The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has been highly successful in helping 31 partner countries prevent HIV/AIDS and treat HIV-infected people, according to a new Institute of Medicine (IOM) report. A diverse, 20-member committee of experts conducted the congressionally mandated IOM evaluation of PEPFAR throughout the last 4 years. IOM compiled evaluation results, based on approximately 400 interviews in 13 countries, into a 680-page report.
The United States contributed $21.8 billion toward PEPFAR efforts from 2004 to 2010. As a result of PEPFAR funding, more than 3 million HIV-infected people received antiretroviral treatment in 2010, and 600,000 pregnant HIV-infected women have received antiretroviral treatment to prevent HIV transmission to their babies.
Although IOM was not charged to compare PEPFAR efforts by country, the report notes “disparities” in amounts spent per HIV-infected person in partner countries. For example, although less than 10 percent of Guyana residents have HIV, Guyana receives $3,842 in PEPFAR support per HIV-infected person. In contrast, Zimbabwe receives only $25 per HIV-infected person, although HIV prevalence is more than 10 percent.
A 2007 IOM evaluation criticized the U.S. Congress for restricting condom distribution, banning needle exchange programs, and requiring abstinence-only education. Congress removed these restrictions from 2008 PEPFAR funding.
The 2013 IOM evaluation recommends that PEPFAR monitor prevention activities more closely, intensify prevention programs, and help partner countries to develop self-sustaining HIV/AIDS efforts. The new IOM recommendations do not require congressional action. Congress has funded PEPFAR through 2013.
The full report, “Evaluation of PEPFAR,” was published online February 20, 2013, by the IOM at http://www.iom.edu/Reports/2013/Evaluation-of-PEPFAR.aspx.