Scale-up of HIV treatment through PEPFAR: a historic public health achievement

J Acquir Immune Defic Syndr. 2012 Aug 15;60 Suppl 3(Suppl 3):S96-104. doi: 10.1097/QAI.0b013e31825eb27b.


Since its inception in 2003, the US President's Emergency Plan for AIDS Relief (PEPFAR) has been an important driving force behind the global scale-up of HIV care and treatment services, particularly in expansion of access to antiretroviral therapy. Despite initial concerns about cost and feasibility, PEPFAR overcame challenges by leveraging and coordinating with other funders, by working in partnership with the most affected countries, by supporting local ownership, by using a public health approach, by supporting task-shifting strategies, and by paying attention to health systems strengthening. As of September 2011, PEPFAR directly supported initiation of antiretroviral therapy for 3.9 million people and provided care and support for nearly 13 million people. Benefits in terms of prevention of morbidity and mortality have been reaped by those receiving the services, with evidence of societal benefits beyond the anticipated clinical benefits. However, much remains to be accomplished to achieve universal access, to enhance the quality of programs, to ensure retention of patients in care, and to continue to strengthen health systems.

Publication types

  • Review

MeSH terms

  • Anti-HIV Agents / administration & dosage*
  • Antiretroviral Therapy, Highly Active / methods*
  • Antiretroviral Therapy, Highly Active / trends*
  • Communicable Disease Control / methods
  • Communicable Disease Control / organization & administration
  • Communicable Disease Control / trends
  • Disease Transmission, Infectious / prevention & control
  • Drug Utilization / statistics & numerical data
  • Global Health
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control
  • HIV Infections / transmission
  • Humans
  • International Cooperation
  • Male
  • National Health Programs / organization & administration
  • National Health Programs / trends
  • Public-Private Sector Partnerships / organization & administration
  • Public-Private Sector Partnerships / trends
  • United States


  • Anti-HIV Agents