I had just finished my first year of graduate school at UCLA when the first case of HIV was reported in Los Angeles. Little did I know how that event, happening so close to my school, would affect and influence my professional life. Over the next three decades, HIV/AIDS would play a central role in my USAID career and become a passion and driver of my work.
As deputy director of the Health and Nutrition Office in the 1990s, I helped oversee the HIV/AIDS division’s work and program. But HIV/AIDS was only a disease I read about and discussed. It took my Foreign Service posting in Zambia in 1998 for HIV/AIDS to become real.
One in five Zambians was HIV positive, and because the epidemic had been underway for 15 years, illness and death were at an all time peak. Our home was on the road to the city cemetery, and long funeral processions were daily occurrences.
It was during my first year there that I personally experienced the devastating death of one of my staff from AIDS. It changed our entire office and we were inspired to do all we could to ensure others did not face the same fate. It was those five years in Zambia, at the heart of the HIV/AIDS epidemic, which convinced me of the importance of prevention—especially reaching the next generation with effective messages.
Reading the predictions for the next HIV/AIDS wave to hit key Asian countries, I was motivated to share what I learned in southern Africa with this region.
With my five-year assignment to India, I was witness to the large scale expansion of the Indian response to high risk groups and key geographic areas. We focused the majority of our efforts on building the local capacity of the government and civil society to ensure sustainability.
The scale of this effort was enormous given that most Indian states’ populations are greater than those of many countries.
I am now back in Washington, leading the HIV/AIDS Office in the Bureau for Global Health. This is a very important time as the second phase of the President’s Emergency Plan for AIDS Relief (PEPFAR) is being implemented with a greater focus on sustainability and country ownership. And with President Obama’s Global Health Initiative underway, USAID is working with our U.S. Government partner agencies to improve integration among our programs.
We have made tremendous progress over these some 30 years—PEPFAR is currently supporting over 3.2 million people on lifesaving antiretroviral (ARV) drugs, and with USG support in fiscal year 2010 alone more than 114,000 infants were born HIV-free. Through partnerships with more than 30 countries, PEPFAR directly supported 11 million people with care and support and provided nearly 33 million people with HIV counseling a testing.
It has also been an exciting time for prevention with the results of the USAID-funded CAPRISA trial proving a microbicide could help prevent HIV transmission. This was met with enthusiasm by the HIV/AIDS community, and Administrator Shah is supportive of an aggressive way forward to advance microbicides from proof of concept to impact in the field to slow transmission of HIV.
So on this World AIDS Day and in the coming year, we should all honor the 33.3 million people who are currently living with HIV and the millions more who have died from this epidemic, and recommit ourselves to do all we can to address the personal tragedy caused by HIV/AIDS.
A Brief History of USAID’s Role in HIV/AIDS
• 1986: USAID officially begins HIV/AIDS programs in the developing world. This is only two years after HIV, the virus that causes AIDS, was isolated and identified.
• 1988: USAID’s Demographic and Health Survey begins collecting data on HIV.
• 1993: USAID is a founding member of the International HIV/AIDS Alliance
• 1998: USAID launches the IMPACT program for HIV prevention and care.
• 2000: USAID launched Regional HIV/AIDS Program for Southern Africa.
• 2001: USAID officially launches the Office of HIV/AIDS within the Bureau for Global Health.
• 2001: USAID begins partnership with the International AIDS Vaccine Initiative.
• 1998: USAID launches the IMPACT program for HIV prevention and care.
• 2000: USAID launched Regional HIV/AIDS Program for Southern Africa.
• 2001: USAID officially launches the Office of HIV/AIDS within the Bureau for Global Health.
• 2001: USAID begins partnership with the International AIDS Vaccine Initiative.
• 2003: The U.S. President’s Emergency Plan for AIDS Relief is announced
• 2005: PEPFAR, in conjunction with USAID, launched the Supply Chain Management System Project
• 2008: The $48 billion Lantos-Hyde reauthorization bill on HIV/AIDS, TB, and malaria is signed into law
• 2009: The President’s Global Health Initiative is announced
• 2010: the CAPRISA 004 trial provides the first ever proof of concept that a microbicide can prevent HIV transmission
