U.S. Government Global HIV/AIDS Activities

How Are U.S. Government Agencies Working to End HIV and AIDS Around the World?

Agencies across the federal government are involved in implementing the President’s Emergency Plan for AIDS Relief (PEPFAR), the largest commitment by any nation to address a single disease in history. These agencies support a range of global HIV/AIDS activities, from research to technical assistance and financial support to other countries to help prevent new HIV infections and assist people with HIV to access life-saving treatment. These activities are coordinated through PEPFAR. A brief summary of each agency’s roles is below.

U.S. Department of State

The U.S. Department of State’s Bureau of Global Health Security and Diplomacy (GHSD) leads and coordinates the Department’s work on strengthening global health security to prevent, detect, and respond to infectious diseases, including HIV/AIDS. GHSD oversees global implementation of PEPFAR, ensuring program and policy coordination among the relevant government agencies and departments.  PEPFAR partners closely with U.S. ambassadors globally, who oversee the work of PEPFAR at their respective posts. GHSD also works closely with the diplomatic corps in Washington, DC, to advance U.S. global health diplomacy and connect health to other U.S. foreign policy priorities, including economic growth, trade, education, political stability, and pandemic preparedness. PEPFAR also closely coordinates with the Global Fund to Fight AIDS, Tuberculosis, and MalariaExit Disclaimer through substantial U.S. Government support.

U.S. Agency for International Development

The U.S. Agency for International Development (USAID) is an independent federal government agency that receives overall foreign policy guidance from the Secretary of State. As a key implementer of PEPFAR, USAID’s Office of HIV/AIDS supports country-led efforts to combat the complex challenges of HIV in over 50 countries around the world. The Agency’s overall goal is to support and sustain the achievement of HIV epidemic control across these countries. It achieves this by providing global leadership in the development of programs that maximize impact, supporting country-led strategies while applying USAID’s broad health and development expertise and specialized HIV technical competencies, and leveraging science, technology, and innovation to support cost-effective, sustainable, and appropriately integrated HIV interventions at scale. It employs a "whole of Agency" Approach to HIV and Optimized Programming, leveraging its work in health, education, democracy and governance, human rights, economic growth, and humanitarian assistance.

U.S. Department of Health and Human Services

The U.S. Department of Health and Human Services (HHS) has a long history of HIV/AIDS work within the United States and internationally. Under PEPFAR, HHS, through its agencies and offices, supports the implementation of HIV prevention, treatment, and care programs in developing countries and conducts HIV research through the following agencies and offices:

Centers for Disease Control and Prevention

As a key implementing partner of PEPFAR, the Centers for Disease Control and Prevention (CDC) plays a unique role—bringing a combination of scientific expertise, technical know-how, and strong partnerships to bear in the fight against HIV. CDC supports more than 11,000 labs or point-of-care testing sites in more than 33 countries, getting life-saving treatment to people with HIV around the world, and works with partners to gather and analyze data from around the world to inform and optimize public health programs and policies aimed towards ending this public health threat. Further, CDC’s Division of Global HIV & TB (DGHT), through PEPFAR, works to tackle HIV and tuberculosis (TB), the world’s two most deadly diseases. These two epidemics are tragically interconnected, as TB is the leading cause of death for those with HIV. CDC’s experts are working on the front lines in 46 countries and regions around the globe, focused on a single mission: to fight these diseases and, ultimately, bring an end to the dual epidemics of HIV and TB.

Food and Drug Administration

The Food and Drug Administration (FDA) plays an integral role in PEPFAR by ensuring safe, effective, and quality-assured antiretroviral drugs (ARVs), the medicine used to treat and prevent HIV, are available for distribution within the program. The FDA’s Office of Global Policy and Strategy (OGPS) serves as the agency lead for PEPFAR issues. Within OGPS, the FDA’s PEPFAR Coordinator serves as the point of contact for internal FDA programs, U.S. government agencies, and external organizations working on HIV/AIDS and related programs. The FDA PEPFAR Coordinator also works with drug firms seeking to participate in the FDA’s review process for ARVs for use in the PEPFAR focus countries. The FDA’s Center for Drug Evaluation and Research (CDER) reviews marketing applications for ARVs for the PEPFAR program through a tentative approval/approval program. View FDA's interactive database of approved or tentatively approved ARVs that are eligible for procurement through PEPFAR.

Health Resources and Services Administration

Since 2003, the Health Resources and Services Administration (HRSA) has been a significant contributor to PEPFAR's achievements. HRSA’s Office of Global Health implements the agency's PEPFAR activities. HRSA's work builds on the agency’s domestic and global experience. Its focus is improving outcomes in treatment and prevention for people living with HIV. HRSA works with host countries and other key partners to assess the needs of each country and design a customized assistance program that fits within the host country’s strategic plan for HIV/AIDS and health. HRSA’s global mission focuses on supporting the delivery of quality HIV/AIDS care and treatment services, providing training and technical assistance to build and strengthen all levels of the health sector, collaborating to build skills and support host countries and local organizations, and preparing a strong health care workforce across service providers.

