O'Neill Institute Papers

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The President’s Emergency Plan for AIDS Relief (PEPFAR) was the largest commitment by any nation to combat a single disease in human history, authorizing up to $15 billion over 5 years. On July 30, 2008, President Bush signed into law the historic reauthorization of PEPFAR, dramatically increasing the financial commitment by authorizing up to $48 billion over 5 years, including $5 billion for Malaria and $4 billion for Tuberculosis. PEPFAR’s global targets are inspiring: treat 3 million people; prevent 12 million new HIV infections, and care for 12 million people, including 5 million orphans and vulnerable children. But, PEPFAR has been mired in controversy. To some, it exemplifies America’s extraordinary compassion and generosity, and to others America’s politicization of public health and unilateral approach to international health. The truth lies somewhere in between. American health assistance to the developing world stands at a crossroad. As PEPFAR is scaled up, will it provide opportunities to fulfill basic human needs, or will its limited focus pull resources from sustainable, capacity-building support in line with poor country priorities?