The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is showing its impact with 5.5 million babies born HIV-free due to comprehensive program efforts. On July 29, 2022, at the 24th International AIDS Conference, U.S. Global AIDS Coordinator and Special Representative for Health Diplomacy Ambassador-at-Large Dr. John Nkengasong, announced that through the reduction of incidence and prevalence of HIV among adolescent girls and young women, women of childbearing age, and adult men, an additional 3.5 million babies were born HIV free from 2004 to 2021. Now, a total of 5.5 million babies have been born HIV-free as a result of PEPFAR and its partners, he said.
According to Nkengasong, “comprehensive prevention and treatment programs have always been a priority for PEPFAR. Historically, we placed an emphasis on mother-to-child transmission of HIV, and that resulted in 2 million babies born HIV-free in PEPFAR-supported countries since 2004.”
The additional 3.5 million babies born HIV free is the outcome of PMTCT coupled with aggressively expanding prevention and treatment services among several target populations.
“In collaboration with countries, communities, and our partners, PEPFAR supported comprehensive HIV prevention programming for adolescent girls and young women, voluntary medical male circumcision, and we scaled up treatment for women and men with viral suppression. In total, 5.5 million babies have been born HIV-free because of our comprehensive prevention program and this is an incredible milestone for our program and for the next generation,” said Nkengasong.
In PEPFAR-supported countries, the program scaled up treatment for all people living with HIV and leveraged the PEPFAR-supported DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) program to begin breaking the cycle of HIV transmission from 30- to 40-year-old men to adolescent girls and young women. That reduced overall HIV incidence and led to fewer HIV-positive women of childbearing age and lowered the risk of babies being born with HIV.
In addition, Nkengasong announced the following program successes:
- At least 12 high HIV disease burden countries have reached the UNAIDS 90/90/90 HIV treatment targets, advancing global progress toward the UN Sustainable Development Goal target of ending the AIDS epidemic as a public health threat by 2030. For example, Botswana’s Population Health Impact Assessment shows the country has had a population-level impact of 95/98/98, already surpassing the UNAIDS 2025 95/95/95 treatment target.
- Nearly 20 million women, men, and children on life-saving antiretroviral treatment – As of March 31, 2022, PEPFAR supported life-saving antiretroviral treatment for nearly 20 million men, women, and children (compared with 17.2 million in Fiscal Year 2020).
- 2 million clients newly enrolled on PrEP to prevent HIV infection since FY20 – As of March 31, 2022, 680,000 individuals have newly enrolled on antiretroviral pre-exposure prophylaxis to prevent HIV infection. Demand for PrEP continues to increase with 1 million people receiving PrEP in FY21 and 312,000 in FY20.
- Lessons from COVID-19 and HIV – PEPFAR has continued to save and improve lives through swift and decisive action, country policy adaptation, agility and innovation. This included:
- Expansion of decentralized distribution and multi-month dispensing of life-saving antiretroviral medications by 480%, essential to have clients stay in care and reduce their exposure to COVID-19.
- Scale up of self-testing by 200% since FY19 with 4.3 million people using HIV self-tests in FY21.
- Increased use of digitalization for the COVID-19 response, with data systems, technologies and innovation that are critical to the HIV response.
- Increasing Investments in Vulnerable Populations – PEPFAR is increasing its investment to close known gaps in services among key populations, adolescent girls and young women, and children, increasing its planned investment from FY 22 in these populations by nearly 15%, 20%, and 30% respectively for FY 23 (pending Congressional Notification).
- Through PEPFAR’s program implementation support, Botswana’s Population Health Impact Assessment shows the country has had a population-level impact of 95/98/98, already surpassing the UNAIDS 2025 95/95/95 treatment target.