Pepfar’s Past: 2003-2008

In the first five years of the program, PEPFAR focused on establishing and scaling up prevention, care and treatment programs.

U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (PEPFAR I)

Passed by the U.S. Congress in 2003, the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act  notes that the magnitude and scope of the HIV/AIDS crisis demands a comprehensive, long-term, international response focused on addressing the causes, reducing the spread, and ameliorating the consequences of the HIV/AIDS pandemic.  Toward this end, the Act specifies a series of broad and specific goals, alternately delegating authority to the President for identifying measurable outcomes in some areas, and specifying by law the quantitative benchmarks to be reached within discrete periods of time in others.  The legislation also established a new Global Coordinator’s Office within the State Department to manage the U.S. interagency response to global HIV/AIDS.  The Act requires the President to report to Congress annually on the effectiveness of reducing the spread of HIV infection, particularly in women and girls, and reducing mother-to-child transmission of the HIV infection.  

When PEPFAR I was signed into law, 15 “focus countries” with the greatest need were designated to receive a majority of the funding (12 in sub-Saharan Africa, 2 in Latin America and 1 in Asia). The reauthorization of PEPFAR in 2008 shifted away from the “focus country” approach by authorizing the development of a Partnership Framework model for regions and countries, with the aim of ensuring long-term sustainability and country leadership.  Through bilaterally-funded programs, PEPFAR now works in partnership with host nations to support treatment, prevention and care for millions of people in more than 85 countries.

Summary and full text of the 2003 global AIDS law