Addressing HIV/AIDS Challenges

Twenty-eight years after the first cases were reported, HIV/AIDS remains a leading global health challenge. During 2007, approximately 2 million people died of HIV-related causes and an estimated 2.7 million people were newly infected with HIV. The first 5-year phase of the President's Emergency Plan for AIDS Relief (PEPFAR) – an interagency initiative authorized by Congress at $15 billion in 2003 – has contributed significantly to the global response to the pandemic. In addition, the U.S. government, through PEPFAR, is the largest contributor to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), providing approximately $4 billion since 2001, or about 27 percent of all resources through 2008. Congress reauthorized PEPFAR in 2008 at $48 billion through fiscal year 2013 and authorized the U.S. government to establish partnership frameworks with host countries to promote a more sustainable approach to combating HIV/AIDS, characterized by strengthened country capacity, ownership, and leadership. For fiscal year 2010, the President has proposed $8.6 billion for global health programs, including $6.7 billion for PEPFAR, as part of a new U.S. Global Health Initiative.

Challenges remain and policymakers should:

• Establish baseline measurements for determining country ownership of U.S.-funded HIV/AIDS programs;
  Highlights of GAO-10-836 (PDF)
• Improve guidance for selection of PEPFAR implementing partners and work with the Centers for Disease Control and Prevention (CDC) and USAID to address a number of factors limiting these agencies' ability to oversee a complex network of implementing partners and subpartners; and
  Highlights of GAO-09-666 (PDF)
• Ensure that HIV/AIDS programs are planned and budgeted based, in part, on the actual cost of delivering commodities and services.
  Full Report of GAO-08-480 (PDF)

^ Back to topWhat Needs to Be Done

State should ensure that the U.S. Global AIDS Coordinator take several actions, including the following:

• Develop and disseminate a methodology for establishing indicators needed for baseline measurements of country ownership prior to implementing partnership frameworks;
  Highlights of GAO-10-836 (PDF)
• Work with CDC and USAID to take several steps to improve PEPFAR implementing partner selection and strengthen implementing partner oversight
  Highlights of GAO-09-666 (PDF)
• Provide appropriate guidance to PEPFAR country teams on how to identify and use cost-related information in the planning and budgeting of PEPFAR programs
  Highlights of GAO-08-480 (PDF)
• Work with the Global Fund's Board Chair and Executive Director to establish standardized expectations for, and systematic evaluations of, its oversight entities
  Highlights of GAO-07-627 (PDF)

^ Back to topKey Reports

President's Emergency Plan For AIDS Relief

President's Emergency Plan for AIDS Relief

Global Malaria Control

Global HIV/AIDS

Global Health

Global Health

Global Health

Global Health

Global Health

Global Health

Global Health

Global Health

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