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91-610: The United States President's Emergency Plan For AIDS Relief ( PEPFAR ) is the global health funding by the United States to address the global HIV/AIDS epidemic and help save the lives of those suffering from the disease. The U.S. allocation of over $ 110 billion marks the largest investment by any country has ever made towards combating a single disease. Launched by U.S. President George W. Bush in 2003, as of May 2020, PEPFAR has provided cumulative funding for HIV/AIDS treatment, prevention, and research since its inception, making it

182-649: A 5-year joint strategic framework for cooperation between the U.S. Government, the partner government, and other partners to combat HIV/AIDS in the host country through service delivery, policy reform, and coordinated financial commitments.See the PEPFAR World Wide Activities Map and PEPFAR Dashboard . Office of the Global AIDS Coordinator (OGAC) Housed in the Department of State, the Office of

273-428: A 61% reduction in deaths from HIV, tuberculosis, and malaria since 2002, saving 65 million lives according to a 2024 analysis. The Global Fund’s latest report highlights a 55% price reduction for bedaquiline, a key drug for treating drug-resistant tuberculosis, and a 25% drop in the cost of tenofovir disoproxil fumarate, lamivudine, and dolutegravir (TLD), the first-line treatment for HIV. A new mosquito net, treated with

364-537: A broad spectrum of representatives from government, NGOs, faith-based organizations, the private sector, and people living with the diseases. This system has kept the Global Fund secretariat smaller than other international bureaucracies. The model has also raised concerns about conflict of interest, as some of the stakeholders represented on the Country Coordinating Mechanisms may also receive money from

455-975: A controversial requirement (see below). The other two thirds was allotted for the widespread array of prevention interventions described above, including counseling, education, injection safety, blood safety and condoms. The 2008 reauthorization of PEPFAR eliminated the 20% recommendation for prevention efforts, including the requirement for abstinence programs. Treatment In addition to providing antiretroviral therapy (ART), PEPFAR supports prevention and treatment of opportunistic infections, as well as services to prevent and treat malaria, tuberculosis, waterborne illness, and other acute infections. PEPFAR supports training and salaries for personnel (including clinicians, laboratorians, pharmacists, counselors, medical records staff, outreach workers, peer educators, etc.), renovation and refurbishment of health care facilities, updated laboratory equipment and distribution systems, logistics and management for drugs and other commodities. This

546-476: A dual-active ingredient insecticide, is now 45% more effective against malaria. By leveraging its purchasing power, the Global Fund has been able to lower drug prices. It currently supports 25 million people on antiretroviral treatment, preventing 1.66 billion hospitalization days and 1.36 billion outpatient visits, saving about $ 85 billion. The U.S. has been involved in Maternal & Child Health (MCH) efforts since

637-533: A new international financial vehicle to combat these diseases emerged. In this context the World Health Organization (WHO) called for a "Massive Attack on Diseases of Poverty" in December 1999. The original concept suggested tackling "malaria, tuberculosis, unsafe pregnancy, AIDS, diarrheal diseases, acute respiratory infections and measles". This list would steadily narrow to only include the three diseases

728-646: A process which interviewed finalised candidates in person for the Board Leadership. The current Board Leadership is made up of Lady Roslyn Morauta and Bience Gawanas , who assumed their tenures in May 2023. The work of the Board operates through three committees where each constituency should be represented in at least one standing committee, which are the Audit and Finance Committee (AFC), Ethics and Governance Committee (EGC), and

819-496: A program PEPFAR 3.0 focusing on Sustainable Control of the AIDS epidemic. This program was designed to address the UNAIDS "90-90-90" global goal: 90 percent of people with HIV diagnosed, 90 percent of them on ART and 90 percent of them virally suppressed by the year 2020. When PEPFAR was signed into law 15 resource-limited countries with high HIV/AIDS prevalence rates were designated to receive

910-460: A separate approach. The Global Fund Secretariat in Geneva , Switzerland , employs about 1300 staff. There are neither offices nor staff based in other countries. In 2013, the Global Fund adopted a new way of distributing its funds in countries to fight AIDS, tuberculosis and malaria. Under this funding model, eligible countries receive an allocation of money every three years for possible use during

1001-474: Is a financing mechanism rather than an implementing agency. Programs are implemented by in-country partners such as ministries of health, while the Global Fund secretariat, whose staff only have an office in Geneva, monitor the programs. Implementation is overseen by Country Coordinating Mechanisms, country-level committees consisting of in-country stakeholders that need to include, according to Global Fund requirements,

