secretary Hillary Rodham Clinton did last year, that achieving an HIV-free generation is possible. As we have learned from the 30-year history and struggle of AIDS, extraordinary things happen when we work together. By uniting around our common humanity in a spirit of sharing, in responding to a challenge in front of us, we can give a chance at a full life to children and mothers around the world. Preventing new HIV infections in children is a smart investment that saves lives, and the United States is proud to partner with countries throughout the world to champion this cause.

This Mother's Day, let's sharpen our resolve to ensure that mothers everywhere have children who are born HIV-free.

Editor's Note: This entry appeared first on The Huffington Post.]]> http://blogs.state.gov/index.php/entires/mothers_pepfar/ 2012-05-13T18:54:35+00:00 PEPFAR and UNAIDS joined with other partners to launch the Global Plan, an initiative to eliminate new HIV infections among children and keep their mothers alive. Last week I was proud to take part in a two-day mission to Nigeria with Michel Sidibe, UNAIDS Executive Director. (As I described in this post last week, our visit was interrupted by the tragic bombings.)

Each year, nearly 400,000 children are born with HIV globally, and prevention of mother to child transmission (PMTCT) is a particular challenge in sub-Saharan Africa, an area characterized by weak health systems. Incredibly, Nigeria alone bears about one-third of the global burden of new HIV infections among children. It is thus one of 22 priority countries of the Global Plan, which collectively account for nearly 90 percent of all new HIV infections among children annually. The Plan's central goal is to reduce the number of new pediatric infections in these countries by 90 percent.

We know what to do to prevent vertical transmission -- the science is long-established, and many countries (including Botswana) have achieved virtual elimination. PMTCT is a top priority for PEPFAR, and in 2011 alone, we supported programs that tested nearly 10 million pregnant women. Of these, more than 660,000 pregnant women were found to be living with HIV, and antiretrovirals (ARVs) for these women allowed more than 200,000 infants to be born HIV-free. These are the highest PMTCT results of any year in PEPFAR's eight-year history.

During our mission, we met with Nigeria's First Lady, Dame Patience Jonathan, who personally leads the country's PMTCT strategy. We also met with the Nigerian Minister of Health and Governors and Health Commissioners from PMTCT focus states, who play key roles in expanding PMTCT services in the country. We also had dialogue with Nigerian business, faith-based, and community leaders about the critical contributions they can make to achieving the elimination goal. Throughout these interactions, we focused on the main barriers to PMTCT progress at both the national level and in priority states, and began to identify the most effective strategies to address these challenges collectively. We also discussed Nigeria's plans to optimize and increase all available resources in the country, in order to achieve a generation born HIV-free.

As we have learned from the 30-year history and struggle of AIDS, extraordinary things happen when we work together. By uniting around our common humanity in a spirit of shared responsibility, we can give a chance at a full life to children and mothers around the world. Preventing new HIV infections in children is a smart investment that saves lives, and the United States is proud to partner with Nigeria and other countries in this cause.]]> http://blogs.state.gov/index.php/entires/nigeria_mother_child_transmission_hiv/ 2012-04-30T22:31:56+00:00
I can't help but reflect on the juxtapositions life sometimes presents after experiencing this tragic event. It not only occurred while we were having a ceremony for our fallen UN colleagues, but during a mission to strengthen the Nigerian plan to reduce the 72,000 pediatric HIV cases born each year. To have such a senseless loss of life, in one brief moment, made me reflect on how fragile and precious life is. And it sharpens my resolve to ensure that children born to HIV-positive mothers -- and all children here -- have every opportunity to reach their full potential.

With particular sadness, I join my U.S. government colleagues in extending my deepest condolences to those who lost loved ones in the bombings, and to all the people of Nigeria.]]> http://blogs.state.gov/index.php/entires/in_nigeria_remembering_lives_lost/ 2012-04-27T16:53:27+00:00 Global Fund Board members in Geneva and I am buoyed by the reform that is happening at the Fund under the leadership of new General Manager Gabriel Jaramillo. As everyone knows, the United States has been pushing aggressively for reform, linking our historic pledge of $4 billion from FY 2011 -- 2013 to it. I am pleased to report that while we have been encouraged by the significant reforms the Fund has been pursuing over the past year, the pace of reform has now quickened -- meaning that the Fund will be able to save even more lives.

