Calling for a strategic and coordinated allocation of resources, a shift from “activities” to targeted outcomes, enhanced support for long-term systems strengthening, the development of comprehensive partnerships and refined program monitoring; members of the IOM evaluation panel highlighted the findings of the nearly 700-page report which was released today at a Washington, DC public briefing. A product of nearly 400 interviews and visits to 13 countries, the report describes the impact of PEPFAR-supported HIV prevention, care and treatment programs as “proof of principle that services can be effectively delivered on a large scale in countries with a high disease burden, resource constraints, and limited infrastructure.”
The sweeping study, 4 years in the making, also calls for a strengthened emphasis on HIV prevention that would include interventions to address “social, economic and policy factors that are linked to HIV risk” as well as biomedical approaches and strategies to decrease behavior that contribute to HIV risk. The findings also flag the proportionately lower coverage of pediatric HIV care and treatment compared to adults. The need to improve linkages among services such as HIV counseling/testing to care and treatment was identified as an “ongoing challenge.” While there is clear evidence that PEPFAR had provided a “lifeline” for millions and strengthened health systems, the study authors acknowledged that there remain “substantial unmet needs” and that the issue of sustainability of these efforts is a critical one. The study committee makes recommendations in four areas—scaling up HIV programs, strengthening systems for the HIV responses in partner countries; transitioning to a sustainable response and transforming knowledge management.
Robert E. Black from the Johns Hopkins Bloomberg School of Public Health chaired the panel and published a related commentary in Lancet today. In addition to Dr. Black, study committee members Dawn Smith from the CDC, Ann Kurth from the New York University School of Nursing and Jennifer Kates from the Kaiser Family Foundation provided the overview. Study Committee members briefed the staffs of the House Foreign Affairs Committee, the Senate Foreign Relations Committee and the Senate Health Education Labor and Pensions Committee yesterday, according to IOM staff member, Patrick Kelley.