Eliminating HIV as a Global Health Threat – Vital Signs

The Overview

Since 2004, the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, has been a driving force in transforming the global response to HIV. When PEPFAR was launched 20 years ago in 2003, HIV was a global crisis, devastating families, communities, and economies worldwide – particularly throughout sub-Saharan Africa. In many countries, lack of access to lifesaving HIV treatment and resources meant an HIV diagnosis almost certainly meant death. Today, thanks to PEPFAR, more than 20 million people living with HIV are leading healthy, productive lives because they are on PEPFAR-supported HIV treatment worldwide.

A recent analysis published in CDC’s Morbidity and Mortality Weekly Report (MMWR) – the most comprehensive study of its kind – reveals that US-led global efforts to scale up lifesaving treatment have led to transformative progress in under 20 years. Despite these tremendous achievements for nearly 20 years, the analysis also revealed significant gaps – fueled by many factors including stigma and discrimination.

These findings affirm PEPFAR’s efforts have not only dramatically altered the course of the HIV pandemic but have also strengthened the systems that keep the world safe from other global health threats. As the United States’ premier public health agency and a PEPFAR implementing agency, CDC is at the forefront of these global HIV efforts, bringing scientific and technical expertise to bear in more than 50 countries and leading the way on a number of critical fronts.

In fact, the analysis found that CDC and partners are responsible for the majority of PEPFAR treatment efforts. While receiving roughly 50% of PEPFAR funding for HIV treatment worldwide, CDC supports more than 60 percent (62%) of all people with HIV on PEPFAR-supported anti-retroviral treatment.

Our Impact

More Than 20 Million People Have Received HIV Treatment Through PEPFAR

The number of people on lifesaving HIV treatment through PEPFAR increased 300 times from just 66,500 individuals in 2004 to over 20 million people in 2022.

CDC is at the Forefront of PEPFAR’s Global HIV Efforts

CDC is leading PEPFAR’s efforts to strengthen health systems, which helps countries respond to their HIV epidemics while also preparing them for future health threats.

PEPFAR and CDC are Strengthening Health Systems Globally

CDC supports the majority (62%) of people receiving lifesaving antiretroviral therapy through PEPFAR. Antiretroviral therapy (ART) is treatment for HIV.

A Story of Hope from Uganda

In 2004, John Robert Engole became the first person in the world to receive antiretroviral therapy (ART) through a CDC-supported clinic as part of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). At the time of his HIV-positive diagnosis, John was incredibly ill due to his weakened immune system. “I had completely lost hope,” he says.

Hear John Engole’s Story

Now, almost 20 years later, John remains on lifesaving treatment, and is healthy and thriving.

John is just one of the millions of people who have received HIV treatment through CDC’s efforts as part of PEPFAR in the 20 years since the initiative’s inception. In Uganda – one of the first countries to provide PEPFAR-supported HIV treatment – ART scale-up since 2004 has helped avert an estimated 500,000 infections, including approximately 230,000 infections among HIV-exposed infants, and 600,000 HIV-related deaths. CDC has helped lead HIV treatment and prevention efforts in Uganda since 1991, working closely with the Ministry of Health and other partners to deliver evidence-based HIV services to those who need it.

The tremendous scale-up of HIV treatment efforts in Uganda has been echoed around the globe, with approximately 20 million persons with HIV infection in more than 50 countries receiving PEPFAR-supported ART since 2004. As a key implementing agency of PEPFAR, CDC has played a critical role – supporting lifesaving treatment for 12.5 million people in 2022, more than 40 percent of all people on HIV treatment worldwide.

“Twenty years after the announcement of PEPFAR, the program’s first patient is now aged 53 years and remains on treatment with a suppressed viral load,” says Dr. Emilio Dirlikov, CDC-Uganda Health Service Branch Chief. “His story has been replicated millions of times over because of the dedicated support of the American people through PEPFAR and CDC’s critical leadership.on the frontlines of these efforts.”

Today, John is a teacher, a father, a husband, and an advocate for HIV treatment in his community. His story is one of hope, resiliency, and infectious enthusiasm for helping others. “Being the first beneficiary of PEPFAR,” he says, “I’d like to thank the U.S. government for the support they’ve given to Uganda, especially in my life.”

The Path Forward

Over the past two decades, PEPFAR and CDC have dramatically altered the course of the HIV epidemic. Looking to the future, we must continue to build on this momentum if we are to eliminate HIV as a global public health threat once and for all. PEPFAR’s 5-year strategy provides a powerful roadmap to achieving this goal. At CDC we are at the forefront, leading global efforts across each of the strategy’s five key pillars: sustaining the response; health equity for priority populations; public health systems and security; transformative partnerships; and following the science. These latest data show that we are on the path to achieving these goals and validate that PEPFAR and CDC’s efforts over the past two decades are working. We cannot stop now.

As a key implementing agency of PEPFAR, CDC is on the frontlines in more than 50 countries, bringing a combination of scientific and technical expertise, and four decades of on-the-ground experience to bear in the fight against HIV. CDC’s longstanding efforts, as part of PEPFAR, are not only transforming countries but saving countless individual lives.

Related Stories:

HIV Overview

Learn more about CDC’s history, leadership, reach and impact in the global HIV response.

Faces from the Frontlines

Hear directly from CDC experts and clients on the frontlines of the HIV epidemic.