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Interview with Ambassador Goosby, U.S. Global AIDS Coordinator

November 6, 2009

What has the United States done to combat global HIV/AIDS since PEPFAR’s launch in 2003?

As the largest commitment in history by any nation to combat a single disease, providing more than $25 billion to the fight against global AIDS, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has had numerous achievements in the past six years. For instance, today, an estimated four million individuals in low- and middle-income countries have access to antiretroviral treatment – and more than half of these individuals are supported by the American people though PEPFAR. 

PEPFAR has also provided compassionate care for more than 10 million people affected by HIV/AIDS, including more than four million orphans and vulnerable children, and we have supported prevention of mother-to-child transmission programs that have allowed nearly 240,000 babies to be born HIV-free.

But these successes would not have been possible without our strong partnerships with countries around the world. As we move into the second phase of the program, we look forward to building on our achievements and working together with our partner countries to ensure a sustainable response.

PEPFAR was reauthorized last year by the U.S. Congress, and as you mentioned, the program is entering its second phase. As the new PEPFAR Coordinator, what is your vision for the future of the program?

Looking forward,  four major themes will guide the program’s work –  intensifying the focus on HIV prevention; pursuing strong country partnerships, country ownership and coordinated multilateral engagement; supporting health systems strengthening through programs and country-driven planning; and taking effective interventions to scale to achieve population-level health outcomes. Focusing on these four areas in the coming years will be crucial if we are to maximize our efforts and expand opportunity and prosperity to more people in more places around the world. 

As we move forward, PEPFAR will continue to work with governments and our global partners to ensure the sustainability of the programs we support in order to create strong national HIV/AIDS responses in the countries in which PEPFAR works. President Barack Obama, Secretary of State Hillary Rodham Clinton and I are committed to addressing the HIV/AIDS crisis around the globe, and the U.S. will not step away from this commitment.

Secretary Clinton has said that she and President Obama are deeply committed to continuing and building on PEPFAR's success. But how exactly does PEPFAR fit into the Obama Administration’s Global Health Initiative?

The fight against global AIDS is a central piece of the global health agenda outlined by President Obama and Secretary Clinton. And as the United States’ global AIDS program, PEPFAR will play a pivotal role in furthering the Administration’s Global Health Initiative. This initiative will continue our country’s leadership on global health priorities like HIV, TB and malaria, while expanding the integration of current U.S.-supported programs with efforts that address maternal and child health, family planning and neglected tropical diseases. As part of this effort, the U.S. will use existing HIV prevention, treatment and care programs as a platform to strengthen and extend health systems in many areas, including human resources, infrastructure, informatics, commodities logistics and laboratory services.

As PEPFAR works to build on its existing efforts, how will the program work to also increase country ownership and sustainability of HIV programs?

The most effective response to HIV and other diseases is one tailored to the specific situation in each country.  Ultimately, national governments carry the long-term responsibility of responding to their respective epidemics, so PEPFAR will work with countries to implement sustainable interventions that address their needs and are grounded in local capacity.  

To ensure this happens, the United States will place a renewed emphasis on partnering with countries to build national HIV/AIDS responses over the next five years. We are already working to engage partner governments through Partnership Frameworks. Through these five-year joint strategic frameworks, PEPFAR is supporting and strengthening national HIV/AIDS strategies and better positioning countries to address their HIV epidemics over the long term.

Along with this effort, America will support country leadership as they engage international partners, civil society and non-governmental organizations to support their fight against HIV/AIDS.  And we will support governments as they work to make universal access a reality in their countries. 

Through these efforts, I believe that we will continue to make progress in the fight against HIV/AIDS.  And the United States will continue to stand strong in our commitment to defeat this pandemic.