Policy & Advocacy
Backgrounder on HIV-AIDS and PEPFAR, May 2008
Background on HIV-AIDS and PEPFAR, May 2008
PEPFAR (President’s Emergency Plan for AIDS Relief) was launched in 2003 as a five-year, $15 billion U.S. initiative to combat the global HIV/AIDS pandemic. By 2008 the epidemic had killed over 25 million people and infected more than 33 million; two-thirds of those living with HIV are in Africa. PEPFAR supports integrated prevention, treatment, and care programs in target countries and has delivered large-scale results in antiretroviral treatment, prevention of mother-to-child transmission, prevention education, training, and care for orphans and vulnerable children. Catholic Relief Services is a major PEPFAR partner, reaching millions with treatment, care, and prevention services.
- Global need: Over 33 million living with HIV in 2008; 2.5 million newly infected that year; 2.5 million of those infected are children.
- PEPFAR scope: Originally a five-year, $15 billion program focused on 15 priority countries in Africa, Latin America, and Asia.
- Major outcomes: Nearly 1.5 million people on ARV drugs; prevention of over 10 million mother-to-child infections; prevention education to 61.5 million people; training for tens of thousands of health workers and prevention providers; care for 6.7 million people including 2.7 million orphans and vulnerable children.
- CRS role: CRS supports over 4 million people through 250+ projects in 52 countries, provides ARVs to 100,000+ patients, and offers prevention, care, nutrition, and support for hundreds of thousands of affected children.
Evidence on prevention approaches
- Several African countries have seen declines in HIV prevalence tied to partner reduction and delayed sexual initiation.
- Public health experts note that generalized epidemics have not been reversed solely by condom-focused strategies.
Reauthorization debate and concerns
- The Bush Administration proposed a larger PEPFAR reauthorization ($30 billion for 2009–2013); Congressional bills raised proposals up to $50 billion and added stronger food, nutrition, workforce, TB, and malaria provisions.
- USCCB and CRS welcomed increased funding and strengthened nutrition and workforce measures but raised concerns about new language that would:
- Integrate PEPFAR with family planning and reproductive health services, potentially including providers linked to abortion, which could undermine faith-based implementers and PEPFAR’s life-saving focus.
- Remove designated funding for abstinence and fidelity (AB) programs, risking the elimination of meaningful AB programming.
USCCB and CRS policy priorities
- Funding: Support robust reauthorization (preferably $50 billion) for morally appropriate programs combating HIV/AIDS, TB, and malaria.
- Program protections: Preserve and clarify funding for abstinence, fidelity, and partner reduction programs to ensure equitable and meaningful support.
- Scope limits: Oppose inclusion of family planning or reproductive health in PEPFAR; seek elimination or clarification of “structural prevention” language to prevent interpretation that would include such services.
- Complementary support: Back strengthened food and nutrition programs, healthcare workforce investments, and continued funding for broader foreign aid accounts to support comprehensive development efforts.