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Past and Future Performance: PEPFAR in the Landscape of Foreign Aid for Health

  • The Global Epidemic (SH Vermund, Section Editor)
  • Published:
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Abstract

This review traces the course of the US President’s Emergency Plan for AIDS Relief (PEPFAR) as a foreign aid program. It illustrates how the epidemiologic and geopolitical environments of the early 2000s influenced PEPFAR’s early directions and contributed to its successes. In addition to scaling up infrastructure and care delivery platforms, PEPFAR led to large increases in the number of people receiving antiretroviral therapy and reductions in mortality. These successes, in turn, have brought its principal challenges—its outsized budget, narrow focus, and problem of entitlement—into sharp relief. PEPFAR’s recent evolution, then, has been in response to these challenges. This review suggests that PEPFAR’s early formulation as an emergency response relieved it from a need to articulate clear goals, and that this freedom is now leading to new challenges as it struggles to identify priorities in the face of expectations to do more with a flat budget.

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Acknowledgements

Eran Bendavid is supported by the Doris Duke Charitable Organization.

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  1. Division of General Medical Disciplines, Stanford University, Stanford, CA, 94305, USA

    Eran Bendavid

  2. Center for Health Policy and the Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA

    Eran Bendavid

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Correspondence to Eran Bendavid.

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Bendavid, E. Past and Future Performance: PEPFAR in the Landscape of Foreign Aid for Health. Curr HIV/AIDS Rep 13, 256–262 (2016). https://doi.org/10.1007/s11904-016-0326-8

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