The Fund remains absolutely committed to ensuring the disbursement of approximately $10 billion in its current funding period, 2011-2013 -- $2 billion more than it disbursed between 2008 and 2010. This includes money for new, ambitious programs, such as Round 10 grants, and will allow countries to continue and, in many cases, scale up, successful programs. Moreover, Mr. Jaramillo is making significant organizational changes, increasing staffing in the priority area of grant and program management by 40 percent, while streamlining other positions to ensure effective and efficient use of all staff resources. The Inspector General will continue to work diligently to crack down on any fraud and abuse that occurs in spite of the best efforts of the Fund.

As the reform occurs, we are also beginning to see others answering the Obama Administration's call to support the Fund. On World AIDS Day, the President said, "To the global community -- we ask you to join us. Countries that have committed to the Global Fund need to give the money that they promised. Countries that haven't made a pledge, they need to do so. That includes countries that in the past might have been recipients, but now are in a position to step up as major donors." Since then, Germany, Japan, Saudi Arabia and the Gates Foundation have all pledged their support. We are aggressively leveraging President Obama's call for $1.65 billion in FY13, which fulfilled our groundbreaking multi-year pledge of $4 billion, in order to expand the total resources available for the fight.

A strong Global Fund is critical as we move aggressively to a sustainable response to HIV/AIDS. When PEPFAR and the Fund coordinate, our investments against AIDS are expanded both geographically and programmatically. Simply put, a strong PEPFAR requires a strong Global Fund. In many countries, the governments outline a division of labor among Global Fund, national, and PEPFAR resources. For example, in Angola and South Sudan, Fund grants support the purchase of ARV drugs while PEPFAR's bilateral program supports health worker training and the delivery of ARVs to patients.

In Malawi, PEPFAR and the Global Fund engage in joint programming and joint financing. Together, PEPFAR and Fund-financed programs support treatment for close to 280,000 people, reaching about 70 percent of those in need. In addition, the government of Malawi targets Global Fund financing to deeply rural communities, where 85 percent of the population lives, working through district governments and local-community based organizations. PEPFAR bilateral funding is then targeted to HIV need in more urban populations. Finally, PEPFAR and UNICEF, which receives Global Fund dollars, partner to address prevention of mother-to-child transmission. UNICEF purchases the drugs, while PEPFAR supports the supply chain, training, laboratory, and quality assurance needed for the program.

I am proud of the U.S. commitment to the Global Fund, in part because it is a commitment to the work of PEPFAR. We have a unique opportunity in a tight fiscal environment to support the Fund at this critical juncture. It is the right thing to do, and together, we will save and improve more lives.]]> http://blogs.state.gov/index.php/entires/update_global_fund_geneva/ 2012-04-09T14:13:31+00:00
In 2003, Rep. Payne was an original author of the legislation to authorize the creation of the President's Emergency Plan for AIDS Relief (PEPFAR). As the ranking member of the Foreign Affairs Subcommittee on Africa, Global Health and Human Rights, he remained a strong supporter of PEPFAR, and provided a vital voice in the global fight against HIV/AIDS.

Speaking for the PEPFAR family to whom Rep. Payne gave so much, I offer my sincere condolences to his family, friends, staff and constituents. While we mourn his loss, we also celebrate his legacy and honor the tremendous impact that his life's work will continue to have on millions of people around the world, from Newark to Nairobi. ]]> http://blogs.state.gov/index.php/entires/donald_payne_passing/ 2012-03-06T23:30:03+00:00
This budget will enable PEPFAR to achieve the President's stated goals for the program, including on prevention and supporting 6 million people on treatment by the end of 2013. As we move towards creating an AIDS-free generation, President Obama and Secretary Clinton are focused on improving and saving lives -- these outcomes are the most important metric of success. The results to date speak for themselves:

o We have more than doubled the number of individuals on lifesaving antiretroviral treatment (nearly 4 million in FY 2011, up from 1.7 million in FY 2008).
o We averted 200,000 infant HIV infections in FY 2011, through increased commitment to prevent mother-to-child transmission.
o We supported care services for almost 13 million people (including 4 million orphans and vulnerable children) in FY 2011, a 55 percent increase from FY 2008.

