PEPFAR’s Future Hinges on Congress Re-Authorizing Funding

ASCP has just won a new five-year cooperative agreement from the Centers for Disease Control and Prevention to support the President’s Emergency Plan for AIDS Relief (PEPFAR). ASCP is part of a consortium, led by the Association of Public Health Laboratories, that will work on the initiative, which will support workforce development in low- and middle-income countries. Now, they must wait for Congress to re-authorize funding for the PEPFAR initiative.

“PEPFAR has been one of the most successful public health programs the United States has ever implemented,” says Ken Landgraf, MSc, Executive Director of ASCP’s Center for Global Health. “It has always had bipartisan support in Congress." 

In 2003, the United States launched PEPFAR to address the HIV/AIDS crisis that was affecting millions around the world. Twenty years and $110 billion later, PEPFAR has saved 25 million lives in 50 countries. It has prevented 7 million infections, and 5.5 million children have been born free of HIV throughout Africa, Asia, and Latin America. Today, thanks to PEPFAR, 65 million people on these continents have access to HIV/AIDS prevention services, testing, and another 20 million are supported on antiretroviral therapy.

ASCP got involved in PEPFAR very early on. In 2003, the Society began discussions with the Centers for Disease Control and Prevention (CDC), one of several federal agencies tasked with implementing the PEPFAR program; a year later, ASCP signed its first cooperative agreement with the CDC to take part in the PEPFAR initiative.  

“We were one of the first laboratory organizations the CDC reached out to, to support PEPFAR because the Agency leaders realized if its goals were to offer lifesaving treatment, it needed to have laboratory services in place to diagnose and monitor patients.,” says Mr. Landgraf. At the time, ASCP worked with Dr. John Nkengasong, who led the CDC’s International Laboratory Branch, in Atlanta, GA. Dr. Nkengasong is now the U.S. Global AIDS Coordinator who oversees the PEPFAR program.

A key to PEPFAR’s success has been a big focus on accountability and transparency, as well as on impact and equity. The program collects a lot of data and uses that data to identify underserved regions, vulnerable population groups, and design programs to meet patients where they are.    

PEPFAR has also strengthened health systems and helped create local organizations that are taking leadership on their population’s health issues. The health systems that were reinforced and strengthened with PEPFAR support are so resilient that when the COVID-19 pandemic hit those regions, because of PEPFAR’s investment in the viral load testing laboratories, those countries already had the testing platforms and skilled workforce needed to conduct testing for COVID-19 very quickly. They were able to respond rapidly to COVID-19 challenges while still addressing the needs of their patients with HIV/AIDS.   

The success of PEPFAR going forward hinges on Congress re-authorizing funding for the program.  “ We urge Congress to stay committed to this bipartisan mission that everyone deserves access to HIV care, whether they live in the U.S, or anywhere around the world. That is part of ASCP’s mission,” says Mr. Landgraf.