PEPFAR: Focusing Resources for Impact

South Africa, with support from the United States through the President’s Emergency Plan for AIDS Relief (PEPFAR), provides 3 million South Africans with antiretroviral treatment (ART) – saving countless lives, keeping families together, and increasing South Africa’s overall economic productivity.

Since 2004, PEPFAR has invested more than $4.9 billion in South Africa’s HIV/ TB response, helping to support an unprecedented expansion of prevention, treatment, and care services.

Initially, to help stem the rising tides of these dual epidemics, PEPFAR directly supported a substantial share of clinical care and treatment services across South Africa.

Now, PEPFAR is committed to investing resources where the HIV virus is.  The PEPFAR Focusing for Impact involves working with the South African Government, and other stakeholders, as we take strategic action to focus PEPFAR resources geographically and programmatically to support HIV/AIDS prevention, care, and treatment programs in high-burden areas.

South Africa is at a critical moment, when the course of the epidemic can be changed if we work together to scale up high-impact interventions in the communities that are hardest-hit by HIV/AIDS, to save more lives and prevent HIV transmission.

This move is consistent with the UNAIDS Fast-Track strategy and 90-90-90 targets for 2020, which the South African Government has embraced, in which 90 percent of people living with HIV/AIDS know their status, 90 percent of people with diagnosed HIV infection receive antiretroviral treatment, and 90 percent of people on antiretroviral treatment are virally suppressed by 2020.

Focusing on high-burden areas allows us to achieve the UNAIDS 90-90-90 targets in the most effective and impactful manner.

To control the epidemic and achieve an AIDS-free generation, it is critical to strategically focus resources in areas with a high burden of HIV/AIDS, where we can reach the most people living with and at risk for the disease.

Resource allocation is determined by PEPFAR and the South African Government and informed by the micro-epidemic data analysis conducted by the National Department of Health.  These data allow us to understand the sub-national and local differences in the epidemic to ensure the needed HIV services are available in the hardest-hit areas.

Previously, PEPFAR implementing partners operated in all 52 districts in South Africa. With the use of evidence-based data, we have been able to determine and agree that we need to concentrate more of our HIV response efforts in 27 districts which have been identified as high-burden areas.

Special focus will also be given to two additional districts with mining and industrial activities, to prevent these areas from becoming high-burden areas.

Building on an 11-year collaboration, PEPFAR will continue to support South Africa’s leadership in doing the right things, in the right places, right now.