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On World AIDS Day, a Moment for Celebration and Self-Reflection

On World AIDS Day, December 1, we honor the advocates that transformed HIV/AIDS from a death sentence to a chronic disease. These activists bequeathed a golden age of global health—a boom in money and programs that is sustained today, evidenced by the recent reauthorization of PEPFAR. But as UNAIDS recognized last year, we still have miles to go despite this extraordinary mobilization. Even today, 40 percent of people in need still lack lifesaving antiretroviral treatment.

Ambassador Deborah Birx speaking at CGD. Photo by Kaveh Sardari

PEPFAR’s New Targets for Local Implementation: Commendable in Theory, Complicated in Practice

In July, United States Global AIDS Coordinator Deborah Birx made a striking commitment: under her leadership, the President’s Emergency Plan for AIDS Relief (PEPFAR) would direct at least 40 percent of its funding to host country governments or organizations by the end of 2019—rising to 70 percent by the end of 2020. The bottom line: PEPFAR’s local targets are commendable in theory, but we suspect their application in practice will prove complicated. Below is our take on the related issues—and some recommendations for PEPFAR to forge the most effective path forward.