The U.S. President's Emergency Plan for AIDS Relief - June 2009 Newsletter

On Tuesday, June 23, 2009, Eric Goosby, MD, assumed the role of Ambassador at Large and Global AIDS Coordinator with the U.S. Department of State. In this role, Ambassador Goosby will lead all U.S. Government international HIV/AIDS efforts. Ambassador Goosby will oversee implementation of the U.S. President?s Emergency Plan for AIDS Relief (PEPFAR), as well as U.S. Government engagement with the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Ambassador Goosby served as CEO and Chief Medical Officer of Pangaea Global AIDS Foundation from 2001 to June 2009. At present, he is also Professor of Clinical Medicine at the University of California, San Francisco. Ambassador Goosby has played a key role in the development and implementation of HIV/AIDS national treatment scale-up plans in South Africa, Rwanda, China, and Ukraine. He focuses his expertise on the scale-up of sustainable HIV/AIDS treatment capacity, including the delivery of HIV antiretroviral drugs, within existing healthcare systems. Ambassador Goosby has extensive international experience in the development of treatment guidelines for use of antiretroviral therapies, clinical mentoring and training of health professionals, and the design and implementation of local models of care for HIV/AIDS. He has worked closely with international partners on the development of successful HIV/AIDS treatment and treatment-based prevention strategies for high-risk populations.

Ambassador Goosby has over 25 years of experience with HIV/AIDS, ranging from his early years treating patients at San Francisco General Hospital when AIDS first

During the Clinton Administration, he served as Deputy Director of the White House National AIDS Policy Office and Director of the Office of HIV/AIDS Policy of the U.S. Department of Health and Human Services. Ambassador Goosby has longstanding working relationships with leading multilateral organizations, including UNAIDS, the Global Fund and the World Health Organization.

The 2009 HIV/AIDS Implementers? Meeting was held this month in Windhoek, Namibia from June 10 ? June 14. The meeting was hosted by the Government of Namibia and co-sponsored by the U.S. President?s Emergency Plan for AIDS Relief (PEPFAR); the Global Fund to Fight AIDS, Tuberculosis and Malaria; UNAIDS; UNICEF; the World Bank; the World Health Organization; and the Global Network of People Living with HIV.

At the opening ceremony, H.E Hifikepunye Pohamba, President of the Republic of Namibia, welcomed 1,500 HIV/AIDS implementers from around the globe to the Meeting.

?Our country is honored to host this event. ? This meeting represents a renewed call to all partners to continue working together to fight the AIDS pandemic. It serves as another important platform to showcase the successes that have been achieved over the years,? said Pohamba.

The conference focused on three major themes: sustainability, efficiency and effectiveness, and prevention. Meeting attendees discussed the need for HIV/ AIDS programs to be locally owned and led, for partners to work together to set clear roles and responsibilities, and for host governments, civil society, and international partners to be held accountable.

Conversations at the meeting also stressed the need to make prevention the center piece of all HIV/ AIDS efforts, noting while treatment has been an extraordinary success, the number of new infections continues to outpace the number added to treatment.

?We have all come out from the sessions convinced, inspired and motivated or sometimes frustrated and disappointed. Inspired and motivated, because there are interventions that work and where it is working, we are making a difference. Frustrated and disappointed because we know that we are not there yet,? said the Honorable Richard Kamwi, Minister of Health and Social Services from the Government of the Republic of Namibia.

The Implementers? Meeting also touched on current global economic pressures.

?Some may question the feasibility of ambitious targets during a global economic downturn. When times are tough, the importance of investing wisely becomes even more important. Speaking on AIDS and other health problems represents the best investment that any society could make. ?Yet the global economic downturn does demand that we use every dollar as effectively as possible to achieve maximum impact. This meeting supports this aim,? said Paul De Lay, UNAIDS Deputy Executive Director, Programme, ad interim and Director of Evidence, Monitoring and Policy.

The meeting concluded after four days of engaging dialogue about multi-sectoral HIV/AIDS programs and conversations regarding the challenges affecting the scale-up of HIV/AIDS prevention, treatment and care and ways to addresses them.

?This exchange will better position host countries to address their HIV epidemics over the long term,? said Michele Moloney-Kitts, Assistant PEPFAR Coordinator.

For more information on the meeting, please visit www.hivimplementers.org. An archived webcast of select sessions from the meeting and related online resources will be available following the meeting.