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1092-578: Is focused on enhanced surveillance, risk communication, community engagement, laboratory supplies, diagnostics, clinical services, and vaccine planning. In 2024, U.S. Global Health Funding includes $ 10 million for the Global Health Worker Initiative, the first time Congress has provided funding for this initiative that increase education and training of healthcare workers in resource limited settings. Global Fund The Global Fund to Fight AIDS, Tuberculosis and Malaria (or simply

1183-423: Is intended to ensure the sustainability of PEPFAR services in host countries, enabling long-term management of HIV/AIDS. PEPFAR-supported care and treatment services are implemented by a wide array of U.S.-based and international groups and agencies. Among the largest "Track 1.0" (treatment) partners are Harvard University, Columbia University's International Center for AIDS Care & Treatment Programs (ICAP),

1274-404: Is its ability to increase the pandemic response to other infectious diseases such as COVID-19 . Research by Anand Reddi and colleagues has documented the effectiveness and sustainability of PEPFAR programs by emphasizing the need for integrated approaches to HIV care that can strengthen overall health systems in resource limited settings. Antiretroviral Local Manufacturing The U.S. government

1365-597: Is provided in the Foreign Operations and Labor, Health and Human Services appropriations bills, which, if the process goes smoothly, are agreed to by the House and Senate in advance of the federal fiscal year beginning October 1. The Office of the Global AIDS Coordinator (OGAC) budgets according to the allocations provided by Congress and the policy of the Administration. Funding figures by program are reported to Congress by

1456-411: Is supporting African production of antiretrovirals (ARVs) to address the continent's HIV epidemic. In July 2024, PEPFAR plans to expand its purchase of ARVs from local suppliers to serve 2 million African patients. The results of the program include: The U.S. is the first and largest donor to the Global Fund to Fight AIDS, Tuberculosis, and Malaria. To date, the U.S. has provided more than $ 7 billion to

1547-759: Is the DoD Executive Agent for the technical assistance, management, and administrative support of the global HIV/AIDS prevention, care and treatment for foreign militaries. Department of Commerce (DoC) The Department of Commerce (DoC) provides support for PEPFAR by furthering private sector engagement through public-private partnerships. Housed within DoC, the U.S. Census Bureau assists with data management and analysis, survey support, estimating infections averted and supporting mapping of country-level activities. Department of Labor (DoL) The Department of Labor (DoL) implements PEPFAR workplace-targeted projects that focus on

1638-611: Is the supreme governing body of the organisation and embodies the partnership approach to global health and incorporates leading stakeholders in an inclusive and effective way. The core functions of the Board include: strategy development; governance oversight; commitment of financial resources; assessment of organisational performance; risk management; and partnership engagement, resource mobilisation and advocacy. The Board includes 20 voting members, with equal representation by implementers and donors. Non-governmental organisations; communities living with and/or affected by HIV, TB and malaria;

1729-551: The Bill & Melinda Gates Foundation ) was one of the first donors to provide seed money for the partnership. From January 2006 it has benefited from certain US Privileges, Exemptions, and Immunities under executive order 13395, which conferred International Organizations Immunities Act status on it. The Global Fund is the world's largest financier of AIDS, TB, and malaria prevention, treatment, and care programs. As of June 2019,

1820-546: The Global Fund to Fight AIDS, Tuberculosis and Malaria . The President’s Malaria Initiative (PMI), led by USAID and co-implemented with the CDC, drives U.S. malaria activities. Additional support comes from NIH and DoD . U.S. bilateral funding for malaria rose from $ 854 million in FY 2015 to about $ 1 billion in FY 2024, representing 9% of the U.S. global health budget. Despite increases over

1911-588: The 1960s and is the largest donor to global MCH activities. Funding, which includes support for polio eradication and contributions to Gavi, the Vaccine Alliance (GAVI), and UNICEF , is managed by USAID, CDC, and the State Department. From FY 2015 to FY 2024, MCH funding increased from $ 1.18 billion to $ 1.29 billion, driven mainly by increased allocations to GAVI and polio, while bilateral MCH funding remained steady. In FY 2024, MCH funding comprised 10% of

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2002-702: The 2012-2014 period for investment in programs. In December 2013, the fourth replenishment meeting was held in Washington, D.C. US$ 12 billion was pledged in contributions from 25 countries, as well as the European Commission, private foundations, corporations, and faith-based organizations for the 2014–2016 period. It was the largest amount ever committed to fighting the three diseases. The fifth replenishment meeting took place in September 2016 in Montreal , Canada, and

