Fifteen years after the creation of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), control of the HIV/AIDS epidemic is within reach across much of sub-Saharan Africa. Thanks to American leadership and generosity, alongside the work of our many partners, we have saved millions of lives, averted millions of infections, and changed the course of the epidemic.
Effective public health investments are fundamentally investments in human capital and are correlated with greater economic growth and development. In the case of HIV/AIDS, the continued expansion of access to antiretroviral treatment (ART) saves lives, reduces disease transmission, and enables people living with HIV to resume their daily activities.
When HIV is unchecked and untreated, it not only has devastating consequences on an individual, but also stunts elements of broader human capital formation, including economic productivity, labor force participation, education, and entrepreneurial energy. Successful HIV prevention and treatment programs in sub-Saharan Africa must now contend with the world’s fastest growing cohort of young people, who are also disproportionately affected by HIV. Africa’s economic future stability depends on ensuring that these young people are healthy, well-educated, and able to hold and create the jobs necessary for sustained prosperity.
In this context, PEPFAR and the U.S. Department of the Treasury (U.S. Treasury) have joined forces to reinvigorate dialogue with finance ministries and key international finance institutions to improve the coordination and efficiency of current HIV programs and plan for their sustainability and the eventual smooth transition of various responsibilities.
On April 19, 2018, on behalf of PEPFAR and the U.S. Treasury, we co-hosted a high-level roundtable discussion on the sidelines of the annual World Bank and International Monetary Fund Spring Meetings in Washington, D.C. The roundtable convened leaders from the U.S. Department of State; the U.S. Treasury; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and the Joint United Nations Programme on HIV/AIDS as well as finance ministers from the countries where PEPFAR collectively invests over 90 percent of its resources.
Together, we discussed how finance ministers can play a leading role in accelerating progress toward achieving and sustaining HIV/AIDS epidemic control, including by instilling accountability and efficiency into their national health spending. In the context of increased pressure on health budgets, participants also heard details of how this could be done from the ministry of finance in Uganda, where the U.S. Treasury is providing technical assistance to support an efficient and sustainable HIV/AIDS response.
In Uganda, the U.S. Treasury is leveraging its deep institutional relationships and policy dialogue with finance ministries as well as its many years of experience providing technical assistance to governments for improving overall resource mobilization and management. The U.S. Treasury is supporting the Ministry of Finance, Planning and Economic Development to establish three key pillars of a sustained HIV/AIDS response: improved engagement and coordination with the Ministry of Health, stronger public financial management of precious health resources, and effective mobilization of domestic resources over time in close collaboration with donors.
The latest PEPFAR data show that the HIV/AIDS epidemic is coming under control in five countries and that up to 13 total countries could reach epidemic control by 2020 with PEPFAR support. These efforts will create a roadmap for health and finance ministers alike in the more than 50 countries where PEPFAR works. Yet, this will only be possible with the leadership and political will of all partners.
To build on our momentum and foster collaborative action, PEPFAR and the U.S. Treasury will follow up directly with finance ministries to drive an efficient and cost-effective response toward ending the HIV/AIDS epidemic and advancing our partners’ continued economic growth.
About the Authors: Heath Tarbert serves as Assistant Secretary for International Markets and Investment Policy at the U.S. Department of the Treasury and Ambassador Deborah L. Birx serves as U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy at the U.S. Department of State.
Editor's Note: This entry also appears in the U.S. Department of State's publication on Medium.com.