Washington, DC–(ENEWSPF)–December 1, 2014. Since taking office, President Obama and his Administration have seen a significant shift in the HIV epidemic, in the United States and in partner countries. More people living with HIV know their status, and more people are on antiretroviral medications. As a result, the number of new infections worldwide is decreasing, as are the number of HIV-related deaths. The numbers, still, are profound: 35 million people are living with HIV, and 1.5 million people die every year. Together, as a global community, we must hold strong to our commitment to reach an AIDS-free generation. The United States investment in the President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and in fighting our own epidemic at home has paid dividends to strengthen capacity and ability to address global public health. We are devoting our resources to interventions that have the greatest impact, through evidence-based programs that provide life-saving services for populations that are most marginalized. Through strategic partnerships with other governments and private sector partners, including philanthropy, faith communities, and academia, the United States remains committed to equitably investing resources to most effectively bend the curve of the epidemic.
As we mark the annual observance of World AIDS Day, we commit to focus our attention on the programs and policies that impact those most vulnerable and explore opportunities to partner to achieve an AIDS-free generation, including here at home. Today, we are releasing the a National HIV/AIDS Strategy progress report, which outlines Administration actions and accomplishments in improving outcomes along the HIV care continuum and meeting the Strategy’s goals. Additionally, we are highlighting a few major accomplishments and new initiatives, globally and domestically, in an effort to better reach communities at risk, both at home and abroad, and demonstrate that everybody is in, and everybody counts.
Global Leadership toward an AIDS-Free Generation
PEPFAR represents America’s commitment to saving lives and the shared responsibility of all global partners toward achieving an AIDS-Free Generation. This year, PEPFAR has surpassed many of its commitments and goals as demonstrated by these statistics, and is announcing new initiatives for the future.
PEPFAR’s commitment to saving lives globally: Today, PEPFAR is supporting a total of 7.7 million men, women, and children on life-saving HIV treatment worldwide (of which, 4.5 million are receiving direct support and an additional 3.2 million are benefiting from essential technical support). This far exceeds President Obama’s 2011 World AIDS Day goal of 6 million people on treatment — a four and a half fold increase (from 1.7 million in 2008) since the start of this Administration. Additionally in Fiscal Year 2014, PEPFAR supported HIV testing and counseling for more than 56.7 million people, providing a critical entry point to prevention, treatment, and care. Also, as of September 30, 2014, PEPFAR has supported more than 6.5 million voluntary medical male circumcision procedures in Eastern and Southern Africa. Together with partner countries and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, we are working to ensure maximal impact of all U.S. government dollars.
Empowering Young Women and Girls: In 2013, over 80 percent of new HIV infections among adolescents in Sub-Saharan Africa occurred in girls, and 380,000 adolescent girls and young women are infected with HIV every year. This is why PEPFAR is launching DREAMS—a $210 million public-private partnership with the Nike Foundation and the Bill & Melinda Gates Foundation—to achieve an AIDS-free future for adolescent girls and young women. Together, we will work with countries to implement a multi-sectorial core package of highly effective interventions to reduce new HIV infections by ensuring adolescent girls and young women are Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe.
Prevention of mother-to-child transmission and supporting children: In 2014, PEPFAR supported HIV testing and counseling for more than 14.2 million pregnant women. PEPFAR provided antiretroviral medications to the 749,313 of the women who tested positive for HIV to prevent mother-to-child transmission of the virus. PEPFAR’s support has ensured that 240,000 babies born to these HIV infected mothers, approximately 95 percent, are HIV-free. PEPFAR also provided care and support to more than 5 million orphans and vulnerable children.
Improving Data Transparency and Use: In the spirit of the Open Government Partnership, PEPFAR has made its annual Country Operational Plans available online for the first time and is also releasing an unprecedented amount of program data on its website on World AIDS Day, enabling all internal and external stakeholders, including researchers, press, civil society organizations, U.S. government agencies, donors, and partner-country governments to view and utilize PEPFAR planned budgets, site-level data, program results and expenditure data to independently analyze PEPFAR program effectiveness and cost efficiency, and help improve accountability of all. Building on PEPFAR’s commitment to transparency, PEPFAR and the Millennium Challenge Corporation are partnering to announce a $21.5 million investment toward greater data transparency and improved accountability by creating country-based, country-driven local data hubs that will include data critical to controlling the epidemic, including health, poverty, and gender data, and will be used to improve strategic planning, quality of care, and ultimately impact health systems and outcomes.