2093-674: The 4th Partnership Forum held in São Paulo, Brazil, the Global Fund Advocates Network (GFAN) was founded. Following which regional entities - GFAN Africa and GFAN Asia-Pacific were also established. Alarms were raised prior to the third replenishment meeting in October 2010 about a looming deficit in funding, which would have led to people undergoing ARV treatment losing access, increasing the chance of them becoming resistant to treatment. UNAIDS Executive Director Michel Sidibé dubbed

2184-458: The Board's strategic focus on its core functions. Their primary role is to manage the affairs of the Board, including ensuring that the Board is organised properly, functions effectively, and meets its obligations and responsibilities. Prior to the end of the term of the Board Leadership, an ad hoc Board Leadership Nominations Committee (BLNC) is formed, and in 2018, for the first time, the BLNC implemented

2275-552: The Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), and Substance Abuse and Mental Health Services Administration (SAMHSA). The Office of Global Health Affairs within HHS coordinates all of the HHS agencies to be sure PEPFAR resources are being used effectively. Centers for Disease Control and Prevention (CDC) As part of

2366-481: The Department of Health and Human Services, the Centers for Disease Control and Prevention uses PEPFAR funding to implement its Global AIDS Program (GAP). GAP works with highly trained physicians, epidemiologists, public health advisers, behavioral scientists, and laboratory scientists in 29 countries, who are part of USG teams implementing PEPFAR. Through partnerships with host governments, Ministries of Health, NGOs, international organizations, U.S.-based universities, and

2457-662: The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), and the AIDSRelief consortium of Catholic Relief Services. Care For those who have already been infected with HIV/AIDS, PEPFAR provides HIV counseling , resources for maintaining financial stability, etc. Special care is given to orphans and vulnerable children (OVCs) and services are provided that meet the unique needs of women and girls, including victims of sex trafficking, rape, abuse, and exploitation (see fact sheet on Gender and HIV/AIDS ). Finally,

2548-565: The Emergency Plan works closely with country leaders, military groups, faith-based organizations, etc. in an attempt to eliminate stigma . Health Systems Strengthening PEPFAR has directly and indirectly contributed to the health systems strengthening of recipient countries including improving laboratory capacity as well as improving monitoring and evaluation including introduction of the electronic medical record systems. Another area of health system strengthening that PEPFAR has contributed to

2639-468: The Global AIDS Coordinator oversees the implementation of PEPFAR and ensures coordination among the various agencies involved in the U.S global response to HIV/AIDS. United States Ambassadors from the State Department provide essential leadership to interagency HIV/AIDS teams and engage in policy discussions with host-country leaders. U.S. Agency for International Development An independent federal agency, USAID receives overall foreign policy guidance from

2730-688: The Global Fund ) is an international financing and partnership organization that aims to "attract, leverage and invest additional resources to end the epidemics of HIV/AIDS , tuberculosis and malaria to support attainment of the Sustainable Development Goals established by the United Nations ". This multistakeholder international organization maintains its secretariat in Geneva , Switzerland . The organization began operations in January 2002. Microsoft founder Bill Gates (through

2821-610: The Global Fund at its summit in July 2001 in Genoa, Italy , although pledges were significantly lower than the US$ 7 billion to US$ 10 billion annually Kofi Annan insisted was needed. According to the G8's final communique, "At Okinawa last year, we pledged to make a quantum leap in the fight against infectious diseases and to break the vicious cycle between disease and poverty. To meet that commitment and to respond to

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2912-625: The Global Fund awarded its first batch of grants – worth US$ 378 million – to fight the three diseases in 31 countries. The Global Fund’s investments have reduced deaths from HIV, tuberculosis, and malaria by 61% since 2002, saving 65 million lives. Recent efforts include lowering the cost of key treatments for drug-resistant TB by 55% and first-line HIV medications by 25%, while introducing a more effective insecticide-treated mosquito net. The Fund’s initiatives, including supporting 25 million people on antiretroviral medication, have saved $ 85 billion by reducing hospitalization and outpatient visits. Since

3003-469: The Global Fund fights today: HIV/AIDS, TB, and malaria. In April 2001, in Abuja, Nigeria at a summit of African leaders, United Nations Secretary General Kofi Annan made the first explicit public call by a highly visible global leader for this new funding mechanism, proposing "the creation of a Global Fund, dedicated to the battle against HIV/AIDS and other infectious diseases". Secretary General Annan made

