3Rd Annual Report 3.9.22.1248:3Rd Annual Report

The Power of Partnerships: The President’s Emergency Plan for AIDS Relief Third Annual Report to Congress The Power of Partnerships: The President’s Emergency Plan for AIDS Relief Third Annual Report to Congress Cover Photo Through HIV counseling and testing for couples at the U.S.-supported Kericho District Hospital, Joyce and David found out they are infected with HIV. Joyce was four months pregnant with her second child at the time of diagnosis. Thanks to the clinic’s program to prevent mother-to-child HIV transmission, Joyce delivered a baby boy who is HIV-negative. After a year of antiretroviral treatment, David has also gained weight and feels healthy – enabling him to provide for his family. Photo by Doug Shaffer This report was prepared by the Office of the United States Global AIDS Coordinator in collaboration with the United States Departments of State (including the United States Agency for International Development), Defense, Commerce, Labor, Health and Human Services (including the Centers for Disease Control and Prevention, the Food and Drug Administration, the Health Resources and Services Administration, the National Institutes of Health, the Substance Abuse and Mental Health Services Administration, and the Office of Global Health Affairs), and the Peace Corps. 2 ❚ The Power of Partnerships: The President’s Emergency Plan for AIDS Relief CONTENTS Acronyms and Abbreviations . 5 Overview – The Power of Partnerships . 9 Chapter 1 – Critical Intervention in the Focus Countries: Prevention. 27 Chapter 2 – Critical Intervention in the Focus Countries: Treatment . .55 Chapter 3 – Critical Intervention in the Focus Countries: Care . .79 Chapter 4 – Building Capacity: Partnerships for Sustainability . .107 Chapter 5 – Responding to Critical Issues: Gender and HIV/AIDS . .129 Chapter 6 – Responding to Critical Issues: Children and HIV/AIDS . .139 Chapter 7 – Improving Accountability and Programming . .153 Chapter 8 – Implementation and Management . .167 Chapter 9 – Strengthening Bilateral Programs Worldwide . .177 Chapter 10 – Strengthening Multilateral Action . .189 Chapter 11 – Engendering Bold Leadership . .199 Appendices . .207 Third Annual Report to Congress ❚ 3 4 ❚ The Power of Partnerships: The President’s Emergency Plan for AIDS Relief ACRONYMS AND ABBREVIATIONS AB Abstinence, Be faithful ABC Abstinence, Be faithful, and, as appropriate, correct and consistent use of Condoms ACT Artemisin-based combination therapy (for malaria) AEI African Education Initiative AIS AIDS Indicator Surveys ANC Antenatal clinic ART An tiretroviral treatment ARV Antiretroviral drug BMIST Battlefield Medical Information System-Tactical CBO Community-based organization CCM Country Coordinating Mechanism CDC Centers for Disease Control and Prevention (U.S.) COP Country Operational Plan COPRS Country Operational Plan and Reporting System COM Chief of Mission CPT Co-trimoxazole preventive therapy CY Calendar year DBS Dried blood spot DHAPP Department of Defense HIV/AIDS Prevention Program DHS Demographic and Health Survey DoC Department of Commerce (U.S.) DoD Department of Defense (U.S.) DoL Department of Labor (U.S.) DOTS Directly Observed Therapy, Short Course DRA Drug regulatory authority DTC Diagnostic testing and counseling FBO Faith-based organization FDA Food and Drug Administration FDC Fixed-dose combination (formulation) FY Fiscal year GAP Global AIDS Program (Centers for Disease Control and Prevention) GBV Gender-based violence Third Annual Report to Congress ❚ 5 GIS Geographic Information Systems GTT Global Task Team on Improving AIDS Coordination Among Multilateral Institutions and International Donors HAART Highly Active Antiretroviral Therapy HBC Home-based care HHS Department of Health and Human Services (U.S.) HMIS Health management information systems HRH Human resources for health HRSA Health Resource and Services Administration ICT Information and communications technology IDU Injecting drug user IT Information technology MAP Multi-Country AIDS Programme (World Bank) M&E Monitoring and evaluation MoH Ministry of Health MSM Men who have sex with men NACP National AIDS Control Program NGO Non-governmental organization NIAID National Institute of Allergy and Infectious Diseases NIH National Institutes of Health NPI New Partners Initiative NRL National Resource Laboratory OGAC Office of the U.S. Global AIDS Coordinator OI Opportunistic infection OMB Office of Management and Budget OVC Orphans and vulnerable children PART Performance Assessment Rating Tool PCR Polymerase chain reaction PDA Personal digital assistant PEP Post-exposure prophylaxis PEPFAR President’s Emergency Plan for AIDS Relief (Emergency Plan) PHE Public Health Evaluation PLWHA People living with HIV/AIDS PMI Presidential Malaria Initiative PMTCT