The President's Emergency Plan for AIDS Relief (PEPFAR) has been one of the largest and most successful foreign assistance programs in history. PEPFAR has received continuous, strong support from two administrations and bipartisan support from Congress. Funding for PEPFAR grew from $2.3 billion in FY 2004 to $6.8 billion in FY 2010. The purpose of this review was to determine how U.S. embassies are fulfilling their responsibilities to coordinate, direct, and support PEPFAR. It considers program oversight by embassy officials and staff, including their role in policy and program implementation; the effectiveness of mission support; implications for program sustainability; and current and anticipated challenges. Contents: Introduction; Context; Overseas Executive Direction of PEPFAR; Interagency Coordination; role of PEPFAR Coordinators; Public Diplomacy Support for PEPFAR; Reporting Requirements; Looking to the Future. Includes country reports on Vietnam, Cambodia, and Dominican Republic. This is a print on demand report.

The U.S. government supports programs to combat global HIV/AIDS through an initiative that is known as the President's Emergency Plan for AIDS Relief (PEPFAR). This initiative was originally authorized in the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 and focused on an emergency response to the HIV/AIDS pandemic to deliver lifesaving care and treatment in low- and middle-income countries (LMICs) with the highest burdens of disease. It was subsequently reauthorized in the Tom Lantos and Henry J. Hyde U.S. Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (the Lantos-Hyde Act). Evaluation of PEPFAR makes recommendations for improving the U.S. government's bilateral programs as part of the U.S. response to global HIV/AIDS. The overall aim of this evaluation is a forward-looking approach to track and anticipate the evolution of the U.S. response to global HIV to be positioned to inform the ability of the U.S. government to address key issues under consideration at the time of the report release.

“Randy Shilts and Laurie Garrett told the story of the HIV/AIDS epidemic through the late 1980s and the early 1990s, respectively. Now journalist-historian-activist Emily Bass tells the story of US engagement in HIV/AIDS control in sub-Saharan Africa. There is far to go on the path, but Bass tells us how far we’ve come.” —Sten H. Vermund, professor and dean, Yale School of Public Health With his 2003 announcement of a program known as PEPFAR, George W. Bush launched an astonishingly successful American war against a global pandemic. PEPFAR played a key role in slashing HIV cases and AIDS deaths in sub-Saharan Africa, leading to the brink of epidemic control. Resilient in the face of flatlined funding and political headwinds, PEPFAR is America’s singular example of how to fight long-term plague—and win. To End a Plague is not merely the definitive history of this extraordinary program; it traces the lives of the activists who first impelled President Bush to take action, and later sought to prevent AIDS deaths at the whims of American politics. Moving from raucous street protests to the marbled halls of Washington and the clinics and homes where Ugandan people living with HIV fight to survive, it reveals an America that was once capable of real and meaningful change—and illuminates imperatives for future pandemic wars. Exhaustively researched and vividly written, this is the true story of an American moonshot.

Since 2004, the U.S. government has supported the global response to HIV/AIDS through the President's Emergency Plan for AIDS Relief (PEPFAR). The Republic of Rwanda, a PEPFAR partner country since the initiative began, has made gains in its HIV response, including increased access to and coverage of antiretroviral therapy and decreased HIV prevalence. However, a persistent shortage in human resources for health (HRH) affects the health of people living with HIV and the entire Rwandan population. Recognizing HRH capabilities as a foundational challenge for the health system and the response to HIV, the Government of Rwanda worked with PEPFAR and other partners to develop a program to strengthen institutional capacity in health professional education and thereby increase the production of high-quality health workers. The Program was fully managed by the Government of Rwanda and was designed to run from 2011 through 2019. PEPFAR initiated funding in 2012. In 2015, PEPFAR adopted a new strategy focused on high-burden geographic areas and key populations, resulting in a reconfiguration of its HIV portfolio in Rwanda and a decision to cease funding the Program, which was determined no longer core to its programming strategy. The last disbursement for the Program from PEPFAR was in 2017. Evaluation of PEPFAR's Contribution (2012-2017) to Rwanda's Human Resources for Health Program describes PEPFAR-supported HRH activities in Rwanda in relation to programmatic priorities, outputs, and outcomes and examines, to the extent feasible, the impact on HRH and HIV-related outcomes. The HRH Program more than tripled the country's physician specialist workforce and produced major increases in the numbers and qualifications of nurses and midwives. Partnerships between U.S. institutions and the University of Rwanda introduced new programs, upgraded curricula, and improved the quality of teaching and training for health professionals. Growing the number, skills, and competencies of health workers contributed to direct and indirect improvements in the quality of HIV care. Based on the successes and challenges of the HRH program, the report recommends that future investments in health professional education be designed within a more comprehensive approach to human resources for health and institutional capacity building, which would strengthen the health system to meet both HIV-specific and more general health needs. The recommendations offer an aspirational framework to reimagine how partnerships are formed, how investments are made, and how the effects of those investments are documented.

