How a Bush Administration Initiative to Combat HIV/AIDS Is Saving Lives

Thursday, April 9, 2009

ONE OF the more positive legacies of the Bush administration is the President's Emergency Plan for AIDS Relief (PEPFAR). It is an unprecedented multiyear and multibillion-dollar commitment by the United States to combat the epidemic's deadly march across Africa. And, according to a just-released study, the program is working.

PEPFAR, the brainchild of President George W. Bush in 2003, has targeted Vietnam, Haiti, Guyana and 12 sub-Saharan nations for HIV testing, counseling and treatment. Statistics through Sep. 30, 2008, show that more than 2 million men, women and children have received antiretroviral treatment because of the program. This would include almost 1.2 million pregnant HIV-positive women. As a result, 240,000 infants were born free of HIV infection. The upshot, according to the Annals of Internal Medicine: a 10.5 percent reduction in the AIDS death rate in 12 PEPFAR countries in Africa compared with neighboring nations.

The authors of the study, Eran Bendavid of Stanford University and Jayanta Bhattacharya of the National Bureau of Economic Research, concluded that "about 1.2 million deaths were averted because of PEPFAR's activities." The program spent $18.8 billion between fiscal 2003 and 2008 in all PEPFAR countries. Last year, Mr. Bush and Congress approved another $48 billion over the next five years to fight HIV/AIDS, tuberculosis and malaria.

The authors also delivered a piece of sobering news: PEPFAR's success in lowering the AIDS death rate hasn't translated to a similar success in lowering the rate of people becoming HIV-infected. But as the report notes, "A reduction in prevalence that may be attributable to PEPFAR would be a consequential accomplishment for the next 5 years of PEPFAR." True. Ultimately, the key to ending the epidemic is reducing the number of people who become HIV-positive.

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