The Biden administration has yet to designate a leader for the President’s Emergency Plan for AIDS Relief, a $7 billion program that sets priorities for AIDS care around the world — except in countries that are facing a pandemic. receive funding from programs without guidance during the course of those who have severe HIV
Pepfar is led by a global AIDS coordinator, a cabinet-level position that was last held by Dr. Deborah Birx. Dr. Birx served from April 2014 to February 2020, when she left to join the White House Coronavirus Task Force. Dr. Angelie Achrekar, a deputy, has served as the interim leader of PEPFAR since President Biden took office.
Global health experts sharply criticized the delay in nominating the permanent chief. “Can’t we think and act about two pandemics at the same time?” Greg Gonsalves, a longtime HIV activist and an epidemiologist at the Yale School of Public Health.
PEPFAR was launched in 2003 by President George W. Bush and has since enjoyed bipartisan support. Funds distributed by PEPFAR are used to support prevention and treatment programs, including offering voluntary male circumcision, as well as testing for HIV and providing antiretroviral therapy to people of all ages.
It is widely considered to be the most successful global health program. Since its inception, the US government has invested more than $85 billion in more than 60 countries, saving an estimated 20 million lives.
“PEPFAR is an example of what can be done when you combine diplomacy and global health,” said Dr. Carlos Del Rio, an infectious disease specialist at Emory University in Atlanta and chairman of PEPFAR’s scientific advisory board. “All over Africa, they are loved and they respect America because of PEPFAR.”
Last week, a group of more than 50 advocacy organizations sent a letter Mr Biden, urging him to immediately appoint “a bold, creative and capable” leader for PEPFAR. “This is unacceptable, especially during the time of the dual pandemic of HIV and COVID-19,” he wrote.
The White House did not respond to a request for comment.
According to one, the coronavirus pandemic has disrupted access to the supply chain of condoms, lubricants and antiretroviral drugs, along with HIV prevention, diagnosis and treatment. recent report from UNAIDS.
And the pandemic has reversed difficult progress in eradicating HIV, including a 23 percent annual reduction in new infections since 2010.
The inertia to name a leader is particularly damaging “when more leadership, ambition and governance are needed to guide global efforts to build up lost ground on the HIV response,” said The Sun, a director of the Treatment Working Group. Maduri said, an advocacy organization based in New York.
A new study released last week showed that people living with HIV are at increased risk of serious illness and death from COVID-19. Experts noted that the coronavirus pandemic could also benefit from the health care infrastructure established to provide services for HIV.
“A lot can happen now by using the PEPFAR structure to combat COVID in those countries,” said Dr. Del Rio.
“Not taking advantage of the Pepfar infrastructure – I think it’s crazy, it’s a huge missed opportunity,” he said. “This administration has been around for six months. Why didn’t we appoint him?”
Dr Del Rio said the heads of PEPFAR have been absolutely absent from global conversations, including recent UN resolutions to end AIDS by 2030 and efforts to enable PEPFAR sites to respond to the coronavirus pandemic. It is also important for the head of PEPFAR to speak up for the program when budget dollars are allocated, Dr Del Rio said: “I almost feel like the program is basically at a standstill.”
Richard Lusimbo, a program manager for the Pan Africa ILGA in Uganda, said the absence of an American voice is also affecting many issues in African countries. Since the beginning of the Biden administration, key events for key populations such as LGBTQ people have been cut in many countries. In Ivory Coast, for example, the budget for major population services was cut in half.
In Kenya, a dispute between its government and the US Agency for International Development has led to a shortage of antiretroviral drugs. A permanent PEPFAR leader with political power would have been able to resolve that dispute, Mr Lusimbo said.
On 13 January, Samantha Power was nominated to lead USAID, even before Mr Biden took office. And last week, the White House Nominated candidates announced for seven other positions.
For weeks, the HIV community has heard that the administration is considering five widely known global health experts to lead PEPFAR: Shannon Hader, Charles Holmes, Chris Bearer, Vanessa Carey and Paul Farmer. But no candidate has been able to come out ahead.
“Unfortunately, we are seeing that global support for the COVID-19 response in Africa is missing, the AIDS response is weakening, and it is unclear who is the leader of the US government on this,” Mr. Lusimbo said. . “Does the administration not understand that, for our communities, the AIDS response and the COVID-19 response are critically intertwined?”