Under this Administration, PEPFAR has matured. We've become more efficient, increasing the impact of our work. The FY 2013 request reflects this focus on finding efficiencies and continuing to drive down costs. By using generic drugs, shipping commodities more cheaply, task-shifting to nurses and community health workers as appropriate, and linking AIDS services to other programs (such as maternal and child health), we have dramatically decreased the per-patient cost of providing treatment and other services. We have reduced PEPFAR treatment costs per person from $1,100 to $335 per person and costs continue to fall -- every dollar we invest is going farther.

The growth in country ownership of programs is another critical piece of the story. Middle income countries with PEPFAR programs have begun to increase their investments in health programs, further reducing our direct costs. South Africa is the leading example of a country that has ramped up its investment (now over $1 billion) and indicates that it will continue to do so -- a key development, as it has the largest number of people living with HIV in the world.

As the PEPFAR program matures, we are able to maximize our impact based on new prevalence data and assessments of absorptive capacity. We focus resources on countries where we can have the largest impact on the HIV epidemics, and we carefully review our levels of support in countries with low HIV prevalence or where significant other resources are available. For example, we are freeing up resources by reducing programs in lower HIV prevalence countries like Ethiopia, and are eliminating support to countries like Russia (which has stated its intention to become a donor country). Kenya is an example of a mature program focused on sustainable country systems for program implementation and building up the capacity of local implementers. As a result, we are able to adjust Kenya funding to better match its capacity to absorb funds through these new mechanisms.

The President's budget for FY 2013 requests $1.65 billion for a contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria, fulfilling his pledge to seek $4 billion over three years for the Fund. As the President has stated, the response to the global AIDS pandemic is a shared responsibility. The Global Fund is the vehicle for others to step up and increase their investments. In fact, each dollar we invest in the Fund leverages $2.50 from other donors, and we will continue to seek to leverage our donations with other partners.

In October 2010, the U.S. tied our historic multi-year pledge to the Global Fund to successful implementation of reforms that increase the impact of grants. The Fund took decisive action in adopting comprehensive reforms last year, and we are encouraged by the appointment of the Fund's new General Manager, Gabriel Jaramillo, who has promised to advance the reform agenda as rapidly as possible. As a sign of support, the Gates Foundation has recently announced a $750 million commitment to the Fund, and Saudi Arabia has stepped up and contributed to the Fund for the first time.

I want to address any concern that our increased investment in the Global Fund may interfere with PEPFAR's ability to reach its bilateral goals. I can say with conviction that if this was the case, we would not be doing it. Our Global Fund investment is critical to the ability of our bilateral PEPFAR program to reach its goals. These two U.S.-supported efforts on global AIDS are now truly interdependent and collaborative. We are jointly funding many country programs and specific service sites, and as we review our country PEPFAR programs, again and again we see that the success of Global Fund grants is a critical factor in the success of our work.

Saving lives is the bottom line, and to reach it, we need a strong PEPFAR and a strong Global Fund.

In their remarks in late 2011, President Obama and Secretary Clinton put forward the inspiring vision of an AIDS-free generation. With this budget, the United States will keep our commitments, and we will meet our ambitious targets.]]> http://blogs.state.gov/index.php/entires/budget_global_aids/ 2012-02-13T16:11:30+00:00
The launch of two groundbreaking initiatives -- the Business Leadership Council and the Social Media Syndicate -- will marshal the power of the private sector, converging business acumen, technology, and other assets to support country-led efforts to prevent new infant infections and save mothers' lives.

This exceptional commitment by the private sector stems from the Global Plan towards the Elimination of New Pediatric Infections and Keeping Mothers Alive, launched last year by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and UNAIDS. The Plan's central goal is to reduce the number of new pediatric infections by 90 percent by 2015 in the 22 countries carrying 90 percent of the global burden of vertical transmission. The science is clear -- achieving a generation born HIV-free is possible. It is a smart investment that will save lives and pay dividends in many of the world's emerging economies.

