USAID implemented its first HIV/AIDS programs in 1986 and currently supports the implementation of Emergency Plan HIV/AIDS programs in nearly 100 countries, through direct in-country presence in 50 countries and through seven regional programs in the remaining countries. As a development agency, USAID has focused for many years on strengthening primary health care systems in order to prevent, and more recently to treat and care for, a number of communicable diseases, including HIV/AIDS.
Under the Emergency Plan, USAID's foreign service officers, trained physicians, epidemiologists, and public health advisors work with governments, NGOs, and the private sector in order to provide training, technical assistance, and commodities (including pharmaceuticals) to prevent and reduce the transmission of HIV/AIDS and to provide treatment and care to people living with HIV/AIDS. As the HIV/AIDS epidemic in most countries outside of the focus countries is still limited to high-risk groups, USAID focuses considerable resources on reducing high-risk behaviors not only in high-risk groups, but also in the general population.
USAID is uniquely positioned to support multi-sectoral responses to HIV/AIDS that address the widespread impact of HIV/AIDS outside the health sector in high-prevalence countries. In these countries, USAID is supporting programs, in areas such as agriculture, education, democracy, and trade, linked to HIV/AIDS and which mutually support the objective of reducing the impact of the pandemic on nations, communities, families, and individuals. USAID also supports the New Partners Initiative (NPI), which builds the capacity of organizations at the community level, while also building local ownership of HIV/AIDS responses for the long term.
Under the Emergency Plan, USAID also supports a number of international partnerships (such as the International AIDS Vaccine Initiative and UNAIDS); provides staff support to the U.S. delegation to the Global Fund to Fight AIDS, Tuberculosis and Malaria; and works with local coordinating committees of the Global Fund to improve implementation of Global Fund programs and ensure that they complement USG programs. Finally, USAID supports targeted research, development, and dissemination of new technologies (including microbicides), as well as packaging and distribution mechanisms for ARVs through the Supply Chain Management System, established in fiscal year 2005.
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