April 10, 2018
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Secretary of State Designee Mike Pompeo Must Show Support for PEPFAR and Recognize the Need for Additional Resources Now or Risk Failing on Administration Promises to Control the HIV Pandemic

A report released today details the devastating impact that years of flat funding the global HIV response has had, providing a new look at the growing gap between the need for life-saving HIV treatment and prevention and the resources available to end AIDS. “Deadly Impact: How Flat Funding is Undermining U.S. Global AIDS Programs” utilizes infographics and a new analysis to detail the human consequences of year after year of flat funding, through the lens of three high HIV-burden countries:

  • Mozambique, where just 47% of people living with HIV know their status and HIV prevalence has increased 15% since 2009;

  • South Africa, home of the world’s largest HIV epidemic, where 2.9 million people – equivalent to the entire population of Kansas – lack access to life-saving HIV treatment; and

  • Cameroon, where only 4 in 10 people living with HIV are on treatment, and the epidemic continues to grow.

As the Senate prepares to hold confirmation hearings for Secretary of State Designee Mike Pompeo on Thursday, the report draws new attention to the impact of under-resourcing PEPFAR, the flagship global HIV program run by the State Department. For the second year in a row, President Trump has proposed more than $1 billion in funding cuts to the U.S. global AIDS response, despite the urgent need for additional resources to save lives and end the pandemic. The full report is available here.

"Years of flat funding pose an insidious threat to the promise of ending the epidemic, just as PEPFAR is reducing AIDS-related deaths and driving down new infections, and ending AIDS is within reach.” said Asia Russell, Executive Director of the Health Global Access Project (Health GAP). “Mozambique, South Africa, and Cameroon each show the deadly impact of year after year of stagnant funding for life-saving treatment and prevention. Without a rapid course correction, starting with the U.S. budget being crafted now, it will be more difficult and more expensive to end AIDS, and millions of people will needlessly die."

"PEPFAR simply cannot do all the right things in the right places without additional funding," continued Russell. "During his confirmation hearing this week, Secretary of State Designee Pompeo should share his vision for leading a high-impact global AIDS response, which must include an influx of additional resources in the next federal budget."

"South Africa continues to face a major HIV epidemic. 7.1 million people are living with HIV, and the rate of new infections (270,000 in 2016) remains stubbornly high. Even at current levels around three million people in South Africa who could benefit from treatment do not have access. A worrying number of people are defaulting on ARVs and dying without access to adherence and counselling support. At the same time, the South African public healthcare system is in crisis. There is currently a stockout of first line ARVs in the North West province meaning people must pay out of pocket or go without. Much more needs to be done for us to drastically reduce new infections and to get more people on treatment and we need the funds, invested in the most strategic interventions, to do this. We need investment to do more, but also we need funds to keep supporting that which is working. We are placing pressure on the South African government to do more, but the epidemic cannot be controlled without more investment from the rest of the world as well," said Anele Yawa, General Secretary of the Treatment Action Campaign (TAC).

"Evidence on the ground shows that the populations most affected by the AIDS epidemic in Mozambique are being left behind. We call on the U.S. government to increase direct funding and to eliminate barriers that keep precious resources out of the hands of local organizations. Indigenous groups know the reality and can do more to solve this crisis. Key actors have to be brought to the center of decision making and implementation and not seen as mere spectators by the big players," said Danilo da Silva, Executive Director of Lambda Mozambique.

In March, hundreds of the world’s leading HIV scientists and clinicians, including Nobel Laureate and co-discoverer of HIV, Dr. Françoise Barré-Sinoussi, decried President Trump’s rejection of evidence on global HIV in formulating the administration’s AIDS spending requests.

There are only 12 years left to achieve the global goal of ending AIDS as a pandemic, and international funding for HIV has reached its lowest level since 2010. Continued underfunding of PEPFAR and other global AIDS programs will drive up the cost of ending the epidemic and undermine 15 years of American leadership. The report comes in the wake of the FY 2018 budget passing in late March, which maintained funding for the global HIV response at 2016 levels and still well below 2011 funding levels.


About Health GAP: Health GAP is an international advocacy organization dedicated to ensuring that all people living with HIV have access to affordable life sustaining medicines. Our team pairs pragmatic policy work with audacious grassroots action to win equitable access to treatment, care and prevention for people living with and affected by HIV worldwide. We are dedicated to eliminating barriers to universal access to affordable life sustaining medicines for people living with HIV/AIDS as key to a comprehensive strategy to confront and ultimately stop the AIDS pandemic. We believe that the human right to life and to health must prevail over the pharmaceutical industry's excessive profits and expanding patent rights.