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Celebrating a Milestone: 15 years of U.S. leadership in the fight against HIV/AIDS

By Frank Beadle de Palomo, President and Chief Executive Officer,


In early 2000 when the HIV/AIDS pandemic was at its height, I remember I visited Soweto, a township outside of Johannesburg, South Africa, and spoke to a young pregnant woman who had just tested HIV-positive. Convinced she was going to die, her primary concern was who would take care of her unborn child and whether the child, too, would become infected. Her husband was no longer alive, her mother had died of tuberculosis, and her father had also passed away. What should have been one the happiest moments of her life, anticipating the arrival of the new life inside her, was filled with pure terror.

The difference between those dark days and today feels like centuries apart. Back in the early 2000s—while the U.S. had achieved epidemic control and mother-to-child transmission of HIV was almost entirely eliminated—an HIV diagnosis was a death sentence across much of Africa. Few people had access to lifesaving HIV treatment, and approximately 1,500 babies were infected with HIV each day globally, most of them in sub-Saharan Africa. People were filled with fear, stigma was rampant, and it felt as if there was no hope.

Today, we are closer than ever to ending AIDS and creating a generation free from HIV, thanks in large part to the remarkable efforts of the U.S. government through the President’s Emergency Plan for AIDS Relief (PEPFAR). Enacted 15-years ago this month with bi-partisan support under the leadership of President George W. Bush, PEPFAR has seen the U.S. government invest nearly $75 billion in the global HIV/AIDS response, the largest commitment made by any nation to address a single disease, ultimately saving more than 13 million lives and enabling more than two million babies to be born HIV-free.

In Africa, PEPFAR has been a game changer. As many as 13 high-HIV burden countries are poised to achieve epidemic control by 2020, thanks in large part to PEPFAR support. The number of babies infected with HIV each day has dropped to 200 in sub-Saharan Africa. Furthermore, the latest PEPFAR data show a 25-40 percent decline or greater in new HIV diagnoses among adolescent girls and young women in the majority of the highest-HIV burden countries implementing PEPFAR’s DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) public-private partnership.

PEPFAR has also been a game changer for m2m as our largest, and one of our longest standing, funders. Starting with our first sub award in 2004/05 and our first direct grant in 2006, PEPFAR’s support has played a critical role in deepening our programme’s scale, scope and impact across eight African countries. That support helped m2m reach almost 2 million clients last year alone, together with our partners, and employ 1,600 HIV-positive women as Mentor Mothers. Furthermore, m2m has virtually eliminated mother-to-child transmission of HIV for the last three years among our enrolled clients.

As the nature of the epidemic is evolving, m2m’s model is too, and so is PEPFAR’s support. Now working with its many partners—which range from government, the private sector, philanthropic organisations, to civil society—PEPFAR is addressing HIV across the life cycle—from babies and children to adolescents and families—so that we can control the epidemic for all populations. This aligns closely with m2m’s own family-centric approach. Thanks to PEPFAR funding, m2m provides early childhood development services to help parents and caregivers nurture and stimulate their child’s development so they thrive, not just survive. We also work with adolescents to promote HIV counseling and testing, as well as critically needed sexual and reproductive health education, to help them make healthy choices. And we support HIV-positive mothers through pregnancy and breastfeeding, and until their children have their final 18-24 month HIV test and are no longer at risk of infection.

PEPFAR has also been supportive of our increasing investment in technical assistance, which has helped us to scale our model and impact beyond what we would have been able to do alone. PEPFAR supported us to provide technical assistance to the Kenyan and South African governments, which ultimately saw our Mentor Mother Model implemented as national policy in both countries. For instance, as of the end of last year, the Kenyan government employed 655 Mentor Mothers at almost 400 sites, bringing benefits to all Kenyans.

Today, I love going into a site and having a nurse or the head of the clinic say, “You need to know that it’s been three years since we have had a baby born in this clinic with HIV because of the peer education and support provided by mothers2mothers.”

While this is remarkable progress, now is not the time to take our foot off the pedal. We must maintain momentum to finish the job, achieve the 90-90-90 targets by 2020, and deliver on the Global Goal to end AIDS, for good, by 2030. There is still a lot of hard work to do – across all stages of the lifecycle: 200 babies are still infected with HIV each day in Eastern and Southern Africa, often during breastfeeding; only 43 per cent of HIV-exposed infants were tested within the recommended first two months of life; nearly 7,000 adolescent girls young women (AGYW) (15-24) are infected with HIV each week, the majority in sub-Saharan Africa.

Through the critical leadership of the U.S. government and PEPFAR, together with a continued global commitment, I am confident that we will end AIDS in our lifetime. And that no woman, like the pregnant woman I met in Soweto so many years ago, will have to fear for her and her child’s future because of HIV/AIDS. Instead, we will be able to tell how we took that darkness and despair and transformed it into health and hope so that all women and families can look forward to a thriving future.

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