Africa: PEPFAR Is Saving Lives and Changing the Course of the Epidemic
New PEPFAR data show for the first time that the AIDS epidemic is becoming controlled in older adults and babies in three key African countries – Malawi, Zambia, and Zimbabwe – where the program has significantly invested. New pediatric HIV infections globally have declined by nearly 70 percent since 2000, and there are significant validated declines in adult HIV incidence across Malawi (76 percent), Zambia (51 percent), and Zimbabwe (67 percent) since 2003.
The results of these surveys and program data have allowed PEPFAR to expand results and impact in a budget-neutral environment. They also demonstrate the urgency of redoubling global resolve toward ending the epidemic by 2030 and delivering the first AIDS-free generation in over three decades.
Ambassador Deborah L. Birx, M.D., U.S. Global AIDS Coordinator and Special Representative for Global Health Diplomacy, said, “PEPFAR’s success is measured in saving lives and changing the course of the pandemic. The fact that the epidemic is becoming controlled in several key African countries demonstrates the remarkable impact of PEPFAR’s investments, which have long received strong bipartisan support.”
These three African countries have achieved an average of 65 percent community viral load suppression among HIV positive adults, approaching the 73 percent target of the UNAIDS 90/90/90 goals. This means they are nearing a point at which HIV transmission would effectively be controlled. However, the data also point to an urgent need for HIV prevention and treatment for young people. Among adolescents and young people in these same countries, the average community viral load suppression is only 42 percent. This is particularly concerning as this young population in sub-Saharan Africa is doubling in size by 2020.
These new data emerge from critical surveys that are funded by PEPFAR and conducted by the U.S. Centers for Disease Control and Prevention and ICAP at Columbia University, as well as local governmental and non-governmental partners.
“It is heartening to see the impressive decrease in HIV incidence and gains in viral suppression,” said Dr. Wafaa El-Sadr, ICAP director. “ICAP is honored to partner with ministries of health, PEPFAR, and CDC to implement these groundbreaking surveys.”
Today, PEPFAR also announced it has surpassed global targets set by President Obama in 2015. PEPFAR now reaches nearly 11.5 million people with life-saving antiretroviral treatment and has provided more than 11.7 million voluntary medical male circumcision procedures. Nearly 2 million babies have been born HIV-free with PEPFAR support
PEPFAR also announced that it is providing life-saving treatment for nearly 1.1 million children globally, which represents a 97 percent increase since 2014, and reached over 1 million adolescent girls and young women with critical comprehensive HIV prevention interventions through its DREAMS partnership.
There is much more work to be done, especially for adolescent girls. In sub-Saharan Africa, young women and adolescent girls are up to 14 times more likely to get HIV/AIDS than young men. To reduce this elevated risk, PEPFAR launched the Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) public-private partnership and the complementary DREAMS Innovation Challenge to develop and drive pioneering solutions, which are often found closest to communities. DREAMS is a $385 million comprehensive, multi-sectoral program focused on addressing the key factors that put young women at increased risk for HIV in 10 sub-Saharan African countries
Dr. Tom Frieden, CDC Director, noted, “The ground-breaking population-based HIV impact assessments show that, as a result of close collaboration with partner government ministries of health, HIV programs are decreasing the spread of HIV. Malawi, Zambia, and Zimbabwe have made remarkable progress helping people learn their HIV status, get life-saving HIV treatment, and suppress the virus completely. This means that more than half of the HIV infected people in these countries can live full, healthy lives – and not spread HIV to others. More importantly, these surveys give us a clear picture of what to do next and where to focus our resources. To further reduce spread of HIV in this new era of Test and Start, we need to reach more men and more young women to provide testing and immediate start of HIV treatment.”