Background Briefing on UNAIDS Event and PEPFAR

Special Briefing
Senior State Department Official
Waldorf-Astoria Hotel
New York City, DC
September 25, 2014

MODERATOR: Well, I’d like to welcome everyone and get ready to start our background briefing on today’s UNAIDS event, as well as PEPFAR activities. So again, as with all of these, this will be on background attributed to a senior State Department official. But for sake of clarity, we have with us [Senior State Department Official], and I will hand it over to [Senior State Department Official] for some introductory remarks and then we’ll take some questions. So please, [Senior State Department Official].

SENIOR STATE DEPARTMENT OFFICIAL: Great. Thank you, and good evening. We just came from – literally just came, running over here from a really incredible global event that brought together heads of state with UNAIDS and certainly our Secretary of State, Secretary Kerry, talking about fast-tracking to the end of AIDS, which I think is particularly relevant now as we celebrate the progress we’ve made over the last 11, 12 years of PEPFAR, the President’s Emergency Plan for AIDS Relief.

I was really taken by two things that the Secretary said during his speech. He talked about us having the tools, the science, the capability, the commitment to actually control the pandemic, and really just said it’s now the time to complete the task. And I think for everyone in the room, it was very important for them to hear that the United States believed that the task could be completed by following UNAIDS’s framework of 90-90-90.

I think the other important comment that the Secretary made that was very compelling to the number of heads of state in the room – and there were five to ten heads of state in the room from all over sub-Saharan Africa, a continent that’s certainly most affected by HIV/AIDS – and he clearly said to everyone that our support is unwavering and our depth of commitment remains unchanged. And I think that is so important for the people of Africa to understand that the United States stands beside them still, unwavering in our commitment to change the tide of HIV/AIDS.

I think we’ve been ecstatic by the progress – a million babies born HIV-free, 6.7 million people on treatment. But this week while we were here for UNAIDS – I mean, for the UN meeting, 25,000 adults died of HIV and 3,600 babies died of HIV this week alone, and 35,000 adults were infected, and 4,600 children, babies were infected – this week. So although we’ve made amazing progress, decreased the pandemic probably by half the size it was, we have to finish now while we have the opportunity. And so it was an exciting – almost a family reunion of those of us who have been working in this fight for a long time, complemented by the heads of state that are deeply dedicated, including President Zuma from South Africa,

The final piece that I just wanted to talk briefly about is the piece that has been missing in our work in sub-Saharan Africa in a resource-limited setting is viral load testing. That’s a test that when people go on treatment, it’s important that their viral load is undetectable. That’s important for two reasons: one, the individual person’s health; and two, they can’t transmit the virus if the virus is undetectable. And so there was an announcement made by UNAIDS, the Clinton Health Access Initiative, PEPFAR, and Global Fund of a real marked reduction to almost half any of the prior costs, allowing us to really move forward and really provide patients with that same viral load testing that they have in developed – the developed world.

So this is a very exciting time for us. We’ve been spending not only our time controlling the pandemic but really building and supporting the health systems essential for the control of HIV/AIDS. But these health system strengthenings have been done in a horizontal manner. So the laboratory strengthening that we’ve done throughout PEPFAR-supported countries and the creation of the African Society for Laboratory Medicine, the sustainable long-term approach to laboratory structures and quality improvement in Africa; the human capacity that has been built – the health centers, the physical infrastructure that has been built by PEPFAR – has been utilized for other diseases, and indeed in the prior Ebola outbreaks in East Africa and the DRC. It was that community relationship and the trust that their health centers would have access to lifesaving treatment that was really – has called the prior Ebola epidemics to be rapidly controlled. Also was used for cholera in Haiti, avian flu containment, and other flu outbreaks in Africa.

So these infrastructures that PEPFAR has systematically and horizontally contributed to are the same infrastructures that are needed for all of the relevant diseases that are important to Africa and to our global wellness.

So that’s just a summary of an hour and a half long event, and I’m happy to take any of your questions.

MODERATOR: Okay. So, open up for questions. Name and outlet, please.

QUESTION: Sure. I’m Matthew Russell Lee, Inner City Press. I wanted to know if this issue of decreased funding for – I don’t know if you’d say a middle income country, but like South Africa, Nigeria – there was a big Times article about South Africa’s program being in jeopardy because PEPFAR was moving its funding to poorer countries. Did this come up, and what do you – how do you respond to that?

And also with all the talk of the medical infrastructure in Liberia, Sierra Leone, and Guinea being so weak that it’s collapsed, what were the programs there? Was there – are these – I mean, do these countries stand out as having very weak systems? Or is this (inaudible)?

SENIOR STATE DEPARTMENT OFFICIAL: Yeah, thank you for those questions. So let me tackle your second question first. PEPFAR does not have resources in those three countries you just mentioned. They had very low HIV prevalence from the beginning and were not a significant investment country. Over the last several years, we’ve been investing about $500,000 a year in Sierra Leone to support their TB laboratory diagnosis, but we’ve had very limited support in those three countries.

I wanted to call your attention – this gives me a great opportunity to call your attention to our website at If you go to the website, part of the three absolute pillars of our program is increasing our transparency, accountability, and impact. So if you go to our website, you’ll be able to see our investments in every single country since the beginning of PEPFAR. And so there has been some confusion about the budget declines, but I think if you go to South Africa you will see that there’s not a substantial budgetary decline in the South African funding. It is planned in the out years to have that type of decline. There has been no decline to the budget in Nigeria.

So although as countries are able to do more with their domestic resources, we have let that be our guide for an investment strategy on those declines. So certainly we’re in a very close partnership with the minister of health of South Africa, Minister of Health Motsoaledi, and there – you can see from the website the current investment strategy. It’s also broken out not only by budget but the results by country. So we’re very much committed to put more and more of our information up on the website so countries can see the investments in each other, and frankly, so that people in Iowa can see the translation of their tax dollars into a highly effective and efficient program.

QUESTION: Okay, thanks.

MODERATOR: Other questions? No? All right. Well, thank you very much.

SENIOR STATE DEPARTMENT OFFICIAL: Oh, absolutely. Thank you for spending your Thursday night here. (Laughter.) Always grateful to see all of you. Thank you.