I am proud to note that in 2011 alone, PEPFAR tested nearly 10 million pregnant women. Of these, more than 660,000 pregnant women were found to be living with HIV, and antiretrovirals (ARVs) for these women allowed more than 200,000 infants to be born HIV-free. These are the highest results of any year in PEPFAR's eight-year history.

Everyone has a role to play. By working together with the private sector, we will enhance our collective impact. Leaders in business and the media have unique core competencies that only they can bring to this effort. I commend these business and media leaders for their commitment and partnership. I also encourage other companies to join this effort, and hope that other sectors will similarly pledge to do more, and do it smarter.

As we have learned from 30 years of struggle, extraordinary things happen when we work together. By uniting around our common humanity and our shared responsibility, we can change, not just the course of the epidemic, but the course of history for families and communities around the world.

Ambassador Eric Goosby serves as the United States Global AIDS Coordinator, leading all U.S. Government international HIV/AIDS efforts. In this role, Ambassador Goosby oversees implementation of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), as well as U.S. Government engagement with the Global Fund to Fight AIDS, Tuberculosis and Malaria.

For more information on PEPFAR, visit: www.pepfar.gov. Follow us on Facebook at www.facebook.com/PEPFAR and Twitter at www.twitter.com/PEPFAR.]]> http://blogs.state.gov/index.php/entires/eliminate_pediatric_aids/ 2012-02-01T15:30:29+00:00 World Health Organization estimates a shortage of at least one million frontline health workers worldwide, with Africa the region in greatest need. PEPFAR, in collaboration with partner countries, is pursuing a number of initiatives to respond.

Our efforts are being reinforced by many actors around the globe. A growing number of health organizations, recognizing the life-saving impact frontline health workers offer, are committed to employing innovative strategies to address the crisis. Tomorrow, 37 of these organizations from the public and private sector are coming together in Washington to launch the Frontline Healthcare Workers Coalition. The coalition will seek to stimulate high-impact investments in frontline health workers in the developing world, in order to save more lives and foster healthier communities.

Through PEPFAR, the United States has been a leader in making such investments. As we have moved from an emergency response toward a more sustainable, country-owned approach, we have been strengthening health systems as the foundation to achieving long-term health objectives -- such as the goal Secretary Clinton announced in November of an AIDS-free generation. PEPFAR and its implementing partners -- many of which are represented in the new coalition -- are working with partner countries to implement game-changing programs.

Two programs that exemplify our efforts to build lasting solutions are the Medical Education Partnership Initiative (MEPI) and the Nursing Education Partnership Initiative (NEPI). Through these, PEPFAR seeks to alleviate Africa's critical shortage of trained healthcare professionals and paraprofessionals, while developing sustainable local capacity to produce skilled doctors, nurses, and midwives for generations to come.

For medical education, over the five years of MEPI, PEPFAR, and the National Institutes of Health are providing $130 million directly to medical schools in a dozen African countries. The schools are using these funds to improve medical education, invest in innovative technologies, and strengthen educational resources. Funds are also used to support the research capacity of MEPI institutions, enabling African researchers and scholars to make invaluable contributions to the larger body of HIV knowledge.

In a similar fashion, PEPFAR is providing training and technical support to nursing and midwifery programs through NEPI. We recently launched NEPI in three countries -- Zambia, Lesotho, and Malawi -- that face extreme challenges in meeting the need for trained nurses and midwives, and will soon expand to additional countries. Partnering with Ministries of Health will be key to NEPI's success, and Ministries have embraced the opportunities to collaborate to develop a strong nursing workforce.

These programs are building on Africa's greatest resource of all -- its people. To make a truly lasting difference in our health and development programs, we will continue to support this kind of work. On this and our other efforts to support human resources for health, we look forward to collaborating with the members of the Frontline Health Workforce Alliance. ]]> http://blogs.state.gov/index.php/entires/frontline_healthcare_coalition/ 2012-01-10T22:39:18+00:00