U.S. Government Global HIV/AIDS Activities
How Are U.S. Government Agencies Working to End HIV and AIDS Around the World?
Agencies across the federal government are involved in implementing the President’s Emergency Plan for AIDS Relief (PEPFAR), the largest commitment by any nation to address a single disease in history. These agencies support a range of global HIV/AIDS activities from research to technical assistance and financial support to other countries to help prevent new HIV infections and assist people with HIV to access life-saving treatment. These activities are coordinated through PEPFAR. A brief summary of each agency’s roles is below.
U.S. Department of State
The U.S. Department of State’s Bureau of Global Health Security and Diplomacy (GHSD) leads and coordinates the Department’s work on strengthening global health security to prevent, detect, and respond to infectious diseases, including HIV/AIDS. GHSD oversees global implementation of PEPFAR, ensuring program and policy coordination among the relevant government agencies and departments. PEPFAR partners closely with U.S. ambassadors globally, who oversee the work of PEPFAR at their respective posts. GHSD also works closely with the diplomatic corps in Washington, DC, to advance U.S. global health diplomacy and connect health to other U.S. foreign policy priorities, including economic growth, trade, education, political stability and pandemic preparedness. PEPFAR also closely coordinates with the Global Fund to Fight AIDS, Tuberculosis, and MalariaExit Disclaimer through substantial U.S. Government support.
U.S. Agency for International Development
The U.S. Agency for International Development (USAID) is an independent federal government agency that receives overall foreign policy guidance from the Secretary of State. As a key implementer of PEPFAR, USAID’s Office of HIV/AIDS supports country-led efforts to combat the complex challenges of HIV in over 50 countries around the world. The Office of HIV/AIDS drives the Agency’s efforts under the U.S. President’s Emergency Plan for AIDS Relief (PEFPAR) in controlling the HIV/AIDS epidemic by providing technical leadership, monitoring impact, ensuring program integrity, and supporting the transition to local partners. The Agency’s goal is to support and sustain the achievement of HIV epidemic control across these countries. It achieves this by providing global leadership in the development of programs that maximize impact and by supporting country-led strategies while applying USAID’s broad health and development expertise and specialized HIV technical competencies. In addition, USAID leverages science, technology, and innovation to support cost-effective, sustainable, and appropriately integrated HIV interventions at scale.
U.S. Department of Health and Human Services
The U.S. Department of Health and Human Services (HHS) has a long history of HIV/AIDS work within the United States and internationally. Under PEPFAR, HHS, through its agencies and offices, supports the implementation of HIV prevention, treatment, and care programs in developing countries and conducts HIV research through the following agencies and offices:
Centers for Disease Control and Prevention
As a key implementing partner of PEPFAR, the Centers for Disease Control and Prevention (CDC) works side-by-side with ministries of health, civil and faith-based organizations, private sector organizations, and other on-the-ground partners to improve methods for finding, treating, and preventing HIV. CDC does so by supporting more than 10,000 labs or testing sites worldwide, getting life-saving treatment to people with HIV around the world, and designing and enhancing surveillance systems and enable countries to understand which geographic areas require urgent HIV attention and services. Further, CDC’s Division of Global HIV & TB (DGHT), through PEPFAR, works to tackle HIV and tuberculosis (TB), the world’s two most deadly diseases. These two epidemics are tragically interconnected, as TB is the leading cause of death for those with HIV. CDC’s experts are working on the front lines in more than 45 countries and regions around the globe, focused on a single mission: to fight these diseases and, ultimately, bring an end to the dual epidemics of HIV and TB.
Food and Drug Administration
The Food and Drug Administration (FDA) plays an integral role in PEPFAR by ensuring safe and effective antiretroviral drugs (ARVs) are available for procurement through PEPFAR so that these drugs can get to countries with high rates of HIV infection in a timely manner. Since 2004, FDA has encouraged sponsors worldwide to submit U.S. marketing applications for single entity, fixed-combination, and co-packaged versions of previously approved ARVs. To speed up approval, FDA uses its existing processes including expedited review for PEPFAR ARVs, while ensuring that these products meet the same standards as similar products for the U.S. market and our own citizens. View FDA's interactive database of approved or tentatively approved ARVs that are eligible for procurement through PEPFAR.
Health Resources and Services Administration
Since 2003, the Health Resources and Services Administration (HRSA) has been a significant contributor to PEPFAR's achievements. HRSA’s in the Office of Global Health implements the agency's PEPFAR activities. HRSA's work builds on the agency’s domestic and international experience and expertise by improving outcomes along the treatment and prevention cascade for people living with HIV. HRSA works with host countries and other key partners to assess the needs of each country and design a customized program of assistance that fits within the host country’s strategic plan for HIV/AIDS and/or the health sector. This work is guided and reinforced by HRSA’s experience building and strengthening the U.S. health system and leading the nation’s response to the HIV epidemic by ensuring that each person living with HIV receives comprehensive care and treatment. Building on this experience, a major component of HRSA’s global efforts is related to ensuring quality of services, building and strengthening local organizations and ensuring the production and readiness of a strong health care workforce across many cadres of facility and community service providers.