Building Health Care Workforce Capacity: Over the past 11 years, PEPFAR investments have built and strengthened country health systems, enhancing their capacity to deliver life-saving HIV services and to train and retain essential health personnel. In 2014, PEPFAR has exceeded its goal and is supporting training (including pre-service training) for more than 140,000 new health care workers to deliver HIV and other health services. PEPFAR is launching a new human resources for health strategy, a $116.5 million effort that will strengthen the capacity of health workers to deliver life-saving HIV services, and also help address Ebola, and other public health threats across Africa.
Domestic Leadership on the National HIV/AIDS Strategy and HIV Care Continuum Initiative
The Obama Administration has accelerated progress along the HIV care continuum by expanding and refocusing programs, reducing stigma and discrimination, building capacity at the state and local levels, and integrating services that could break down barriers to accessing care and ultimately improve outcomes along the continuum.
Improving Knowledge of HIV Status: Most recent data show that 86 percent of the 1.2 million people living with HIV in the US know their HIV status. From 2006 to 2011, the number of people living with HIV whose infection had not been diagnosed decreased by 16 percent. This was accomplished through coordinated federal investments and community implementation of the United States Preventive Services Task Force guidance on routine HIV testing. In 2012, Federal programs supported testing for more than nine million Americans. With continued investment, our 2015 National HIV/AIDS Strategy target of increasing the percentage of people living with HIV who know their serostatus to 90 percent by 2015 is within reach.
Expanding coverage under the Affordable Care Act: With implementation of the Affordable Care Act, many more people living with HIV have access to affordable healthcare coverage. Health plans can no longer deny coverage based on pre-existing conditions, including HIV, and cannot place lifetime caps on coverage. Additionally, the new health plans are required to cover HIV testing, without cost sharing, for millions of Americans, as recommended by the USPSTF.
High impact investments at the state and local levels: In 2014, Federal agencies and their partners have worked to implement new programs and modify existing programs to improve linkage to HIV medical care. The Centers for Disease Control & Prevention (CDC) announced the availability of $210 million to support up to 100 community-based organizations for a 5-year project that will increase access to HIV testing and prevention in communities that are most heavily affected by HIV and also improve outcomes along the HIV care continuum. The Health Resources and Services Administration (HRSA) has recently funded a new initiative to enhance the capacity of Ryan White program grantees to increase focus and increase engagement and retention in care of young gay men of color. CDC has also re-directed $40 million in HIV prevention funds to support Community High-Impact Prevention, a new approach to promote high impact prevention strategies that further the goals of the HIV Care Continuum Initiative.
Integrating Behavioral Health into HIV Services: In 2014, the Substance Abuse and Mental Health Services Administration (SAMHSA) created the Minority AIDS Initiative Continuum of Care Pilot-Integration of HIV Medical Care into Behavioral Health Programs. This four year program will integrate behavioral HIV care into programs for racial/ethnic minority populations at high risk for behavioral health disorders and at high risk for or living with HIV, primarily in substance abuse treatment programs and community mental health programs.
Supporting the intersection of housing and healthcare: The Department of Housing and Urban Development (HUD) and HRSA are partnering to widely distribute HUD’s white paper titled, The Connection Between Housing and Improved Outcomes Along the HIV Care Continuum, to educate housing, health care, and community based organizations on the intersection of housing and health care by highlighting important research findings which emphasize the beneficial impact that stable housing can have on health outcomes at each step of the HIV care continuum.
The Administration is committed to accelerating our efforts along the HIV care continuum and supporting our global investments through PEPFAR. Smart investments and new collaborations continue to provide unique opportunities to scale up effective strategies for those most vulnerable and those living with HIV. In order to continue the momentum, we will need a focused and comprehensive approach, domestically and globally, to ensure that everybody counts. To that end, the Administration will be updating the National HIV/AIDS Strategy objectives and setting new PEPFAR program targets in the upcoming year. By working together towards common goals, we will move closer to our collective vision of ending the epidemic.
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