In addition, a blog on the conference by former Boston Globe reporter John Donnelly is available on the Center for Global Health Policy website at http:// sciencespeaks.wordpress.com/category/hiv_conference/. The blog features guest entries and interviews by representatives from meeting co-sponsors, implementing partners, and civil society organizations.

The Government of the United States and Government of the Republic of Malawi recently took a major step forward in the ongoing fight against HIV/AIDS. On May 18, Peter W. Bodde, U.S. Ambassador to Malawi, and Randson Mwadiwa, Secretary to the Treasury of the Government of the Republic of Malawi, signed a landmark document that establishes a new framework for the partnership between the United States and Malawi to combat HIV/AIDS.

The document also establishes a new foundation on which the United States and Malawi will collaborate to improve the health policy environment in the country.

The new Framework focuses on reducing new HIV infections, while maintaining ongoing activities aimed at improving the quality of treatment and care and mitigating the impacts of HIV/AIDS on individuals and households. These objectives are to be achieved within a framework of enhanced Malawian leadership and ownership of the overall response.

Ambassador Bodde commented to the Malawian and American officials at the signing event, ?Not only is this the first framework document of its kind, it will serve as the model for those that follow in other countries. Your work in negotiating and finalizing this plan will undoubtedly have a tremendous impact on many people?s lives. Let me emphasize however, negotiating and signing the document is the easy part ? the real work of implementing it begins now.?

Secretary Mwadiwa warmly thanked the Ambassador for this new partnership between the two governments, and he committed his government to fully and successfully implementing the plan.

The Partnership Framework with Malawi is the first signed with any country following the reauthorization in 2008 of the U.S. President?s Emergency Plan for AIDS Relief (PEPFAR).

On June 24, 2009, the Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria (GBC) presented their 2009 Business Excellence Awards to eight standard-setting companies, including Warner Bros., for their innovative programs working to combat global disease.

In partnership with the U.S. President?s Emergency Plan for AIDS Relief (PEPFAR), Warner Bros. applied its core competence to develop an action-based videogame pilot that is delivering targeted HIV prevention messages to East African youth.

The videogame combines traditional game play with messages aimed at changing behavior, focusing on five key behaviors that can reduce HIV infections among youth: delaying the onset of sexual activity, abstinence, avoiding multiple sex partners, correct and consistent condom use, and uptake of voluntary counseling and testing services. The pilot game is called ?Pamoja Mtaani,? which is Swahili for ?Together in the Hood.?

The game development is part of The Partnership for an HIV-Free Generation, a public-private partnership among PEPFAR and businesses with critical core competencies such as messaging, new technologies and market research.

?The way to get the job done is for everyone to work together. The fight against HIV/AIDS, TB, and malaria cannot be won without the corporate sector stepping up and playing an active role ? and these award winners are doing exactly the kind of thing that all companies can and should do. They don?t just talk, they take action. And their action saves lives,? said John Tedstrom, GBC?s President and CEO.

When Jack* was first referred to a home-based care group supported by the U.S. President?s Emergency Plan for AIDS Relief (PEPFAR) in Bangkok, Thailand, he had almost given up on life. HIV-positive as a result of former drug use, and troubled with tuberculosis and an opportunistic infection, Jack was temporarily disabled and quickly losing the will to live.

?You never knew what I have to face,? Jack recalled. ?You never understand how I feel. Discrimination is all around.?

But outreach workers refused to allow Jack to give up. HIV-positive themselves, they understood his fear of stigma and discrimination; however, unlike Jack, they also understood that HIV/AIDS need not be a death sentence. The home-based care group worked tirelessly to convince him to seek and receive appropriate care and treatment.

As a result of the group?s perseverance, Jack agreed to start antiretroviral treatment (ART).

?The main task of home-based care is to provide comfort, understanding, and knowledge?not only to the patient, but also to their family members, because of the discrimination they all may face,? said the head of the PEPFAR-supported home-based care group.

Half a year later, Jack?s health and lifestyle have improved. Jack continues to receive ART and visits from the home-based care providers.

He also receives income generation support from the Thailand Ministry of Social Development and Human Security.

Today, Jack is a volunteer for the group and has begun disclosing his status to others. And while his income is small, Jack regularly donates money to orphans and vulnerable children.

?They are my role model,? Jack said of the home-based care group. ?They are providing great help to HIV-positive people.?