3094-429: The Global Fund was created in 2002, public sector contributions have constituted 95 percent of all financing raised; the remaining 5 percent comes from the private sector or other financing initiatives such as Product Red . The Global Fund states that from 2002 to July 2019, more than 60 donor governments pledged a total of US$ 51.2 billion and paid US$ 45.8 billion. From 2001 through 2018, the largest contributor to fund

3185-639: The Global Fund, either as grant recipients, sub-recipients, private persons (e.g. for travel or participation at seminars) or contractors. At the end of the 20th century, international political will to improve coordinated efforts to fight the world's deadliest infectious diseases began to materialize. US Ambassador to the UN Richard Holbrooke recognized early on that diseases such as AIDS and Malaria posed as national security threat and advocated for policy that would shore up against those threats. Through various multilateral fora, consensus around creating

3276-440: The Global Fund. The Global Fund typically raises and spends funds during three-year "replenishment" fund-raising periods. Its first replenishment was launched in 2005, the second in 2007, the third in 2010, the fourth in 2013, and the fifth in 2016. As part of the public-private partnership, all stakeholders play an important role in resource mobilisation efforts - including communities and civil society organisations. In 2011, at

3367-407: The Global Fund. Cases of corruption had also been found in several African countries such as Mali, Mauritania, Djibouti, and Zambia. Sweden, the Global Fund's 11th-biggest contributor at the time (2011), suspended its US$ 85 million annual donation until the corruption problems were resolved. Germany, the third-biggest contributor at the time, also blocked any financing until a special investigation

3458-433: The Office of the Global AIDS Coordinator. For FY 2013, President Obama requested $ 6.42 billion, including more than $ 4.54 billion for bilateral HIV/AIDS programs and $ 1.65 billion for the Global Fund. For FY 2014, President Obama requested $ 6.73 billion, including more than $ 4.88 billion for bilateral HIV/AIDS programs and $ 1.65 billion for the Global Fund. For FY 2024, President Biden requested at least $ 4.7 billion for

3549-467: The PEPFAR budget was to be spent on prevention, with the remaining 80% going to care and treatment, laboratory support, antiretroviral drugs, TB/HIV services, support for orphans and vulnerable children (OVC), infrastructure, training, and other related services. Of the 20% spent on prevention, one third, or 6.7% of the total, was to be spent on abstinence-until-marriage programs in fiscal years 2006 through 2008,

3640-504: The PEPFAR program in its annual budget request to Congress in addition to funding for the multilateral Global Fund to Fight AIDS, Tuberculosis and Malaria . PEPFAR was exempt from the Mexico City Policy . Annual data on the PEPFAR budget, spending by budget code, and impact estimates are available online at PEPFAR Panorama Spotlight . Funding amounts to specific in-country implementing mechanisms and partners are only available for

3731-515: The Secretary of State and is the agency primarily responsible for administering civilian foreign aid. USAID supports the implementation of PEPFAR programs in nearly 100 countries, through direct in-country presence in 50 countries and through seven other regional programs. Department of Health and Human Services (HHS) Under PEPFAR, the Department of Health and Human Services (HHS) implements PEPFAR-funded prevention, treatment and care programs through

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3822-806: The Strategy Committee (SC). In January 2011, the Associated Press reported vast corruption in some programs financed by the Global Fund, citing findings of the Global Fund Office of the Inspector General – an auditing unit independent from the Global Fund Secretariat – that up to two-thirds of funds in some of the reviewed grants were lost to fraud. The Office of the Inspector General report showed that systematic fraud patterns had been used across countries. The Global Fund responded to

3913-753: The U.S. global health budget, making it the third largest category. Dr. Ezekiel Emanuel , a senior advisor to President Obama in the early 2010s, recommended funding MCH initiatives at the expense of future funding increases for PEPFAR. Dr. Emanuel claimed that PEPFAR "is not the best use of international health funding," and "fails to address many of the developing world's most serious health issues." Anand Reddi and Sarah Leeper rebutted Emanuel by stating "The idea that differing global health initiatives must compete with each other lacks not only ethical legitimacy but also scientific merit. Maternal and child health, need not to be framed in opposition to PEPFAR. Confronting illness in isolation -- whether by funding PEPFAR at

4004-458: The U.S. global health budget, with FY 2024 allocations totaling $ 5.4 billion, including $ 4.9 billion for PEPFAR and $ 575 million for NIH research. The Biden administration recently announced a six percent cut to the PEPFAR budget for FY 2025 with a proposed budget $ 4.4 billion. The U.S. has participated in global malaria efforts since the 1950s and is currently the second largest donor, following