National Institutes of Health
The National Institutes of Health (NIH) provides the largest public investment in HIV/AIDS research globally. Coordinated by the Office of AIDS Research (OAR), NIH’s HIV research program encompasses basic, clinical, behavioral, and social sciences; translational and implementation science research on HIV infection, prevention, treatment, and cure; and research on HIV-associated coinfections, comorbidities, and complications. This research will lead to a better understanding of the basic biology of HIV/AIDS and the development of next-generation therapies to treat it. It also will foster the design of better counter-measures to prevent new infections, including vaccines and prophylaxis with ARVs and microbicides.
Office of Global Affairs
HHS’s Office of Global Affairs (OGA), within the Office of the HHS Secretary, is the diplomatic voice of HHS, fostering critical global relationships, coordinating international engagement across HHS and the U.S. government, and providing leadership and expertise in global health diplomacy and policy to contribute to a safer, healthier world. OGA works with HHS and other agencies implementing PEPFAR to ensure the federal government is leveraging HHS’s scientific and technical expertise to accelerate HIV epidemic control and achieve an AIDS-free generation.
Substance Abuse and Mental Health Services Administration
The Substance Abuse and Mental Health Services Administration (SAMHSA) leads public health efforts to advance the behavioral health of the nation and to improve the lives of individuals living with mental and substance use disorders, and their families. SAMHSA works through state and tribal governments and faith- and community-based programs to support the prevention, treatment, and recovery from substance use and mental health disorders, including by supporting an educational and training center network that disseminates state-of-the-art information and best practices. This technical expertise and program experience is being applied to PEPFAR to assist other countries in addressing serious substance use—including opioid-related—disorders and mental disorders that make the treatment and prevention of HIV more complicated.
The Peace Corps contributes to the global response to HIV by partnering with people and communities to adopt healthy behaviors and mitigate the impact of the disease. Peace Corps Volunteers around the world provide capacity development support to non-governmental, community-based, and faith-based organizations, with an emphasis on ensuring that community-initiated projects and programs provide holistic support to people with and affected by HIV/AIDS. Many Peace Corps Volunteers across the globe are trained as advocates and educators on HIV/AIDS prevention and care. Some Volunteers collaborate with community and nongovernmental organizations in their host countries to address concerns related to HIV and AIDS.
U.S. Department of Commerce
The U.S. Department of Commerce fosters public-private partnerships and makes presentations in industry/trade advisory committee meetings on how the private sector can contribute to global HIV/AIDS interventions. In addition, the U.S. Census Bureau, housed within Department of Commerce, provides support for PEPFAR by assisting with data management and analysis, survey support, and mapping of country-level activities. With funds from PEPFAR, the U.S. Census Bureau maintains and annually updates the HIV/AIDS Surveillance Data Base to meet the needs of policy makers and program planners around the world. This database is a compilation of information from widely scattered small-scale surveys on the HIV/AIDS pandemic in population groups in developing countries, and hosts information from the medical and scientific literature, presentations at international conferences, and the press. Explore the HIV/AIDS Surveillance Data Base.
U.S. Department of Defense
The Department of Defense's (DoD) HIV/AIDS Prevention ProgramExit Disclaimer (DHAPP) is responsible for assisting foreign military partners with the development and implementation of culturally focused, military-specific HIV/AIDS prevention, care, and treatment programs in more than 55 countries around the globe. DHAPP employs an integrated bilateral and regional strategy for HIV/AIDS cooperation and security assistance. DHAPP also is the DoD implementing agency for PEPFAR. As such, DHAPP plans activities and sets targets based on the specific context of the partner military and the clients seen at military heath facilities and uses information from military HIV seroprevalence studies, programmatic data, and other sources to implement programs at military locations with a significant burden of HIV.
U.S. Department of Labor
The Department of Labor (DoL) implements PEPFAR workplace-targeted projects that focus on prevention and reduction of HIV/AIDS-related stigma and discrimination. DoL brings to these endeavors its unique experience in building strategic alliances with employers, unions, and Ministries of Labor, which are often overlooked and can be difficult to target.
U.S. Department of the Treasury
The Department of the Treasury is working to promote financial effectiveness and fiscal sustainability of the HIV/AIDS response in partner countries, primarily in Africa. The goal of Treasury’s work is to increase awareness and understanding of the economic and financial dimensions of HIV/AIDS, especially among finance ministries; include the disease response as part of national economic strategies; strengthen financial resource mobilization and efficient utilization; and build capacity to implement policy improvements. Treasury’s work entails both policy engagement and technical assistance to support implementation of improved policies, generally in partnership with finance ministries. Illustrative examples include supporting HIV expenditure oversight committees, strengthening budget systems and execution in health and finance ministries, and developing capacity for health cost analysis.