Stanford Study Gives US Global AIDS Program High Marks

In 2003, President Bush launched PEPFAR, the President's Emergency Plan for AIDS, to combat the AIDS pandemic in developing countries.

"With the approval of Congress, we'll devote $15 billion to fight AIDS abroad over the next five years, beginning with $2 billion in the year 2004," Bush said.

Much of the money went to relieve the suffering of AIDS victims in sub-Saharan Africa, the epicenter of the pandemic.

The U.S. Global AIDS coordinator who oversees PEPFAR is Ambassador Eric Goosby.  He recalls what it was like before the program was launched.

"AIDS was wiping out a generation and reversing health gains in Africa.  At that time, AIDS threatened the foundations of society," Goosby said.

Today a positive AIDS test no longer means certain death. Ambassador Goosby says it's almost impossible to overstate the U.S. contribution to fighting the AIDS pandemic. Former President Bush has called PEPFAR the greatest achievement of his presidency. A new Standford University assessment says PEPFAR has been essential to slowing the spread of HIV.

"On a global scale, about two thirds of all the people who live with HIV live in sub-Saharan Africa," said Dr. Eran Bendavid, who led the research.

Dr. Bendavid and other researchers studied more than a million and a half people in 27 African countries. Nine of these countries had partnership agreements with PEPFAR.  

"A lot of times, there are concerns that foreign aid disappears somewhere in the path between the coffers in Washington and the recipients on the ground," Bendavid said.

PEPFAR funded HIV education, prevention and treatment. And, the researchers found,  the aid actually got to the people who needed it.

"We estimate that in those nine countries, during that period between 2004 and 2008, about 740,000 adults did not die in association with the program," said Bendavid.

Ambassador Goosby describes the impact he believes PEPFAR has had. Before its implementation, he says, hospitals were overcrowded with people dying from AIDS.  

"I was in many hospitals in sub-Saharan Africa where you'd have an open ward and you'd have four or five people having grand-mal seizures happening at the same time. That was a very typical picture. That isn't happening any more," Goosby said.

Ambassador Goosby says most AIDS patients are now treated earlier, as outpatients, before opportunistic infections can set in.

One of the criticisms of PEPFAR is that it siphoned money away from research on other diseases and their treatments. But the Stanford University study found that in countries served by PEPFAR, people without HIV were also doing better.

"The mortality reduction was, if anything, larger in the general population than in the HIV-infected population," Bendavid said.

His research team did not look into why this happened, but Dr. Bendavid believes it could have been the result of improvements in the healthcare system, or because those in better health were able to care for those still in need.

The study was published in the Journal of the American Medical Association.