PEPFAR

What is PEPFAR?

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) saves lives, prevents millions of HIV infections, and supports several countries to achieve HIV epidemic control—all while significantly strengthening global security.

PEPFAR is the largest commitment by any nation to address a single disease in history, enabled by strong bipartisan support across ten U.S. congresses and four presidential administrations, and through the American people’s generosity. PEPFAR shows the power of what is possible through compassionate, cost-effective, accountable, and transparent American foreign assistance.

Since PEPFAR’s inception in 2003, the U.S. government has invested over $100 billion in the global HIV/AIDS response, saving over 25 million lives, preventing millions of HIV infections, and supporting several countries to achieve HIV epidemic control, all while significantly strengthening global health and economic security.

PEPFAR works closely with partner countries toward achieving HIV/AIDS epidemic control while promoting the long-term sustainability of their responses. It forges strategic partnerships with the private sector that support and specifically complement its prevention, care, and treatment work, addressing key gaps in innovative ways. PEPFAR partners with and strengthens the capacity of civil society and communities, including faith-based communities and organizations, recognizing that successful and sustainable HIV/AIDS interventions must involve, be informed by, and be tailored to those whom it serves.

PEPFAR is managed and overseen by the U.S. Department of State's Bureau of Global Health Security and Diplomacy and implemented by seven U.S. government departments and agencies, leveraging the power of a whole-of-government approach to controlling the HIV/AIDS epidemic. On December 1, 2022, PEPFAR announced a five-year strategy: Fulfilling America’s Promise to End the HIV/AIDS Pandemic by 2030. The Strategy centers on collaboration and partnership to confront the challenge of HIV/AIDS in the wake of other emerging health threats.

What Are PEPFAR’s Priorities?

• Progress: When PEPFAR was launched in 2003, an HIV diagnosis was a death sentence in much of the world; entire families and communities were falling ill. In the intervening years, death and despair have been overwhelmingly replaced with vibrant lives and hope. With the American people’s generosity, the United States has saved 25 million lives and prevented millions of HIV infections through PEPFAR. Working together with our partners in more than 50 countries, PEPFAR has accelerated progress toward controlling the HIV/AIDS pandemic – community by community.
• Policies: PEPFAR ensures every dollar is optimally focused for impact through data-driven policies, and supports partner countries to do the same.
• Populations: PEPFAR reaches the populations that are most affected by the HIV/AIDS epidemic with innovative solutions that meet their needs.
• Partnerships: PEPFAR leverages the power of partnerships across multiple sectors to increase its impact and advance sustainability.

What Has Been PEPFAR’s Impact?

PEPFAR’s strategic rigor has allowed the program to significantly expand its lifesaving results and impact without increasing financial resources and impact without increased financial resources. Below are details on just some of PEPFAR’s latest global program achievements.

Delivering on Demand for Highly Effective PrEP for HIV Prevention

Between FY 2020 and FY 2024, new annual PrEP initiations supported by PEPFAR increased by more than 500%, reaching 2.5 million people protected from HIV infection in FY 2024.

PEPFAR accounts for more than 90% of PrEP initiations globally. PEPFAR is providing long-acting injectable PrEP in five countries and plans to launch it in six additional countries by the end of 2024. As part of effective HIV combination prevention interventions, innovations in long-acting injectable PrEP hold the potential to accelerate progress toward ending HIV/AIDS as a public health threat.

Changing the Trajectory of the HIV Epidemic

Available UNAIDS estimates show there were 52% fewer new HIV infections in 2023 than in 2010 across PEPFAR-supported countries, compared with a 39% reduction globally. During the same time frame, AIDS-related deaths decreased by 59% in PEPFAR-supported countries, compared with 51% globally.

Increasing HIV Testing

PEPFAR provided HIV testing services to 83.8 million people in FY 2024, 12 million more than in FY 2023.

Providing Life-Saving Antiretroviral Treatment

Across 55 countries, PEPFAR is supporting life-saving antiretroviral therapy (ART) for 20.6 million people, including 566,000 children with HIV, as of September 30, 2024. Viral load testing coverage and suppression among people on treatment continues to increase for children and remains high for adults — 95 % of adults and 89 % of children are currently virally suppressed. The massive, rapid expansion in access to treatment stands as one of PEPFAR’s greatest achievements for many reasons: not only has ART saved the lives of millions of people with HIV and increased their life expectancy to near-normal levels, but it allows individuals to achieve and maintain viral suppression, the strongest available intervention to prevent HIV transmission.

Empowering and Equipping Adolescent Girls and Young Women to Stay HIV-Free

PEPFAR reached 2.3 million adolescent girls and young women with comprehensive HIV prevention services in FY 2024. This year marks the 10th anniversary of PEPFAR’s flagship DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) program, which has reduced new HIV infections through interventions including access to PrEP, support for secondary school, and violence prevention. PrEP initiations among adolescent girls and young women ages 15-24 is 1.4 times higher in districts implementing DREAMS, with nearly 475,000 initiated in FY 2024.

Enabling Babies to be Born HIV-Free and Supporting Orphans, Vulnerable Children, and Caregivers

As of September 30, 2024 , PEPFAR has enabled 7.8 million babies to be born HIV-free to mothers living with HIV. The program has also provided critical care and support for 6.6 million orphans, vulnerable children, and their caregivers so they can survive and thrive.

Preventing HIV Infection in Men and Boys

PEPFAR has provided 35.1 million voluntary medical male circumcisions in East and Southern Africa to help prevent new HIV infections since 2007, including 2.7 million in FY 2024.  

Strengthening Health Systems

PEPFAR directly supported more than 342,000 health workers to deliver quality HIV-related prevention, treatment, and supportive services in clinics and communities in FY 2024 .

Latest Program Results

PEPFAR regularly reports on results achieved by its programs.

• Read about the latest global results from PEPFAR-supported activities
• For more detailed information, visit the PEPFAR Data Dashboards.