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PEPFAR Blueprint Factsheet

The President’s Emergency Plan for AIDS Relief (PEPFAR) Blueprint: Creating an AIDS-free Generation

“The goal of an AIDS-free generation may be ambitious, but it is possible with the knowledge and interventions we have right now. And that is something we’ve never been able to say without qualification before. Imagine what the world will look like when we succeed.” – U.S. Secretary of State Hillary Rodham Clinton, November 8, 2011


On November 8, 2011, Secretary Clinton declared that, for the first time in history, the world is at the point where an AIDS-free generation is in sight. And at the July 2012 International AIDS Conference, the Secretary called on the President’s Emergency Plan for AIDS Relief (PEPFAR) to produce a blueprint outlining how the United States will contribute to reaching this goal.

Secretary Clinton defined an AIDS-free generation as one where virtually no children are born with HIV; where, as these children become teenagers and adults, they are at far lower risk of becoming infected than they would be today; and where those who do acquire HIV have access to treatment that helps prevent them from developing AIDS and passing the virus on to others. Creating an AIDS-free generation is an ambitious, but reachable, goal—and now a policy imperative of the United States.

The PEPFAR Blueprint: Creating an AIDS-free Generation reflects lessons learned from almost ten years of experience in supporting countries to rapidly scale-up HIV prevention, treatment and care services. It demonstrates the opportunity for the world to help move more countries toward and beyond the tipping point in their epidemics and put them on a path to achieving an AIDS-free generation. The blueprint makes clear that the United States’ commitment to this goal will remain strong, comprehensive and driven by science. It clearly outlines what PEPFAR is doing, and will continue to do, to help make it a reality.

The blueprint also emphasizes that it will take a shared responsibility to create an AIDS-free generation. The United States leads the world in contributions in the fight against AIDS, having invested over $37 billion to date in bilateral funding and over $7 billion in the Global Fund to Fight AIDS, Tuberculosis and Malaria. However, the United States alone cannot achieve an AIDS-free generation. It requires the commitment of partner countries, reinforced with support from donor nations, civil society, people living with HIV, faith-based organizations, the private sector, foundations and multilateral institutions. It means investing in the principle of country ownership — the end state in which partner countries lead, manage, coordinate and over time increasingly finance the efforts needed to achieve an AIDS-free generation in order to ensure that the AIDS response is effective, efficient and durable.

PEFFAR Blueprint: Creating an AIDS-free Generation


Scientific advances and their successful implementation have brought the world to a tipping point in the fight against AIDS. The United States believes that by making smart investments based on sound science and a shared global responsibility, we can save millions of lives and achieve an AIDS-free generation.

PEPFAR’s Principles for the Blueprint

To fulfill this vision, PEPFAR has based its blueprint on the following principles:

  • Make strategic, scientifically sound investments to rapidly scale-up core HIV prevention, treatment and care interventions and maximize impact.
  • Work with partner countries, donor nations, civil society, people living with HIV, faith-based organizations, the private sector, foundations and multilateral institutions to effectively mobilize, coordinate and efficiently utilize resources to expand high-impact strategies, saving more lives sooner.
  • Focus on women and girls to increase gender equality in HIV services.
  • End stigma and discrimination against people living with HIV and key populations, improving their access to, and uptake of, comprehensive HIV services.
  • Set benchmarks for outcomes and programmatic efficiencies through regularly assessed planning and reporting processes to ensure goals are being met.

These principles drive all of PEPFAR’s work and are the foundation for the road maps that comprise the blueprint. Each road map—the Road Map for Saving Lives; the Road Map for Smart Investments; the Road Map for Shared Responsibility; and the Road Map for Driving Results with Science—contains specific goals and comprehensive action and implementation steps on how PEPFAR will support partner countries’ efforts to meet these goals.

Road Map for Saving Lives

This road map addresses Secretary Clinton’s call in her November 8, 2011 speech to scale-up combination HIV prevention and treatment interventions to save more lives.

Specifically, this road map outlines PEPFAR’s plan to:

  1. Work toward the elimination of new HIV infections among children by 2015 and keeping their mothers alive.
  2. Increase coverage of HIV treatment both to reduce AIDS-related mortality and to enhance HIV prevention.
  3. Increase the number of males who are circumcised for HIV prevention.
  4. Increase access to, and uptake of, HIV testing and counseling, condoms and other evidence-based, appropriately-targeted prevention interventions.