4095-466: The US$ 1.2 billion lack in funding would "lead to difficult decisions in the next three years that could slow down the effort to beat the three diseases". In November 2011, the organization's board cancelled all new grants for 2012, only having enough money to support existing grants. However, following the Global Fund's May 2012 board meeting, it announced that an additional US$ 1.6 billion would be available in

4186-603: The United Nations, and was a member of the high-level independent panel that looked at the Global Fund's fiduciary controls and oversight mechanisms. Jaramillo reorganized and reduced Global Fund staff in response to the previous year's critics of the Global Fund. Dr. Mark R. Dybul was appointed executive director in November 2012. He previously served as the United States Global AIDS Coordinator, leading

4277-483: The United States of over $ 110 billion, represents the largest investment ever made by any nation in a single disease. The U.S. began funding global HIV initiatives in 1986, with efforts increasing substantially in 2003 with the launch of the President’s Emergency Plan for AIDS Relief (PEPFAR) by U.S. President George W. Bush , the largest program dedicated to a single disease globally. PEPFAR accounts for

4368-518: The United States. The Global Fund board named Global Fund Chief of Staff Marijke Wijnroks of the Netherlands as interim executive director while the nominating process restarted. The Global Fund board selected banker Peter Sands as executive director in 2017. He assumed the role in 2018. The Global Fund was formed as an independent, non-profit foundation under Swiss law and hosted by the World Health Organization in January 2002. In January 2009,

4459-495: The World Health Organization – to support countries in designing and drafting their applications and in supporting implementation. The United Nations Development Programme , in particular, bears responsibility for supporting Global Fund-financed projects in a number of countries. As a result, the organisation is most accurately described as a financial supplement to the existing global health architecture rather than as

4550-820: The appeal of the UN General Assembly, we have launched with the UN Secretary-General a new Global Fund to fight HIV/AIDS, malaria and tuberculosis. We are determined to make the Fund operational before the end of the year. We have committed $ 1.3 billion. The Fund will be a public-private partnership and we call on other countries, the private sector, foundations, and academic institutions to join with their own contributions – financially, in kind and through shared expertise." The Global Fund's initial 18-member policy-setting board held its first meeting in January 2002, and issued its first call for proposals. The first secretariat

4641-437: The applications and there will be an iterative process towards the finalisation of the applications. Once the applications are approved, the Global Fund provides funding to the principal recipients based on achievement toward agreed indicators and actual expenses. Performance and expenses are periodically reviewed by a "local fund agent", which in most countries is an international financial audit company. The Global Fund board

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4732-404: The conclusion of an external evaluation in 2009 that criticized the organization's weak procurement practices. Warnings of inadequate controls had also been reported periodically. Financial Times also reported that its own review found that neither Global Fund staff nor "local fund agents" (the entities entrusted with audit-like tasks at the country level) had noticed the deficiencies reported by

4823-409: The controversy surrounding the misuse of Global Fund grants in perspective. Gerson stated, "The two-thirds figure applies to one element of one country's grant – the single most extreme example in the world. Investigations are ongoing, but the $ 34 million in fraud that has been exposed represents about three-tenths of 1 percent of the money the fund has distributed. The targeting of these particular cases

4914-461: The decision made by the Global Fund board in November 2011 to appoint a general manager, leaving Kazatchkine's role to that of chief fund-raiser and public advocate. Communications later disclosed by the United States government stated that Kazatchkine's performance was deemed unsatisfactory by the Global Fund board, notably in relation to the funding of activities related to the First Lady of France at

5005-767: The expense of programs that target maternal or child health or vice versa -- cannot be our way forward. We should be advocating for funding both PEPFAR and maternal and child health together instead of favoring one program over another." In 2024, the U.S. government announced a new $ 20 million PEPFAR Youth Initiative to combat HIV/AIDS among young people; the initiative aims to improve HIV prevention, testing, and treatment services, focusing on youth in high-burden countries and addressing gaps in care and support for young people living with HIV. The United States has provided an additional $ 17 million USD to support clade I mpox preparedness and response in Central and Eastern Africa. This funding

5096-434: The fight against HIV/AIDS.Peace Corps volunteers provide long-term capacity development support to nongovernmental, community-based, and faith-based organizations as they provide holistic support to people living with and affected by HIV/AIDS. The U.S. President's Emergency Plan for AIDS Relief: Five-Year Strategy report from 2009 outlines the PEPFAR strategy and programs for the fiscal years 2010-2014. Prevention To slow

