March 22, 2024
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Key takeaways:
- The House reauthorized the U.S. President’s Emergency Plan for AIDS Relief for 1 year as part of a spending package.
- Since its launch in 2003, PEPFAR has saved more than 25 million lives, according to the CDC.
The U.S. House of Representatives reauthorized the U.S. President’s Emergency Plan for AIDS Relief for 1 year as part of a spending package passed on Friday, sending the plan to the Senate for consideration.
The reauthorization runs through March 25, 2025, funding PEPFAR at the same level as before. Authorization for PEPFAR had partially expired in September, when Congress failed to pass a budget.
Data derived fromJohnson BC, et al. Abstract 1036. Presented at IDWeek; Oct. 11-15, 2023; Boston.
Since its launch in 2003, PEPFAR has saved more than 25 million lives, according to the CDC. It has increased the number of people with HIV who take ART by 300-fold in the last 20 years, data show. Roughly 20 million people in 54 countries receive treatment through the program.
“The administration applauds the inclusion of … the 1-year reauthorization of the PEPFAR program, although the administration continues to call on the Congress to reauthorize PEPFAR for an additional 5 years,” the White House said in a statement.
PEPFAR was originally funded in 2003 with a 5-year, $15 billion budget. It was reauthorized for another 5 years in 2008 with a $48 billion budget, but funding remained flat when it was reauthorized in 2013 and 2018.
In addition to HIV prevention and treatment, PEPFAR has also helped to strengthen public health agencies in sub-Saharan Africa, helping to significantly increase COVID-19 testing and to deliver tuberculosis preventive treatment for 13.4 million people with HIV who are on ART.
“Pleased to see PEPFAR will be extended in the minibus (spending package) we are considering this week,” U.S. Sen. Dick Durban wrote on X, formerly known as Twitter. “It is bewildering to me that some have argued we shouldn’t reauthorize this historic, lifesaving program.”
Reauthorization had been held up by Republican and conservative concerns that PEPFAR funds were being used to for sexual and reproductive health, according to members of Congress.
If the package is approved by the Senate and signed by Biden, PEPFAR will once again be up for reauthorization in the 2025 budget, which Congress has already started to debate.
References:
Perspective
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Paul A. Volberding, MD
PEPFAR is, really, with no question, a remarkable story of success in expanding life-saving state-of-the-art medical and public health measures to economically distressed populations in the global South. With consistently bipartisan support, and in partnership with branded and generic medicine producers, the program has saved millions of lives and reduced HIV transmission — particularly and remarkably so in infants otherwise destined to become infected and die in this devastating epidemic.
PEPFAR has made essentially the same array of HIV medicines available as are used in resource-abundant regions at a fraction of the cost and with almost no taint of corruption or political interference. Treatment of persons infected with HIV medicines allows them to recover and remain healthy and to block further transmission, both to sexual partners and to newborn infants. HIV medicines provided by PEPFAR can also prevent acquisition by uninfected persons through pre- or post-exposure prophylaxis.
The success of PEPFAR is a stunning record of the best approaches to public health. The continued funding of the program, even temporarily, gives us hope that this life-saving investment can continue and that PEPFAR can prove to be a model for addressing other health disparities afflicting so much of our global community.
Paul A. Volberding, MD
Chief Medical Editor, Healio | Infectious Disease News
Professor emeritus of medicine
University of California, San Francisco
Disclosures: Volberding reports serving on data and safety monitoring boards for Gilead, Merck and the National Institutes of Allergy and Infectious Diseases.
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