The Good, the Bad, the Ugly: The state of PEPFAR and future advocacy opportunities


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CASE STUDY: Students and Health professionals helped reauthorize PEPFAR

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  • The Good, the Bad, the Ugly: The state of PEPFAR and future advocacy opportunities

    1. 1. The Good, the Bad, the Ugly: The state of PEPFAR and future advocacy opportunities Jirair Ratevosian, MPH Physicians for Human Rights Jennifer Kasper, MD, MPH Doctors for Global Health
    2. 2. Fifth Annual Report to Congress <ul><li>Treatment for 2.1 million men, women and children </li></ul><ul><li>Care for 10.1 million, including more than 4 million orphans and vulnerable children. </li></ul><ul><li>HIV counseling and testing for nearly 57 million </li></ul><ul><li>TB treatment for more than 395,400 HIV-infected p </li></ul><ul><li>Reached 58.3 million people through community outreach programs to prevent sexual transmission using the ABC approach. </li></ul><ul><li>Supplied more than 2.2 billion condoms worldwide </li></ul><ul><li>PMTCT for 16 million pregnancies, ARV prophylaxis for 1.2 million pregnant women HIV+ = 240,000 infants HIV-free. </li></ul><ul><li>3.7 million training and retraining encounters for health care workers. </li></ul>
    3. 3. CASE STUDY: Students and Health professionals helped reauthorize PEPFAR
    4. 4. <ul><li>PHR organized in key states—CA, FL, ME, NH, MN, KS, and NY—to bring their expertise and experience to lawmakers. </li></ul><ul><li>Students helped get Deans and Faculty to sign onto letters promoting best public health and human rights practices in addressing HIV/AIDS—which PHR presented on their behalf to Congress. </li></ul>
    5. 5. <ul><li>PHR's policy team wrote key documents that supported best public health- and evidence-based practices that provided the philosophical underpinnings for changes to the bill—most notably: </li></ul><ul><ul><li>boosting efforts to address Africa's health workforce shortage </li></ul></ul><ul><ul><li>mainstreaming harm reduction for injection drug users </li></ul></ul><ul><ul><li>lifting the HIV travel ban </li></ul></ul>
    6. 6. <ul><li>During Global AIDS Week of Action, students did joint actions with colleagues in Kenya and Uganda </li></ul>
    7. 7. <ul><li>Student chapters hosted PHR during important visits by leading AIDS physicians from Uganda and Kenya to the US to meet with policymakers and the press—to provide first-hand accounts of how PEPFAR </li></ul><ul><li>In the critical final weeks and days of the reauthorization process, thousands of students and health professionals repeatedly called and wrote and met with targeted legislators to provide them with essential facts </li></ul>
    8. 9. <ul><li>PHR policy demands aired in op-eds, news articles, broadcast pieces and letters to the editor. </li></ul>
    9. 10. Students kept AIDS in the media
    10. 12. PEPFAR Reauthorized: Key wins! <ul><li>$48 Billion </li></ul><ul><li>Treatment for 3 million, prevent 12 million infections, care for 10 million (including 5 million OVC) </li></ul><ul><li>Support countries in developing long-term health workforce plans, fund 140,000 new health workers </li></ul><ul><li>Increased attention given to IDUs, which favors increased access to HIV prevention for this group </li></ul><ul><li>Women's unique vulnerability to HIV is explicitly discussed, important targets for PMTCT </li></ul><ul><li>Repeal of the ban preventing people with HIV from visiting the US </li></ul>
    11. 13. But… Future Advocacy Opportunities <ul><li>Appropriations is key! </li></ul><ul><ul><li>Even with the great advances of the past 5 years, five people become infected with HIV for every two people added to treatment. </li></ul></ul><ul><ul><li>To catch up with the pandemic, the US needs to contribute $50 billion over the next 5 years. </li></ul></ul><ul><ul><li>Meet MDG goals and to lead the fight globally </li></ul></ul><ul><ul><li>Foreign assistance= smart power </li></ul></ul><ul><ul><li>Re-invigorate our moral leadership in the world </li></ul></ul><ul><ul><li>Support the Global Fund </li></ul></ul>
    12. 14. Strengthening Health Systems and Workforce <ul><li>140,000 new health professionals and paraprofessionals, especially physicians and nurses, are trained and retained . </li></ul><ul><li>All partner countries are quickly able to begin implementing fully funded, rights-based health workforce plans </li></ul><ul><li>Health workers and facilities in these countries are well managed and equipped </li></ul><ul><li>Health workers have safe working conditions and access to health care, including treatment for HIV </li></ul>
    13. 15. Recognizing Feminization of HIV <ul><li>Exceed 80% target of reaching pregnant women with PMTCT </li></ul><ul><li>Hold initiatives accountable for the development and implementation of programs that specifically address the underlying social and economic vulnerabilities of women </li></ul><ul><li>Women and girls have access to comprehensive prevention information beyond ABC </li></ul><ul><li>Educate and empower health workers to promote women’s rights, including reproductive health rights </li></ul><ul><li>Promote the integration of sexual reproductive health services, including family planning and other primary health services, with HIV programs </li></ul>
    14. 16. Global Gag Rule <ul><li>Prohibits health organizations receiving US $$ for family planning from making referral for safe abortion services emphasizing the importance of integrated GGR reproductive health care and HIV prevention services. </li></ul><ul><li>Next, reverse bloated interpretation of Kemp-Kasten Amendment, which denies federal funding to programs &quot;that support or participate in coercive abortion or involuntary sterilization&quot; </li></ul>
    15. 17. Science-Based Prevention Efforts <ul><li>Addressing Injection Drug Use and HIV </li></ul><ul><ul><li>Bill makes only brief mention of need for prevention strategy </li></ul></ul><ul><ul><li>Enable US funding for syringe exchange </li></ul></ul><ul><li>Addressing MSM </li></ul><ul><ul><li>Bill makes only passing reference </li></ul></ul><ul><ul><li>Program should be implemented in way that truly recognizes needs </li></ul></ul>
    16. 18. HIV Travel Ban <ul><li>Good first step: removal of statutory bar embedded in Immigration and Naturalization Act </li></ul><ul><li>United States Department of Health and Human Services must remove HIV/AIDS from its list of &quot;dangerous communicable diseases&quot; that prohibit entry to US </li></ul>
    17. 19. <ul><li>What can we do? </li></ul>
    18. 21. Meetings With Congressional Offices <ul><li>Let policymaker know constituency cares about the issue </li></ul><ul><li>Educate policymaker about issue and explain why his/her support important </li></ul><ul><li>Thank policymaker for prior support </li></ul><ul><li>Established dialogue and connection with office- set stage for follow-up communication </li></ul>