A PEPFAR Primer

What is the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)?

PEPFAR has been described as the U.S. government’s global effort to fight HIV. It was first announced by then President George W. Bush in early 2003 and authorized later that year in “The Leadership Act” and was reauthorized in 2008, 2013 and 2018.

In FY2020, PEPFAR was funded at $6.9 billion and, to date, PEPFAR funding to the Global Fund to Fight AIDS, Tuberculosis and Malaria, UNAIDS and through U.S. federal agencies, exceeds $90 billion.

PEPFAR Administering Agencies

The federal agencies that administer PEPFAR funds include the U.S. Department of Health and Human Services (HHS), the Peace Corps, U.S. Agency for International Development, and the U.S. departments of Commerce, Defense, Labor, State and Treasury.

HHS has several offices and subagencies that administer these funds: the Office of Global Affairs, Centers for Disease Control and Prevention (CDC), National Institutes of Health, U.S. Food and Drug Administration, Substance Abuse and Mental Health Services, and Health Resources and Services Administration (HRSA).

The DREAMS Innovation Challenge

In June 2016, the State Department awarded a multimillion dollar award to a Boston, MA-based nonprofit to administer the DREAMS Innovation Challenge. The Challenge was a public-private partnership to reduce HIV infections among adolescent girls and young women in sub-Saharan Africa using innovative solutions. The organization funded 46 grantees to implement a range of programs and activities in 10 countries. Those grantees then subcontracted with 35 local organizations to implement programs to meet the needs of their local populations.

Some of the country-specific lessons from the Challenge include reducing the root causes of high school dropout rates for girls, designing aligned programs aimed at adolescent girls, implementing skills-based training to build bridges to employment, and centering local public libraries as community resources of critical public health information and as meeting spaces for mentoring programs.

Leveraging Expertise

PEPFAR funding from federal agencies with missions centered on public health, health research, health security, health information systems, and other health-centered topics has focused on leveraging the US government’s scientific and technical expertise.

PEPFAR funding priorities administered by U.S. Department of Health and Human Services subagencies include:

  1. Protecting and Improving through Surveillance, Epidemiological Research, Disease Detection and Prevention (CDC)
  2. Protecting and Improving Health Globally; Building and Strengthening Public Health Impact, Systems, Capacity and Security (CDC)
  3. Health Systems Strengthening and HIV/AIDS Prevention, Care and Treatment under the PEPFAR (HRSA)

To learn more about PEPFAR initiatives managed by the State Department, visit PEPFAR.gov. An overview of HHS-administered PEPFAR programs can be found here. More information about PEPFAR can also be found at kff.org. Finally, visit Grants.gov to find PEPFAR grant funding announcements.