Over the past seven years, the Bush administration has launched a revolution in U.S. foreign aid. At no time since the administration of President Kennedy have there been more changes in the volume of aid, in aid's purposes and policies, in its organization, and in its overall status in U.S. foreign relations. George Bush's Foreign Aid: Transformation or Chaos? analyzes in detail the array of recent reforms of U.S. economic assistance and the difficult issues these reforms raise, while placing the changes and the manner of their implementation in a historical and political context. Lancaster draws out the challenges and opportunities this transformation of U.S. aid offer for the next administration to engage the emerging world of the 21st century.

In 2003, Congress passed the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act, which established a 5-year, $15 billion initiative to help countries around the world respond to their AIDS epidemics. The initiative is generally referred to by the title of the 5-year strategy required by the act-PEPFAR, or the President's Emergency Plan for AIDS Relief. PEPFAR Implementation evaluates this initiative's progress and concludes that although PEPFAR has made a promising start, U.S. leadership is still needed in the effort to respond to the HIV/AIDS pandemic. The book recommends that the program transition from its focus on emergency relief to an emphasis on the long-term strategic planning and capacity building necessary for a sustainable response. PEPFAR Implementation will be of interest to policy makers, health care professionals, special interest groups, and others interested in global AIDS relief.

While much progress has been made on achieving the Millenium Development Goals over the last decade, the number and complexity of global health challenges has persisted. Growing forces for globalization have increased the interconnectedness of the world and our interdependency on other countries, economies, and cultures. Monumental growth in international travel and trade have brought improved access to goods and services for many, but also carry ongoing and ever-present threats of zoonotic spillover and infectious disease outbreaks that threaten all. Global Health and the Future Role of the United States identifies global health priorities in light of current and emerging world threats. This report assesses the current global health landscape and how challenges, actions, and players have evolved over the last decade across a wide range of issues, and provides recommendations on how to increase responsiveness, coordination, and efficiency â€" both within the U.S. government and across the global health field.

This report presents three hypothetical case studies for how the AIDS epidemic in Africa could evolve over the next 20 years based on policy decisions taken today by African leaders and the rest of the world; and considers the factors likely to drive the future responses of African countries and the international community. The scenarios draw on the age-old tradition of story-telling, rather than using data projections, to explore the wider context of the AIDS epidemic, reflecting the complexity of the subject matter.

The world’s problems are indeed world problems: social and environmental crises, global trade and politics, and major epidemics are making public health a pressing global concern. From this constantly changing scenario, global health diplomacy has evolved, at the intersection of public health, international relations, law, economics, and management—a new discipline with transformative potential. Global Health Diplomacy situates this concept firmly within the human rights dialogue and provides a solid framework for understanding global health issues and their negotiation. This up-to-the-minute guide sets out defining principles and the current agenda of the field, and examines key relationships such as between trade and health diplomacy, and between global health and environmental issues. The processes of global governance are detailed as the UN, WHO, and other multinational actors work to address health inequalities among the world’s peoples. And to ensure maximum usefulness, the text includes plentiful examples, discussion questions, reading lists, and a glossary. Featured topics include: The legal basis of global health agreements and negotiations. Global public goods as a foundation for global health diplomacy. Global health: a human security perspective. Health issues and foreign policy at the UN. National strategies for global health. South-south cooperation and other new models of development. A volume of immediate utility with a potent vision for the future, Global Health Diplomacy is an essential text for public health experts and diplomats as well as schools of public health and international affairs.