Through its continued support for scale-up of combination prevention and treatment interventions in high-burden countries, PEPFAR will help countries reduce new HIV infections and decrease AIDS-related mortality, while simultaneously increasing the capacity of countries to sustain and support these efforts over time. This support will, in turn, move more countries past the programmatic tipping point in their HIV epidemics — the point at which the annual increase in new patients on antiretroviral treatment (ART) exceeds annual new HIV infections — and put them on the path toward achieving an AIDS-free generation.

Road Map for Smart Investments

To achieve an AIDS-free generation, countries must target efforts where the virus is — reaching and supporting those populations at greatest risk and urgently needing services. Accordingly, PEPFAR will work with countries to scale-up activities that have a strong evidence base to produce a population-level impact. PEPFAR will not support interventions that fail to target the epidemic. Concurrently, PEPFAR will work to realize efficiency gains to deliver greater results for its investments. PEPFAR has vastly increased value for money in its investments by reducing the costs of antiretroviral drugs (ARVs), streamlining supply chains, and working with partner countries to increase their investments.

PEPFAR will also continue to lead efforts to strengthen the Global Fund, which leverages U.S. contributions with contributions from other donors. This road map outlines how PEPFAR will follow the epidemic, invest in evidence-based interventions, and continue to generate greater value for money in its investments.

Specifically, this road map outlines PEPFAR’s plan to:

  1. Target HIV-associated tuberculosis (TB) and reduce co-morbidity and mortality.
  2. Increase access to, and uptake of, HIV services by key populations.
  3. Partner with people living with HIV to design, manage and implement HIV programs to ensure that they are responsive to, and respectful of, their needs.
  4. Strengthen PEPFAR’s continued focus on women, girls and gender equality.
  5. Reach orphans and vulnerable children (OVC) affected by AIDS, and support programs that help them develop to their full potential.
  6. Strengthen programmatic commitment to and emphasis on reaching and supporting young people with HIV services.
  7. Strengthen PEPFAR supply chains and business processes to increase the efficiency of our investments.
  8. Increase efficiencies through innovation and greater integrations of services with other U.S., bilateral and multilateral global health investments.

Road Map for Shared Responsibility

The goal of creating an AIDS-free generation is a shared responsibility with partner countries in a convening role. Neither the United States nor any other single entity cannot accomplish this goal alone. Rather, it requires a country to demonstrate political will and effective coordination of multiple partners that finance and carry out interventions both inside and outside of the health sector, and most importantly, meaningfully involve those living with and affected by HIV in all aspects of the response.

Specifically, this road map outlines PEPFAR’s plan to:

  1. Partner with countries in a joint move toward country-led, managed and implemented responses.
  2. Increase support for civil society as a partner in the global AIDS response.
  3. Expand collaboration with multilateral and bilateral partners.
  4. Increase private sector mobilization toward an AIDS-free generation.

Road Map for Driving Results with Science

Scientific advances have brought the world to the point where calling for an AIDS-free generation is possible. And it is science that will underpin all PEPFAR efforts to help achieve this goal and save even more lives. To deliver the greatest response, PEPFAR will continue to support programs guided by scientific evidence. PEPFAR will go to where the science leads, translating science into program impact.

Specifically, this road map outlines PEPFAR’s plan to:

  1. Leverage greatest impact by continuing to invest in implementation science.
  2. Support implementation research.
  3. Evaluate the efficacy of optimized combination prevention.
  4. Support innovative research to develop new technologies for prevention (e.g., microbicides, vaccines) and care (e.g., new treatments or treatment regimens).
  5. Develop evidence-based approaches to reaching people early enough in their disease progression to help maintain a strong immune system; stave off opportunistic infections, particularly TB; and reduce new HIV infections.
  6. Support the deployment of suitable technology for measurement of viral load, both through tiered laboratory networks and ‘point-of-care’ tests as they become available.
  7. Assist countries in adopting breakthrough new technologies with proven impact, such as new, molecular-based TB tests that have dramatically reduced diagnosis and treatment time for people living with TB and HIV.