More than 1.2 million lives were saved due to the work of the U.S. President's Emergency Plan for AIDS Relief, according to a report in the Annals of Internal Medicine.
The report, the first to gauge PEPFAR's effectiveness, found that death rate in 12 countries where PEPFAR was active fell 10.5 percent from 2004 to 2007. These countries are Botswana, Ivory Coast, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia.
"By the end of 2007, PEPFAR spent more than $6 billion on HIV care, prevention, and treatment in the 12 focus countries examined in this study. In those countries, a reduction in the death rate of 10.5% implies that about 1.2 million deaths were averted because of PEPFAR's activities," the report found. "This large benefit cost about $2450 per death averted, assuming that PEPFAR directed half of its budget toward treatment."
However, the report also found that annual growth of the number of people living with HIV in these countries did not slow at a more rapid pace from 2004 to 2007, the years that PEPFAR has been active.
The report also warned that the cost of treatment in countries where PEPFAR is active is expected to increase dramatically in the coming years. To meet this need, PEPFAR will need large funding increases soon.
"Projections of financial resources needed to sustain the treatment scale-up suggest that even with PEPFAR's greater commitment, the gap between the available funds and those needed will continue to increase unless the incidence of HIV in Africa is substantially reduced," the report said. "Striking the right balance between treatment and prevention with insufficient resources for the burden of the epidemic is a major challenge for comprehensive care programs, such as PEPFAR."
Robert Clay, director of the U.S. Agency for International Development's Office of HIV/AIDS, welcomed the report, asserting it was proof that PEPFAR was "changing the dynamics of the HIV/AIDS epidemic."
But the report said it is difficult to determine how effective PEPFAR has been because it has been active for such a short time. Better indications would be available in the coming years.
President Barack Obama has made global health a priority in his 2010 budget request. Last year, the Senate authorized a $48 billion budget for PEPFAR over the next five years.