“We will deliver the right things, in the right places, at the right times,” said new Global AIDS Coordinator Deborah Birx on Monday when outlining her broad vision for the third phase of the President’s Emergency Plan for AIDS Relief at a town hall hosted by Kaiser Family Foundation. With an increasingly limited budget, Birx said PEPFAR will need to do more with less and work to expand services by shifting resources towards proven interventions.
“We will decrease transmission by saturating high prevalence areas with core services,” she said. Shifting resources and concentrating human and laboratory capacities and commodities to where they are most needed and focusing on what works will have the highest impact, she said, citing how Malawi has been able to reduce new infections through focusing on high impact interventions like PMTCT and antiretroviral therapy, while Mozambique, which has nearly the same epidemic, hasn’t seen similar results because of delays in rolling out similar interventions.
PEPFAR must do more to reach populations that have been left behind, she said, citing that with 7,000 new infections per week, young women in sub-Saharan Africa are an especially vulnerable population, and when mixing in the high prevalence of sexual violence, they are four times more likely to contract sexually transmitted infections, she said.
The global response to HIV/AIDS must also do more to address LGBT rights, Birx said. “Human rights for LGBT needed to be addressed yesterday,” she said, bringing up recent anti-homosexuality laws in Uganda and Nigeria. These laws are “absolute barriers to public health services,” she said. Before, there were PEPFAR sites where “people could go and be comfortable,” she said, but now that LGBT people are too scared to seek out services, other vulnerable people, like adolescent girls, will stop coming for services. “This could overcome our ability to be successful.”
PEPFAR’s third phase will also focus on transparency, she said, which includes making country budget data available on PEPFAR’s website.