5187-484: The first contribution to the Global Fund in 2001. Having just been named the recipient of the 2001 Philadelphia Liberty Medal , Annan announced he would donate his US$ 100,000 award to the Global Fund "war chest" he had just proposed creating. In June 2001 the United Nations General Assembly endorsed the creation of a global fund to fight HIV/AIDS. The G8 formally endorsed the call for the creation of

5278-481: The founding contribution in 2001, includes these contributions as part of PEPFAR. However, U.S. contributions are subject to restrictions, including a funding match requirement. While U.S. contributions peaked at $ 2.0 billion in FY 2023, they decreased to $ 1.7 billion in FY 2024 due to these restrictions. Additionally, the U.S. Congress allocated $ 3.5 billion in emergency funds in FY 2021 to mitigate COVID-19 impacts on HIV programs. Global Fund investments have led to

5369-421: The fund. Of the estimated 8 million individuals in low- and middle-income countries who currently receive treatment, nearly 6.8 million receive support through PEPFAR bilateral programs, the Global Fund, or both. There is additional evidence in the published literature that funding towards PEPFAR vis-a-vis antiretroviral therapy also affirmed maternal and child health in addition to HIV treatment outcomes Since

5460-482: The implementation of grants. However, the Global Fund's five-year evaluation in 2009 concluded that without a standing body of technical staff, the Global Fund is not able to ascertain the actual results of its projects. It has therefore tended to look at disbursements or the purchase of inputs as performance. It also became apparent shortly after the organization opened that a pure funding mechanism could not work on its own, and it began relying on other agencies – notably

5551-499: The implementation of the President's Emergency Plan for AIDS Relief (PEPFAR), and went on to be co-director of the Center for Global Health and Quality at Georgetown University Medical Center after he ended his appointment in 2017. A nominating process to find a successor to Dybul ran into trouble in 2017 because nominees had spoken out against Donald Trump as a candidate for president of

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5642-451: The inspector general. After pushing countries to reclaim stolen funds from the parties responsible and recovering only about half, the organization began in 2014 as a last resort reducing future grants by twice the amount of misappropriated funds. As of February 2016, this resulted in US$ 14.8 million of reductions (collectively) for Bangladesh, Guatemala, Nigeria and Sri Lanka. . Current status

5733-778: The largest global health program focused on a single disease in history until the COVID-19 pandemic . PEPFAR is implemented by a combination of U.S. government agencies in over 50 countries and overseen by the Global AIDS Coordinator at the United States Department of State . As of 2023, PEPFAR has saved over 25 million lives, primarily in sub-Saharan Africa . PEPFAR began with President George W. Bush and his wife, Laura Bush , and their interests in AIDS prevention, Africa , and what Bush termed “ compassionate conservatism .” According to his 2010 memoir, Decision Points ,

5824-538: The majority (89%) of U.S. global HIV funding, which includes support for UNAIDS and international HIV research. Managed by the Department of State 's Bureau for Global Health Security and Diplomacy, PEPFAR funding is detailed in annual congressional appropriations and also supports agencies like USAID , CDC , and DoD . The National Institutes of Health (NIH) also contributes to international HIV research. From FY 2015 to FY 2024, global HIV funding represented 42%-50% of

5915-425: The majority of the funding. The 15 "focus countries" were Botswana , Côte d'Ivoire , Ethiopia , Guyana , Haiti , Kenya , Mozambique , Namibia , Nigeria , Rwanda , South Africa , Tanzania , Uganda , Vietnam , and Zambia . Most of the $ 15 billion for the program was to be spent on these focus countries, $ 4 billion was allocated for programs elsewhere, and for HIV/AIDS research (the other $ 1 billion

6006-412: The organization became an administratively autonomous organization, terminating its administrative services agreement with the World Health Organization. The initial objective of the Global Fund – to provide funding to countries on the basis of performance – was supposed to make it different from other international agencies at the time of its inception. Other organizations may have staff that assist with

6097-423: The organization had disbursed more than US$ 41.6 billion to support these programs. According to the organization, in 2023 it helped finance the distribution of 227 million insecticide-treated nets to combat malaria , provided anti-tuberculosis treatment for 7.1 million people, supported 25 million people on antiretroviral therapy for AIDS, and since its founding saved 65 million lives worldwide. The Global Fund

6188-489: The past decade, U.S. funding for TB has significantly increased, rising from $ 242 million in FY 2015 to $ 406 million in FY 2024, now comprising about 3% of the U.S. global health budget of 12.9 billion USD. The Global Fund to Fight AIDS, Tuberculosis and Malaria is an independent, multilateral institution that funds HIV, TB, and malaria programs in low- and middle-income countries using contributions from public and private donors. The U.S., its largest donor since providing

