Sustainability Readiness in PEPFAR Countries
Data Note
PEPFAR 2023 Country and Regional Operational Plan (COP/ROP) Guidance for all PEPFAR-Supported Countries.
See, for example: Cohen JM, Smith DL, Cotter C. et al., “Malaria resurgence: a systematic review and assessment of its causes”, Malaria Journal, 11(122), 2012; Greenwood B, Zongo I, Dicko A, Chandramohan D, Snow RW, Ockenhouse C, “Resurgent and delayed malaria”, Malaria Journal, 21(1), 2022; Institute of Medicine, Ending Neglect: The Elimination of Tuberculosis in the United States, 2000; WHO, Global Tuberculosis Report, 2022; WHO World Malaria Report, 2022.
In most cases, the targets used for benchmark scoring are globally set standards; however, there were a few exceptions. See Methods for more details about these.
Most countries are identified by PEPFAR as belonging to a specific epidemic control status grouping, but four were not; we categorized these countries into epidemic control groups using PEPFAR’s definition/metrics approach. See Methods for more details.
Incidence-to-mortality (IMR) are defined as the ratio of new HIV infections to the total number of deaths from all causes among people living with HIV. As part of PEPFAR’s efforts to help countries reach epidemic control, the target for this value is at or below 1. For more information on countries’ progress in reaching this target, see the KFF dashboard Progress Toward Global HIV Targets in PEPFAR Countries.
The global viral load suppression target is defined as at least 73% of people living with HIV having suppressed viral loads. This target is part of the UNAIDS 90-90-90 targets which had a target date of 2020. For more information on countries’ progress in reaching this target, and the updated 95-95-95 targets, see the KFF dashboard Progress Toward Global HIV Targets in PEPFAR Countries.
Countries that have a stabilized HIV/AIDS epidemic, as shown by a trend of decreasing IMR, and have reached a VLS of 73% or higher among all people living with HIV, per the PEPFAR 2023 COP Guidance/FY 2024 Technical Considerations.
Countries that have a stabilized HIV/AIDS epidemic, as shown by a trend of decreasing IMR, but have not yet reached a VLS of at least 73% among all people living with HIV, per the PEPFAR 2023 COP Guidance/FY 2024 Technical Considerations.
Countries that show a trend of increasing or flat IMR and have not yet achieved a VLS of at least 73% among all people living with HIV, per the PEPFAR 2023 COP Guidance/FY 2024 Technical Considerations.
Methods
For the Dominican Republic, Ukraine, and Vietnam, we relied on UNAIDS data for incidence-to-mortality ratio (IMR) and viral load suppression (VLS) among people living with HIV estimates using the latest year of data available (2021). For Mozambique, we relied on PEPFAR’s 2021 SID for Mozambique for an IMR estimate and Mozambique’s PHIA for an estimate of VLS among people living with HIV. Mozambique and Vietnam were categorized as “Near Epidemic Control” due to decreasing IMR trends, but viral load suppression rates below the global target of 73%. The Dominican Republic and Ukraine were categorized as “Not Near Epidemic Control” due to increasing IMR trends and viral load suppression rates below the global target of 73%.