Anti-AIDS program must build on successes, says report

The U.S. initiative to fight AIDS around the world should scale up its programs, better target resources and direct more focus toward prevention, according to a new assessment.

The Institute of Medicine (IOM) directed high praise Wednesday at the President's Emergency Plan for AIDS Relief (PEPFAR), citing the "millions of lives worldwide" that have been saved and improved by U.S. investments against AIDS.

The congressionally mandated report described a path for PEPFAR that would build on its progress and increase its effectiveness as countries seek to "sustainably manage the response to HIV."

"PEPFAR has achieved — and in some cases surpassed — its initial ambitious aims," the report said. "That success has in effect 'reset' the baseline and shifted global expectations for what can be achieved in partner countries."

The IOM recommended that PEPFAR take the long view in its efforts to fight HIV and AIDS, fostering delivery systems and best practices that will serve AIDS-ridden countries in the future.

New policies should tighten the links between diagnosis and treatment for HIV/AIDS patients and encourage treatment adherence, the IOM said. PEPFAR must also encourage a greater focus on prevention, targeted services and program monitoring in partner countries, the report said. 

"As it moves forward, PEPFAR must continue to be bold in its vision, implementation, and global leadership," said international health expert Robert Black, who led the study.

He added, "During our visits to partner countries, we repeatedly heard PEPFAR described as a lifeline. People credit the initiative with restoring hope."

PEPFAR was launched by President George W. Bush in 2003 with $15 billion to spend against AIDS worldwide. It was subsequently reauthorized in 2008 with up to $39 billion through this year.

The IOM is part of the National Academy of Sciences. It lasted evaluated PEPFAR in 2007. 

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