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AIDS in Africa, Lessons for the U.S.

Dr. Deborah Birx shared insights from her nearly six years as U.S. Global AIDS Coordinator before a packed audience on Jan. 31. The former U.S. Army Colonel oversees the President's Emergency Plan for AIDS Relief (PEPFAR), which has dramatically reduced infections on the African continent.
Dr. Deborah Birx shared insights from her nearly six years as U.S. Global AIDS Coordinator before a packed audience on January 31. The former U.S. Army Colonel oversees the President's Emergency Plan for AIDS Relief (PEPFAR), which has dramatically reduced infections on the African continent.

 

"HRSA is playing a key role in the Trump Administration's Initiative to End the HIV Epidemic ... This includes seven mostly rural states - Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma and South Carolina -- as well as 48 counties, Washington D.C., and San Juan, where more than half of new HIV diagnoses occurred in 2016 and 2017. We want to highlight what others around the world are doing to reach populations similar to the ones HRSA serves today."

--Tom Engels, HRSA Administrator, welcoming Ambassador Birx

Tom Engels, HRSA Administrator

 

Launched in 2003 by President Bush and carried forth by Presidents Obama and Trump, PEPFAR is "the largest commitment by any nation to combat a single disease in history," Engels reminded the audience. In all, 65 countries are under its umbrella.

HRSA -- along with the CDC, NIH and several major non-profits -- is a primary funder of the initiative. In 2018 alone, PEPFAR provided screenings to nearly 95 million people and life-sustaining medications to 14.6 million. PEPFAR also paid for the training of more than 270,000 new health care workers in countries where the virus once went largely unchecked.

Thanks to PEPFAR, more than 2.4 million babies were born HIV-free to mothers who had contracted the disease.

"During 40 years of response to the epidemic, you have been the ones teaching us."

--Ambassador Birx, lauding the "HRSA care model"of community-based, patient-centered primary care and screening.

Standing room only: An audience of some 250 staff -- with 200 more online -- were on hand for a Q & A with Ambassador Birx and BPHC's Angela Powell, Dir., Office of Southern Health Services.  Both BPHC and HAB play central roles in the administration's initiative, Ending the HIV Epidemic: A Plan For America.
Standing room only: An audience of some 250 staff -- with 200 more online -- were on hand for a Q & A with Ambassador Birx and BPHC's Angela Powell, Dir., Office of Southern Health Services. Both BPHC and HAB play central roles in the administration's initiative, Ending the HIV Epidemic: A Plan For America.

 

Birx -- who oversaw early HIV/AIDS efforts for both the Army and the CDC -- said simple steps often have led to enormous gains in Africa:

Among them: eliminating fees for basic health services to help reach underserved patients who may never have been screened; directing outreach campaigns to mothers; and employing large numbers of community health workers and volunteers, rather than over-relying on cadres of doctors and nurses.

In Africa, as in the U.S., she added, the core public health problem is that the virus spreads in communities through contact with people who do not know they are infected, often for lack of routine health screening. The problem is especially common in health care shortage areas.

"No one is intentionally infecting someone else," she stressed, noting that PEPFAR has covered screening for more than a billion people since its launch. "They don't know that they have HIV. They're asymptomatic. They feel great ... the majority of young men do not know if they are HIV positive."

Watch the archived video of the Ambassador's presentation HRSA Exit Disclaimer -- the first in the Administrator's Speaker Series.

Date Last Reviewed:  February 2020