America's Commitment to the Fight Against Global AIDS (September 2009)


“President Obama and I are deeply committed to PEPFAR’s continued success. ...And we see PEPFAR’s potential to serve as a platform upon which to build other essential health services for individuals and families through the Obama Administration’s Global Health Initiative and our commitments to partner with governments to help them develop their own capacity to fight the disease and the epidemics that they themselves are confronting.”

- Secretary of State Hillary Rodham Clinton

The fight against global AIDS is a central piece of the foreign policy and global health agenda outlined by President Barack Obama and Secretary of State Hillary Rodham Clinton. This Administration’s Global Health Initiative will continue our country’s leadership on global health priorities like HIV, tuberculosis and malaria, as well as expand our focus on integrating current programs with those that address maternal and child health, family planning and neglected tropical diseases.

Secretary Clinton has emphasized the need to elevate development as a core pillar of American foreign policy. To achieve this end, the U.S. is placing a renewed emphasis on partnerships. Increasing partner country ownership and ensuring the sustainability of our efforts will be key to maximizing our development efforts, through PEPFAR and through other development programs, and expanding opportunity and prosperity to more people in more places around the world.

Building a Sustainable Response through Country-level Leadership:

An important role of international development partners such as PEPFAR is to develop and support country-level leadership, and a principal focus of PEPFAR over the next five years will be building the long-term sustainability of national HIV/AIDS responses.

  • PEPFAR will increase efforts around supporting partner government capacity to plan, oversee and manage programs; to deliver quality services with the participation of local civil society and communities; and ultimately, to finance health programs.
  • Strong national government commitment is essential because each government is ultimately responsible for promoting the health of its population.
  • PEPFAR Partnership Frameworks – five-year joint strategic plans designed to fully align PEPFAR support with national HIV/AIDS strategies – are one vehicle for promoting partner government leadership of HIV/AIDS efforts, along with strong civil society and community participation.


Supporting Health Systems Strengthening:

A critical goal of the Global Health Initiative – and a longstanding PEPFAR activity – is support for health systems strengthening.

  • It is important to note that investments in HIV do not just address a single disease. Over the past decade, the significant resources directed to HIV have had a cumulative impact on the health systems where PEPFAR works. For example, investments in HIV have resulted in beneficial impacts on child mortality and women’s access to care in multiple countries in sub-Saharan Africa.
  • Continued and intensified investment in this area, including the health workforce, will be crucial to scaling up proven interventions and adding to the sustainability of PEPFAR, and other health and development programs.
  • PEPFAR support has already strengthened and extended health systems in many areas including human resources, infrastructure, informatics, commodities logistics, and laboratory services.


Scaling up Proven Interventions:

  • PEPFAR is committed to placing a renewed emphasis on scaling up proven interventions, and will continue to use data on what works and what doesn’t work to inform program implementation.


Expanding Integration Across Programs:

  • The U.S. Government will work to strengthen PEPFAR’s efforts by expanding integration across programs – looking for opportunities to link with activities supported by the U.S. Government and international partners, particularly around maternal and child health programming, but also expanding our activities with multilateral partners.

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