*EPF105 09/20/2004
Excerpt: U.S. Plan Expands Treatment for HIV/AIDS
(25,000 receiving treatment now, 200,000 by 2005) (1310)

The U.S. Global AIDS Coordinator (GAC) reports that the launch of the President's Emergency Plan for AIDS Relief in early 2004 has provided almost 25,000 people with life-saving treatment for those living with HIV.

In a progress report to Congress, the GAC predicts that the numbers receiving treatment in the program's 15 target countries will climb to at least 200,000 by 2005. So far, the GAC has distributed $865 million under the five-year, $15 billion plan, an amount that is expected to grow in the next year as local organizations in the region develop greater capacity to implement AIDS treatment and care plans.

Beyond the distribution of antiretroviral drugs, the plan also aims to provide treatment and care for people living with HIV/AIDS and other affected persons. In the first year of implementation, 1.2 million people will receive such treatment, the GAC report says.

The introduction to the GAC report is excerpted below. The full report is available at http://www.state.gov/documents/organization/36287.pdf

(begin excerpt)

Bringing Hope and Saving Lives:
Building Sustainable HIV/AIDS Treatment

The President's Emergency Plan for AIDS Relief Report on Current Activities Underway to Expand Treatment for HIV/AIDS

August 2004

"For too long, anti-AIDS programs offered too little treatment for those who had already contracted the disease. And so today we're helping other nations to buy drugs... so that we can extend lives. Because, you see, every life matters to the Author of life, and so they matter to us."

President George W. Bush, June 23, 2004

Introduction: A New Approach

Since President Bush announced the Emergency Plan for AIDS Relief in the State of the Union Address in January 2003, the United States Government has committed significant energy and resources to turn the tide against global HIV/AIDS. The President pledged $15 billion over five years to the Emergency Plan, and with the support of the Congress and the American people, much progress has been made toward implementing this historic humanitarian effort.

Critical to this effort has been a decisive commitment to treat two million HIV-infected individuals in 15 focus countries (1) by providing life-prolonging anti-retroviral drug therapy (ART). Previous U.S. Government efforts focused primarily on HIV prevention activities; the Emergency Plan, however, capitalizes on the focused use of greatly expanded resources and years of U.S. Government technical and medical expertise to implement integrated prevention, care, and treatment programs. These integrated programs will ease the suffering of millions infected and affected by HIV/AIDS, and will spare millions of others from the effects of this global tragedy. In the absence of treatment, HIV causes debilitating illness and certain death, and continues its destructive march through heavily burdened societies. The Emergency Plan has moved rapidly to mitigate the consequences of HIV through treatment and care.

The United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 requires a one-time report, due 15 months after enactment of the legislation, on the programs and activities of the relevant executive branch agencies that are directed to the treatment of individuals in foreign countries infected with HIV or living with AIDS (Title III, Subtitle B, Sec. 305). On May 27, 2003, Congress authorized President George W. Bush's Emergency Plan for AIDS Relief. On July 2, 2003, President Bush nominated the first United States Global AIDS Coordinator, Ambassador Randall L. Tobias, and he was confirmed by the U.S. Senate on October 3, 2003. On January 23, 2004, eight months after enactment, the Emergency Plan received its first funding from Congress. One month later, on February 23, 2004, the Office of the Global AIDS Coordinator disbursed the first $350 million of the total $865 million FY04 funds for prevention, treatment, and care activities in the focus countries. Within weeks, patients were being provided antiretroviral drugs.

After a period of initial capacity building and program development, full implementation of the program began June 25, 2004, when Congress approved the use of an additional $515 million for prevention, treatment, and care activities in the focus countries.

U.S. Government agencies, including the U.S. Agency for International Development (USAID), the Departments of State (DOS), Health and Human Services (HHS), and Defense (DOD), and several other agencies report significant progress in rapidly scaling-up treatment programs in the 15 focus countries of the President's Emergency Plan. In addition, the Emergency Plan is building the foundation for long-term, sustainable treatment programs in the focus countries. This report describes what the Emergency Plan has achieved since the first disbursement of funds on February 23, 2004.

As of July 31, 2004, the Emergency Plan is supporting ART for at minimum, 24,900 HIV-infected men, women, and children in nine countries. Of this number, the Emergency Plan is directly funding ART for approximately 18,800 HIV-infected individuals at the point of service delivery. At least an additional 6,100 persons are receiving indirect treatment support through U.S. Government contributions to national, regional, or local activities such as laboratory support, training, logistical systems strengthening, and treatment policy and protocol development. Over the next few months, numerous sites in all 15 focus countries will provide ART with the goal of reaching at least 200,000 by June 2005. By meeting this goal, the Emergency Plan will approximately double the number of persons receiving ART in sub-Saharan Africa. The Emergency Plan will also provide palliative care and support to approximately 1.2 million people infected and affected by HIV/AIDS, including orphans and other vulnerable children, in its first year of implementation.

The Emergency Plan recognizes and shares Congress' sense of urgency in rapidly scaling-up treatment within the focus countries. At the same time, the Emergency Plan will expand capacity to promote high-quality, sustainable, widely- available access to these life-prolonging therapies. The U.S. Government will obligate $2.2 billion government-wide on international HIV/AIDS programs this fiscal year; more than the rest of all other donor governments combined. The following chart outlines treatment and care goals by country for fiscal year 2004 (FY04) and fiscal year 2008 (FY08), based on the number of people living with HIV/AIDS in each country, the number of people currently receiving treatment in each country, and the current capacity within each country to rapidly scale up treatment activities.

(Table excerpted)

The Office of the U.S. Global AIDS Coordinator, under the direction of Ambassador Randall L. Tobias, coordinates all U.S. Government international HIV/AIDS programs. One of the first tasks of the Coordinator's Office was to develop a five-year global strategy to guide the Emergency Plan's efforts. Released in February 2004, the global AIDS strategy identified four key interventions for achieving the Emergency Plan treatment goal:

-- Rapidly scale up treatment availability through network systems;
-- Build capacity for long-term sustainability of quality HIV/AIDS treatment programs;
-- Advance policy initiatives that support treatment; and
-- Collect strategic information to monitor and evaluate progress and ensure quality and compliance with Emergency Plan and national policies and strategies.

The remainder of this report will focus on five areas:

-- First, the report reviews activities the U.S. Government supports to rapidly scale up treatment programs in the focus countries. These scale-up programs aim to maximize the number of patients placed on treatment as quickly as possible, recognizing the emergency status of the epidemic.
-- Second, the report reviews the critical capacity-building activities related to treatment, the development of network systems.
-- Third, the report discusses care activities associated with treatment, including treatment of opportunistic infections.
-- Fourth the report reviews supply-chain management activities.
-- Finally, the report discusses monitoring and surveillance activities that will measure the Emergency Plan's success.

1 Botswana, Cote d'Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Zambia, and as of June 2004, Vietnam.

(end excerpt)

(Distributed by the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

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