US PEPFAR "at risk" from unfocused goals

The AIDS Healthcare Foundation, a USA-based global health care charity providing care to HIV/AIDS patients, has warned that US President George W Bush's President's Emergency Plan for AIDS Relief is at risk of losing its focus, following proposals to amend the program in the US Congress as it faces renewal. The PEPFAR, launched in 2003, has largely concentrated on the delivery of antiretroviral drugs to 15 countries with the goal of supplying these products to two million people and preventing the infection of seven million more. A controversial element of the scheme is the insistence that 30% of the funds are used to finance "abstinence-promoting" organizations (Marketletters passim).

Despite criticism from NGOs and critics of the faith-based elements of the PEPFAR, it has succeeded in providing ARV drugs to 1.4 million people so far, in contrast with the World Health Organization's more ambitious, but less effective, "3 by 5" initiative (Marketletter June 5, 2006) which has been hampered by the failure of governments in developing countries to lower tariffs and taxes on imported drugs; as well as bureaucratic obstacles, including lengthy drug registration processes.

The AHF warns that, despite a significantly increased budget, Pres Bush's initiative runs the risk of diverting efforts away from its core competence: ARV distribution. Michael Weinstein, the group's president, said: "while the proposed bill more than triples the amount of money available, it only calls for PEPFAR to increase the number of people on life-saving antiretroviral treatment by half, and makes no provision for HIV testing in order to locate those with the virus and get them into treatment."