The American program that brought HIV. Treatment to 20 million people

In two decades, Pepfar may have saved around 25 million lives, helping to slow the AIDS pandemic.

In the 20 years since its inception, the President's Emergency Plan for AIDS Relief has provided lifesaving treatment to more than 20 million people in 54 countries , the most successful global health campaign of its kind, according to a report released Tuesday.

The $7.5 billion program, hosted by the Department of State, must be reauthorized by Congress this year. In the past, it has received strong bipartisan support.

President George W. Bush announced the creation of Pepfar in January 2003, when HIV treatment. was unavailable in many parts of the world. In 2004, the program began providing antiretroviral drugs to people in Africa.

The initial goal was to treat two million people with HIV. over five years. Today, Pepfar is estimated to have saved up to 25 million lives.

"I knew it was going to be big, but I think it ended up turned out to be even bigger and better than we thought," program architect Dr. Anthony S. Fauci said in an interview. "This should serve as a model of what can be done when you make a major commitment ."

About 38 million people were living with HIV in 2021, and about 29 million of them were receiving treatment. About 650,000 people died from an HIV-related cause that year, and an estimated 1.5 million people were newly infected with the virus.

Antiretroviral drugs can suppress HIV levels , prevent transmission of the virus to sexual partners and reduce the risk of transmission from infected pregnant women to their babies.

Pepfar "was trying to do something that had never been done before, to provide treatment for millions of people living with H.I.V. in Africa where there was no healthcare infrastructure,” said Dr. Carlos del Rio, an infectious disease expert at Emory University in Atlanta and chair of Pepfar's Scientific Advisory Board.

< p class="css-at9mc1 evys1bk0">"Americans should be proud of this incredible program," said Dr. del Rio.

To assess Pepfar's success , researchers from the Centers for Disease Control and Prevention analyzed data from six countries that have received funding from the program. Between January 2004 and September 2022, the program increased the number of people receiving treatment by 300 times, the team found.

"Pepfar's efforts have significantly changed the course of the global HIV epidemic,” CDC Chief Medical Officer Dr. Debra Houry said in a statement.

In Uganda, one of the first Pepfar-supported countries, the program has prevented nearly half a million HIV infections since 2004 and saved more than 600,000 lives.In Eswatini, the rate of new cases of HIV infections has halved between 2011 and 2016.

In Nigeria, the number of people newly diagnosed with HIV who started treatment increased eightfold in 18 months.

Yet HIV treatment is uneven among some vulnerable groups, including young children, pregnant women, men who have sex with men and transgender people. “Eliminate HIV. as a global public health threat demands that we understand and address the root causes of health disparities, including stigma, discrimination and social inequities,” Hank Tomlinson, Division Director of Global H.I.V. & Tuberculosis at the C.D.C., said Tuesday during a call with reporters.

The C.D.C. is a key implementing agency of Pepfar and provided treatment to 62 percent of those who received it. The agency is also supporting more than 10,000 labs or testing sites worldwide, training health workers and stepping up surveillance to detect areas of high need.

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