Among global public health advocates, there is a growing concern that President Trump may cut back, or even eliminate, programs that have played a critical role in fighting diseases worldwide. While every administration should strongly review our nation’s overseas commitments, and there are undoubtedly programs that we should cut, I hope he recognizes the success and importance of one in particular: the President’s Emergency Plan for AIDS Relief.
I have been treating patients in Africa and Haiti for 20 years. When I was Senate majority leader in 2003, I led the Senate’s passage of the plan, called Pepfar, on an overwhelming voice vote. It has since been reauthorized twice. President Trump, like his predecessors, will have the chance to put his own stamp on this winning program.
Pepfar was created in a moment of crisis: In the late 1990s, H.I.V.-AIDS was the No. 4 killer worldwide, and No. 1 in Africa. The program aimed to bring reliable, proven measures like antiretroviral drugs, counseling and prevention services to underserved communities around the world — and it worked. Today, Pepfar reaches 11.5 million people with antiretroviral drugs, a 50 percent increase since just 2014. Two million babies with infected mothers have been born H.I.V.-free thanks to Pepfar interventions, and 6.2 million orphans and vulnerable children receive care from the program.
The program has been able to expand, without a significant change in its budget, because it leverages the latest scientific innovations and reductions in drug prices. As a result, the rate of new H.I.V. infections in Malawi, for example, has dropped 76 percent in just three years. But the work is far from over. One million people worldwide died of AIDS last year, and only about half of those afflicted with the disease are getting proper treatment.