PEPFAR Still Leaderless. HIV Activists Want to Know Why.


The Biden administration has yet to nominate a leader for the $7 billion President’s Contingency Plan for AIDS Relief, which sets priorities for AIDS treatment worldwide; especially scary For those with HIV

PEPFAR, most recently Dr. It is led by a global AIDS coordinator, a cabinet-level position held by Deborah Birx. Dr. Birx served from April 2014 until February 2020, when she left to join the White House coronavirus task force. A member of parliament, Dr. Angeli Achrekar has served as interim leader of PEPFAR since President Biden took office.

Global health experts sharply criticized the delay in appointing a permanent chief. “Can’t we think and act on two pandemics at the same time?” He asked Gregg Gonsalves, a longtime HIV activist and epidemiologist at the Yale School of Public Health.

PEPFAR was launched by President George W. Bush in 2003 and has had bipartisan support ever since. Funds distributed by PEPFAR are used to support voluntary male circumcision as well as prevention and treatment programs, including testing for HIV and providing antiretroviral therapy to people of all ages.

It is widely recognized as the most successful global health program. Since its inception, the US government has invested more than $85 billion in more than 60 countries, saving an estimated 20 million lives.

D., an infectious disease specialist at Emory University in Atlanta and chair of PEPFAR’s scientific advisory board. “PEPFAR is an example of what can be done when you combine diplomacy with global health,” said Carlos del Rio. “Across Africa, they love and respect the USA because of PEPFAR.”

Credit…US Department of State

Last week, a group of more than 50 advocacy organizations sent a letter He called on Mr. Biden to “immediately appoint a bold, creative and qualified leader” for PEPFAR. “This is unacceptable, especially during the duel of the HIV and Covid-19 pandemics,” they wrote.

The White House did not respond to a request for comment.

The coronavirus pandemic has disrupted access to supply chains for HIV prevention, diagnosis and treatment, as well as condoms, lubricants and antiretroviral drugs. final report from UNAIDS.

And the pandemic has reversed hard-won progress in ending HIV, including a 23 percent annual decline in new infections since 2010.

Inertia in identifying a leader is particularly harmful when “greater leadership, ambition and governance are sorely needed to guide global efforts to make up for lost ground in HIV response,” said Suraj Madoori, director of the Treatment Action Group, an advocacy organization. Based in New York.

A new study published last week found that people living with HIV risk of serious illness and death From Covid-19. Experts noted that the coronavirus pandemic could also benefit from the healthcare infrastructure established to provide services to HIV.

Dr. “There is a lot that can happen right now in these countries using the PEPFAR structure to confront Covid,” del Rio said.

“Not leveraging PEPFAR infrastructure – I think it’s crazy, a huge missed opportunity,” he added. “This administration has been here for 6 months. Why couldn’t we fire them?”

Dr. del Rio said the head of PEPFAR was prominently absent from global talks, including a recent UN resolution. Ending AIDS by 2030and efforts to enable PEPFAR sites to respond to the coronavirus pandemic. Dr. Del Rio added that it’s also important for the PEPFAR chief to raise his voice for the program once the budget is allocated: “I feel the program has basically stopped.”

Richard Lusimbo, program manager at Pan Africa ILGA in Uganda, said that the US’s inability to make its voice heard had ripple effects on many issues in African countries. Since the beginning of the Biden administration, core programs for key populations such as LGBTQ people have been interrupted in many countries. For example, in Ivory Coast, the budget allocated to basic population services has been cut by half.

In Kenya, a dispute between its government and the US Agency for International Development has led to a shortage of antiretroviral drugs. Mr. Lusimbo said a permanent PEPFAR leader with political power could resolve this conflict.

Mr. Biden appointed Samantha Power as head of USAID on January 13, even before taking office. And last week the White House announced candidates for the other seven positions.

For weeks, the HIV community has heard that the administration is considering five widely recognized global health experts to lead PEPFAR: Shannon Hader, Charles Holmes, Chris Beyrer, Vanessa Kerry, and Paul Farmer. However, the prominent candidate did not emerge.

“Unfortunately, we are watching the lack of global support for the response to Covid-19 in Africa, the weakening of the response to AIDS, and it is unclear who is the leader of the US government on this issue,” Lusimbo said. said. “Doesn’t the administration understand that the AIDS response and the Covid-19 response for our communities are critically interconnected?”


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