National Institutes of Health

The National Institutes of Health (NIH) provides the largest public investment in HIV/AIDS research globally. Coordinated by the Office of AIDS Research (OAR), NIH’s HIV research priorities are reducing the incidence of HIV, developing next-generation HIV therapies, conducting research toward an HIV cure, addressing HIV-associated comorbidities, coinfections, and complications, and advancing cross-cutting areas of research. These research priorities are based on current data about the pandemic and the science to prevent, treat, and ultimately cure HIV.

Office of Global Affairs

HHS’s Office of Global Affairs (OGA), within the Office of the HHS Secretary, is the diplomatic voice of HHS, fostering critical global relationships, coordinating international engagement across HHS and the U.S. government, and providing leadership and expertise in global health diplomacy and policy to contribute to a safer, healthier world. Through relationships with multilateral organizations, foreign governments, ministries of health, civil society groups, and the private sector, OGA creates and maintains the pathways for HHS to apply its expertise globally, learn from our overseas counterparts, and advance policies that protect and promote health at home and worldwide.

Substance Abuse and Mental Health Services Administration

The Substance Abuse and Mental Health Services Administration (SAMHSA) leads public health efforts to advance the behavioral health of the nation and to improve the lives of individuals living with mental and substance use disorders, and their families. SAMHSA works through state and tribal governments and faith- and community-based programs to support the prevention, treatment, and recovery from substance use and mental health disorders, including by supporting an educational and training center network that disseminates state-of-the-art information and best practices. This technical expertise and program experience is being applied to PEPFAR to assist other countries in addressing serious substance use—including opioid-related—disorders and mental disorders that make the treatment and prevention of HIV more complicated.

Peace Corps

The Peace Corps contributes to the global response to HIV by partnering with host countries and local governments to enhance the capacity of organizations from the community to the national level to improve equitable and person-centered care while providing communities the knowledge and skills necessary to adopt healthy behaviors and implement risk strategies. Peace Corps trains and supports Volunteers who work specifically on HIV programming and wider efforts at health systems strengthening, as well as Volunteers from other sectors who integrate HIV awareness, education, and prevention activities into their day-to-day work.

U.S. Department of Commerce

The U.S. Department of Commerce fosters public-private partnerships and makes presentations in industry/trade advisory committee meetings on how the private sector can contribute to global HIV/AIDS interventions. In addition, the U.S. Census Bureau, housed within the Department of Commerce, provides support for PEPFAR by assisting with data management and analysis, survey support, and mapping of country-level activities. With funds from PEPFAR, the U.S. Census Bureau maintains and annually updates the HARVEST HIV/AIDS Statistic Dashboard to meet the needs of policymakers and program planners around the world. This central repository for global HIV/AIDS data seeks to provide as complete a picture as possible for select indicators that represent the state of the epidemic and progress toward controlling it.

U.S. Department of Defense

The Department of Defense's (DoD) HIV/AIDS Prevention ProgramExit Disclaimer (DHAPP) is responsible for assisting foreign military partners with the development and implementation of culturally focused, military-specific HIV/AIDS prevention, care, and treatment programs in more than 55 countries around the globe. DHAPP employs an integrated bilateral and regional strategy for HIV/AIDS cooperation and security assistance. DHAPP also is the DoD implementing agency for PEPFAR. As such, DHAPP plans activities and sets targets based on the specific context of the partner military and the clients seen at military heath facilities and uses information from military HIV seroprevalence studies, programmatic data, and other sources to implement programs at military locations with a significant burden of HIV.

U.S. Department of Labor

The Department of Labor (DoL) implements PEPFAR workplace-targeted projects that focus on the prevention and reduction of HIV/AIDS-related stigma and discrimination. DoL brings to these endeavors its unique experience in building strategic alliances with employers, unions, and Ministries of Labor.

U.S. Department of the Treasury

The U.S. Department of the Treasury is working to promote financial effectiveness and fiscal sustainability of the HIV/AIDS response in partner countries, primarily in Africa. The goal of Treasury’s work is to increase awareness and understanding of the economic and financial dimensions of HIV/AIDS, especially among finance ministries; include the disease response as part of national economic strategies; strengthen financial resource mobilization and efficient utilization; and build capacity to implement policy improvements. Treasury’s work entails both policy engagement and technical assistance to support the implementation of improved policies, generally in partnership with finance ministries. Illustrative examples include supporting HIV expenditure oversight committees, strengthening budget systems and execution in health and finance ministries, and developing capacity for health cost analysis.