6279-463: The past decade, funding has stabilized in recent years. The U.S. Agency for International Development (USAID) initiated a global tuberculosis (TB) control program in 1998, the U.S. has become one of the leading donors to global TB control. U.S. bilateral TB funding, managed by USAID, includes contributions to the TB Drug Facility and the Global Fund to Fight AIDS, Tuberculosis and Malaria . Over

6370-504: The president for identifying measurable outcomes in some areas, and specifying by law the quantitative benchmarks to be reached within discrete periods of time in others. The legislation also established the State Department Office of the Global AIDS Coordinator to oversee all international AIDS funding and programming. PEPFAR continues to be a cornerstone of U.S. global health efforts. On April 4, 2014, Ambassador Deborah L. Birx

6461-455: The prevention and reduction of HIV/AIDS-related stigma and discrimination. DoL programs (in over 23 countries) consist of three main components: increasing knowledge aboutHIV/AIDS, implementing workplace policies to reduce stigma and discrimination and building capacity of employers to provide support services. Peace Corps With programs in 73 countries, the Peace Corps is heavily involved in

6552-496: The private sector, GAP assists with HIV prevention, treatment, and care; laboratory capacity building; surveillance; monitoring and evaluation; and public health evaluation research. Department of Defense (DoD) The Department of Defense (DoD) implements PEPFAR programs by supporting HIV/AIDS prevention, treatment, care, strategic information, human capacity development and program/policy development in host military and civilian communities. The DoD HIV/AIDS Prevention Program (DHAPP)

6643-468: The private sector; and private foundations are also represented as voting members. There are also eight non-voting members, including the board chair and vice-chair; representatives of partner organisations including the World Health Organization and World Bank ; as well as the Additional Public Donors constituency. The chair and vice-chair of the Board (together the "Board Leadership") lead

6734-570: The same three-year period. The total amount of all allocations across all countries depends on the amount contributed by governments and other donors through the "replenishment" fundraising during the same three-year period. The countries, through their Country Coordinating Mechanism (CCM)), submit applications outlining how they will use the allocation, including selecting the main implementers of grants in countries called Principal Recipients (PR) to carry about programs within their respective countries. An independent Technical Review Panel (TRP) reviews

6825-454: The scenario of a funding deficit an "HIV Nightmare". The Global Fund stated it needed at least US$ 20 billion for the third replenishment (covering programs 2011–2013), and US$ 13 billion just to "allow for the continuation of funding of existing programs". Ultimately, US$ 11.8 billion was mobilized at the third replenishment meeting, with the United States being the largest contributor – followed by France, Germany, and Japan. The Global Fund stated

6916-451: The spread of the epidemic, PEPFAR supports a variety of prevention programs: the ABC approach ( A bstain, B e faithful, and correct and consistent use of C ondoms); prevention of mother to child transmission (PMTCT) interventions; and programs focusing on blood safety, injection safety, secondary prevention ("prevention with positives"), counseling and education. Initially, a recommended 20% of

7007-474: The start of PEPFAR in 2003, the program has utilized multi-year appropriations. PEPFAR reports to Congress on an annual basis, providing programmatic and financial data as required by law. The Fourteenth Annual Report to Congress on the President's Emergency Plan for AIDS Relief is available on the official PEPFAR website, as are more specific reports, financial information and other information. Global AIDS funding

7098-615: The story with a news release, stating, "The Global Fund has zero tolerance for corruption and actively seeks to uncover any evidence of misuse of its funds. It deploys some of the most rigorous procedures to detect fraud and fight corruption of any organization financing development." After the Associated Press story, a number of op-eds, including one by Michael Gerson published in The Washington Post in February 2011, sought to put

7189-527: The time, Carla Bruni-Sarkozy . Following Kazatchkine's resignation, the Global Fund announced the appointment of Gabriel Jaramillo, the former chairman and chief executive officer of Sovereign Bank, to the newly created position of general manager. Jaramillo, who had retired one year earlier, had since served as a Special Advisor to the Office of the Special Envoy for Malaria of the Secretary General of

7280-462: The two of them developed a serious interest in improving the fate of the people of Africa after reading Alex Haley ’s Roots , and visiting The Gambia in 1990. In 1998, while pondering a run for the U.S. presidency, he discussed Africa with Condoleezza Rice , his future secretary of state; she said that, if elected, working more closely with countries on that continent should be a significant part of his foreign policy. She also told him that HIV/AIDS