Prevention of mother-to-child HIV transmission PPP Public-private partnership 6 ❚ The Power of Partnerships: The President’s Emergency Plan for AIDS Relief PR Principal recipient PSC Policy and Strategy Committee SAMHSA Substance Abuse and Mental Health Services Administration SCMS Supply Chain Management System SI Strategic information STI Sexually transmitted infection TB Tuberculosis UNAIDS Joint United Nations Programme on HIV/AIDS UNHCR United Nations High Commission for Refugees UNICEF United Nations Children’s Fund USAID United States Agency for International Development USAID/OIG U.S. Agency for International Development Office of the Inspector General USG United States Government VCT Voluntary counseling and testing WHO World Health Organization XDR-TB Extensively Drug-Resistant Tuberculosis ZDV Zidovudine Third Annual Report to Congress ❚ 7 8 ❚ The Power of Partnerships: The President’s Emergency Plan for AIDS Relief “Our work in the world is also based on a timeless truth: To whom much is given, much is required. ... We must continue to fight HIV/AIDS.” President George W. Bush State of the Union January 23, 2007 President George W. Bush and Mrs. Laura Bush tour the Pasteur Institute in Ho Chi Minh City, Vietnam November 20, 2006. Overview - The Power of Partnerships: The Impact of Partnerships Between Host Countries and the President’s Emergency Plan for AIDS Relief in Turning the Tide against HIV/AIDS The Transformational Power of Partnerships Initiative, the $600 million Africa Education Initiative, The President’s Emergency Plan for AIDS Relief and the $55 million Women’s Empowerment and Justice (Emergency Plan/PEPFAR) is part of a broader renaissance Initiative. in partnerships for international development. Under the leadership of President George W. Bush, and with the The Emergency Plan is central to U.S. efforts to “connect bipartisan support of Congress, this renaissance – with a the dots” of international development. Emergency Plan particular focus on Africa – has represented both a massive programs are increasingly linked to other important pro- commitment of treasure and a change of heart. The United grams – including those of other U.S. Government agen- States is changing the paradigm for development, rejecting cies and other international partners – that meet the needs the flawed “donor-recipient” mentality and replacing it of people infected or affected by HIV/AIDS in such areas with an ethic of true “partnership.” as nutrition, education and gender. Partnership is rooted in hope for and faith in people. It is important to note that PEPFAR is not the only inter- Partnership means honest relationships between equals national partner of host nations. Other key international based on mutual respect, understanding and trust, with partners include: the Global Fund to Fight AIDS, obligations and responsibilities for each partner. Tuberculosis and Malaria (Global Fund); the World Bank; Partnership is the foundation of PEPFAR’s success and of United Nations agencies, led by the Joint United Nations what Secretary of State Condoleezza Rice has called “trans- Programme on HIV/AIDS (UNAIDS); other national gov- formational diplomacy.” ernments; and – with growing commitment – the business- es and foundations of the private sector. All have vital con- All told, the President has presided over a tripling of devel- tributions to make to the work of saving lives in the field. opment support for Africa, and this has meant not only dollars but a new ethic of partnership. The $15 billion While impressive results are reported here, they are not PEPFAR commitment joins other key initiatives: a dou- fundamentally the work of Americans. They are the work bling of U.S.-Africa trade, the $5 billion Millennium of courageous people in nations devastated by HIV/AIDS Challenge Account, the $1.2 billion President’s Malaria who are saving the lives of their countrymen and women. Overview – The Power of Partnerships ❚ 9 The American people, through the President’s Emergency partnerships a reality. The history of this pandemic in the Plan, have provided resources and support for communi- 21st Century has taken a course that was impossible to fore- ties around the world to meet the challenge of this pan- see just a few years ago. demic. These partnerships are having a global impact and transforming the face of our world today. This transformation from despair to hope will be a project of a generation or more. While we are in its early days, There is a growing consensus that the world’s response to many lives have already been saved, and the way forward to global HIV/AIDS has undergone a transformation in save many millions more is now clear. recent years – and that new U.S. partnerships with hard-hit nations have

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