PEPFAR, which the Bush administration initially established as a five-year, $15 billion plan, has kept people alive by effectively providing funds for AIDS treatment and care, according to a study from the Stanford University School of Medicine.
PEPFAR is the largest U.S. foreign aid program devoted to a single disease.
The study will be published in the April 7 online issue of the Annals of Internal Medicine. It will also be published in the May 19 print version of the journal.
The researchers found that in the years leading up the program, death rates rose in all of the countries studied. As PEPFAR funding became available, the death toll declined by more than 10 percent in the focus countries, compared to the control countries, with more than 1 million lives saved, the researchers estimated. The difference in death rates was most pronounced between 2005 and 2006, during PEPFAR’s third year of operation.
The researchers calculated that for every life saved, PEPFAR spent roughly $2,450 on treatment. “This is not a trivial cost, and PEPFAR will need to make the available resources go a long way to continue changing the course of the epidemic,” Bendavid said.
As more people survived with antiretroviral treatment, the number of those living with HIV rose more rapidly in the PEPFAR countries, compared with the control countries. But there was no significant difference in adult prevalence of HIV between the focus countries and the control countries, either before or after the program was launched. “For prevalence, the trends remain perfectly parallel, regardless of when PEPFAR came in,” Bendavid said.
As the program enters a new phase under the Obama administration, Bendavid said it’s important that it continually be monitored and evaluated to ensure these vast taxpayer funds are efficiently spent.
“It is working,” he said of the program. “It’s reducing the death toll from HIV. People who are not dying may be able to work and support their families and their local economy.” But he noted, “evaluating how the money is being spent, and which aspects of the program work best, could help it improve.”
The study was funded by a training grant from the Agency for Healthcare Research and Quality.
Source: Stanford University Medical Center, USA