7371-755: The year 2013 onward. In 2008, funding data was obtained by the Center for Public Integrity from PEPFAR's own information system COPRS. The data were obtained after CPI sued the U.S. State Department to gain access to the data. The data were analyzed by the HIV/AIDS Monitor team at the Center for Global Development , who also share the full dataset. Global health funding by the United States In 2024, total U.S. global health funding through regular appropriations reached approximately $ 12.3 billion in FY 2024, up from $ 5.4 billion in FY 2006. The allocations by

7462-559: Was global health funding by the United States , followed by France , the United Kingdom , Germany , and Japan . The donor nations with the largest percent of gross national income contributed to the fund from 2008 through 2010 were Sweden , Norway , France, the United Kingdom , the Netherlands , and Spain . Per law in the United States, funding for the Global Fund cannot exceed one-third of total contributions from all donors to

7553-629: Was "considered the strongest of three shortlisted candidates to head the Global Fund ... A selection committee has evaluated the three nominees' qualifications and ranked 'Nabarro first, Kazatchkine second and (Alex) Cotinho third,' according to a Fund source." In September 2011, the AIDS Healthcare Foundation called for Kazatchkine's resignation in the wake of isolated yet unprecedented reports of "waste, fraud, and corruption" in order that "reforms may begin in earnest". In January 2012, Kazatchkine ultimately declared his resignation, following

7644-510: Was a central problem in Africa but that the United States was spending only $ 500 million per year on global AIDS, with the money spread across six federal agencies, without a clear strategy for curbing the epidemic. The U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (or the Global AIDS Act) specified a series of broad and specific goals, alternately delegating authority to

7735-479: Was a new record amount of funding, US$ 15.7 billion. Richard Feachem was named the Global Fund's first executive director in April 2002 and faced early criticism from activists for stating the Global Fund has "plenty" of money to start. Feachem served from July 2002 through March 2007. Dr. Michel Kazatchkine was then selected as executive director over the Global Fund's architect, David Nabarro , even though Nabarro

7826-479: Was complete. Funding was eventually restored. Other cases of abuse of funds, corruption and mismanagement in a series of grants forced the Global Fund to suspend or terminate the grants after such dealings became publicly known in Uganda , Zimbabwe , Philippines , and Ukraine . In February 2011, Financial Times reported that the Global Fund board failed to act previously on concerns over accountability including on

7917-511: Was contributed to the Global Fund ). With the reauthorization of PEPFAR in 2008 there was a shift away from the "focus country" approach by authorizing the development of a Partnership Framework model for regions and countries, with the aim of ensuring long-term sustainability and country leadership. Through bilaterally-funded programs, PEPFAR works in partnership with host nations to support treatment, prevention and care for millions of people in more than 85 countries. Partnership Frameworks provide

8008-437: Was established in January 2002 with Paul Ehmer serving as team leader, soon replaced by Anders Nordstrom of Sweden who became the organization's interim executive director. By the time the Global Fund Secretariat became operational, the organization had received US$ 1.9 billion in pledges. In March 2002, a panel of international public health experts was named to begin reviewing project proposals that same month. In April 2002,

8099-643: Was hosted by Canadian Prime Minister Justin Trudeau . Donors pledged US$ 12.9 billion (at 2016 exchange rates) for the 2017–2019 period. France held the sixth replenishment meeting in 2019 in Lyon , hosted by President Emmanuel Macron raising US$ 14.02 billion for 2020–2022. The seventh replenishment meeting was hosted by the United States on 19–21 September 2022 in New York City hosted by President Joe Biden , announced by Secretary of State Antony Blinken . The final total

8190-518: Was not random; they were the most obviously problematic, not the most typical." Global Fund spokesman Jon Liden told the Associated Press, "The messenger is being shot to some extent. We would contend that we do not have any corruption problems that are significantly different in scale or nature to any other international financing institution." Previous reviews of grants and the Global Fund had shown substantial misconduct in some programs, lack of adequate risk management, and operational inefficiency of

8281-631: Was sworn in as United States Global AIDS Coordinator . She held the position until January 2021 when Angeli Achrekar filled the Acting role, from being Principal Deputy. In May 2022, Dr. John N. Nkengasong was confirmed by the U.S. Senate as the U.S. Global AIDS Coordinator and was officially sworn in on June 13, 2022. A little over a year later, Ambassador Nkengasong joined U.S. Secretary of State Anthony J. Blinken to launch State Department’s Bureau of Global Health Security and Diplomacy (GHSD) August 1, 2023, which he leads. In December 2014, PEPFAR announced

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