The Good, the Bad, the Ugly: The state of PEPFAR and future advocacy opportunities

The Good, the Bad, the Ugly: The state of PEPFAR and future advocacy opportunities

Jirair Ratevosian, MPHPhysicians for Human Rights

Jennifer Kasper, MD, MPHDoctors for Global Health

Fifth Annual Report to Congress

Treatment for 2.1 million men, women and children

Care for 10.1 million, including more than 4 million orphans and vulnerable children.

HIV counseling and testing for nearly 57 million

TB treatment for more than 395,400 HIV-infected p

Reached 58.3 million people through community outreach programs to prevent sexual transmission using the ABC approach.

Supplied more than 2.2 billion condoms worldwide

PMTCT for 16 million pregnancies, ARV prophylaxis for 1.2 million pregnant women HIV+ = 240,000 infants HIV-free.

3.7 million training and retraining encounters for health care workers.

CASE STUDY: Students and Health professionals helped reauthorize PEPFAR

PHR organized in key states—CA, FL, ME, NH, MN, KS, and NY—to bring their expertise and experience to lawmakers.

Students helped get Deans and Faculty to sign onto letters promoting best public health and human rights practices in addressing HIV/AIDS—which PHR presented on their behalf to Congress.

PHR's policy team wrote key documents that supported best public health- and evidence-based practices that provided the philosophical underpinnings for changes to the bill—most notably: boosting efforts to address

Africa's health workforce shortage

mainstreaming harm reduction for injection drug users

lifting the HIV travel ban

During Global AIDS Week of Action, students did joint actions with colleagues in Kenya and Uganda

Student chapters hosted PHR during important visits by leading AIDS physicians from Uganda and Kenya to the US to meet with policymakers and the press—to provide first-hand accounts of how PEPFAR

In the critical final weeks and days of the reauthorization process,

thousands of students and health professionals

repeatedly called and wrote and met with targeted

legislators to provide them with essential facts

PHR policy demands aired in op-eds, news articles, broadcast pieces and letters to the editor.

Students kept AIDS in the media

PEPFAR Reauthorized: Key wins!

$48 Billion Treatment for 3 million, prevent 12 million

infections, care for 10 million (including 5 million OVC)

Support countries in developing long-term health workforce plans, fund 140,000 new health workers

Increased attention given to IDUs, which favors increased access to HIV prevention for this group

Women's unique vulnerability to HIV is explicitly discussed, important targets for PMTCT

Repeal of the ban preventing people with HIV from visiting the US

But… Future Advocacy Opportunities

Appropriations is key! Even with the great advances of the past 5

years, five people become infected with HIV for every two people added to treatment.

To catch up with the pandemic, the US needs to contribute $50 billion over the next 5 years.

Meet MDG goals and to lead the fight globally Foreign assistance= smart power Re-invigorate our moral leadership in the world Support the Global Fund

Strengthening Health Systems and Workforce

140,000 new health professionals and paraprofessionals, especially physicians and nurses, are trained and retained.

All partner countries are quickly able to begin implementing fully funded, rights-based health workforce plans

Health workers and facilities in these countries are well managed and equipped

Health workers have safe working conditions and access to health care, including treatment for HIV

Recognizing Feminization of HIV Exceed 80% target of reaching pregnant women with

PMTCT Hold initiatives accountable for the development and

implementation of programs that specifically address the underlying social and economic vulnerabilities of women

Women and girls have access to comprehensive prevention information beyond ABC

Educate and empower health workers to promote women’s rights, including reproductive health rights

Promote the integration of sexual reproductive health services, including family planning and other primary health services, with HIV programs

Global Gag Rule

Prohibits health organizations receiving US $$ for family planning from making referral for safe abortion services emphasizing the importance of integrated GGR reproductive health care and HIV prevention services.

Next, reverse bloated interpretation of Kemp-Kasten Amendment, which denies federal funding to programs "that support or participate in coercive abortion or involuntary sterilization"

Science-Based Prevention Efforts

Addressing Injection Drug Use and HIV Bill makes only brief mention of need

for prevention strategy Enable US funding for syringe exchange

Addressing MSM Bill makes only passing reference Program should be implemented in way

that truly recognizes needs

HIV Travel Ban

Good first step: removal of statutory bar embedded in Immigration and Naturalization Act

United States Department of Health and Human Services must remove HIV/AIDS from its list of "dangerous communicable diseases" that prohibit entry to US

What can we do?

Meetings With Congressional Offices Let policymaker know constituency cares

about the issue Educate policymaker about issue and

explain why his/her support important Thank policymaker for prior support Established dialogue and connection with

office- set stage for follow-up communication