OPINION: PEPFAR Funding Trends 'Worrisome'

Michael Merson, director of the Duke Global Health Institute, writes in The Hill’s “Congress Blog” that much of the progress in the fight against HIV/AIDS “has been made — and the lives of millions of people saved — because of PEPFAR, … [t]he largest ever global investment in health by the United States government.” With PEPFAR’s “aggressive new goals” — to provide antiretroviral drugs to six million people in low- and middle-income countries, “fund 4.7 million male circumcisions and provide antiretroviral therapy to 1.5 million HIV-infected pregnant women by 2013” — “[w]e need to ask: Are we setting ambitious goals that we’re not prepared to fund or meet? Are we setting up one of our country’s greatest successes for failure?” Merson asks. He notes that “PEPFAR funding has flatlined despite these new targets and is not nearly enough to maintain progress and continue reducing new HIV/AIDS cases and deaths” and that “uncertainty” surrounds the “commitment by Congress” and the outcome of the presidential election. Saying that “PEPFAR itself also needs to continue to adjust its priorities,” Merson states that “treatment, prevention, care, health system capacity and scientific research to develop an HIV vaccine require financial commitment, strong political will and investment in resources from all stakeholders. Let us not fall behind now and bring back the suffering of the past” (7/20).