PEPFAR Five Year Strategy: Is OGAC Charting A Bold New Course? Print

by Brian Ackerman, Program Manager, International Policy

I just finished a first quick review of the long-anticipated PEFPAR Five-Year Strategy which was released today by OGAC (the Office of the U.S. Global AIDS Coordinator). (The full strategy can be found here.

I wanted to share some of the things that stood out to me, though on balance, I find the document encouraging--mostly because of these two bullets (though throughout the document a number of items are particularly positive):


  • PEPFAR’s Targets from Fiscal Year (FY) 2010-FY 2014: Prevention

    "In every partner country with a generalized epidemic, provide 100% of youth in PEPFAR prevention programs with comprehensive and correct knowledge of the ways HIV/AIDS is transmitted and ways to protect themselves, consistent with the Millennium Development Goal indicators in this area."

  • Programmatic Strategy for Linking HIV/AIDS to Women's and Children's Health (p. 7):

    "Expanding integration of HIV prevention, care, support, and treatment services with family planing and reproductive health services, so that women living with HIV can access necessary care and so that all women know how to protect themselves from HIV infection."

Both of these bullets are extremely promising, yet some frustratingly infamous omissions remain causes of concern.
 

 


 
1.  No mention of young people/adolescents living with HIV (once again there is the gap between "children living with HIV/AIDS" and adults, but adolescents are conveyed almost exclusively through a prevention/orphan optic). 
 
2.  No mention of the term "comprehensive sex education"
 
3.  Only one mention of "rights"--though a good one one--on p. 16 "PEPFAR also utilizes its services as a mechanism through which to advance the rights of populations that face stigma, and expand equal access to care."  It's great to see this--but it wouldn't hurt to have a more explicit statement that PEPFAR is a rights-based response to the HIV pandemic. The focus on the access to information and integrated RH/FP services is inherently rights-based, as is the whole section titled "PEPFAR is responsive to people, not just to a virus" on p. 15, so the lack of explicit terminology may not be particularly problematic, but because documents like this set such standards for the semantic and conceptual framing of the pandemic and our response to it, more explicit rights-based language can be positive.
 
4. No mention of the need for data to be disaggregated by age/gender in the Programmatic Strategy for Metrics and Standardized Monitoring (though this will likely appear if there is an annex on research/metrics etc.
 
On the whole, despite these omissions, I am encouraged by the 5-year strategy from my first quick read, and I hope that the annexes, once released, will also be encouraging with more specifics and supplementary information (particularly regarding prevention for youth and metrics for monitoring and evaluation).    Perhaps most indicative of our frustration with Obama Administration policies, what is in the document is generally good, it's what's missing (and why it's missing) that is concerning. Thus these omissions and others are crucial for us to be aware of and to continue to press OGAC on as the second phase of PEPFAR moves forward.