Twenty years ago, the sight of women, men and children being carried to hospitals in wheelbarrows as they clung to the fragile threads of life, was heartbreakingly common. 

AIDS was not just a disease. It was a shadow of despair that loomed over our communities, threatening to engulf us in darkness. But then, in a remarkable act of bipartisanship, US President George W Bush and the US Congress introduced the President’s Emergency Plan for AIDS Relief (PEPFAR) and, like the first rays of dawn, it brought hope where there was once only despair.

There was a unanimous call for a five-year reauthorisation of PEPFAR from African Heads of State and government at the African Union Assembly when they met in  February 2023 in Addis-Ababa, Ethiopia. This is a call to action. This crucial extension is not merely a legislative act; it is a covenant with future generations, affirming our shared commitment to ending AIDS by 2030.

The impact of PEPFAR has been nothing short of miraculous. Imagine, 25 million souls given another chance at life, 5.5 million infants cradled in their mothers’ arms, HIV-free, and 20 million individuals now with the medicine that not only sustains their lives but shields others from the virus. 

The spectre of AIDS that once snatched infants and young children from this world has been pushed back by a staggering 70%. Villages and cities have witnessed life expectancies surge by over a decade, a testament to the resilience of the human spirit when given a fighting chance.

Through PEPFAR, the very fabric of our societies has been fortified. Our economies, reflected in the GDP per capita, have grown more robust by 2% faster in countries embraced by PEPFAR’s warm reach. 

Seven million children, who might have been orphaned due to AIDS, now find solace and support from their parents. 

Health infrastructure transformed

Our healthcare infrastructure has been transformed with the construction of 70,000 clinics, the establishment of 3,000 laboratories, and the addition of 340,000 dedicated healthcare workers. This strengthened network of care has become our shield and spear, not just against AIDS but against other scourges like COVID-19, Ebola, and more, safeguarding our future from health threats yet unseen.

Amidst our collective stride towards a brighter tomorrow, we find ourselves at a crossroads, confronted by the complex politics surrounding abortion. Let it be clear: in many of our lands, abortion is permitted only under the most stringent of circumstances. 

Our faith-based partners, who have stood valiantly at the forefront of this battle against HIV and AIDS from its inception, would have stepped back if PEPFAR had strayed from its mission to prevent HIV and AIDS. 

Yet, they remain, more committed than ever, a testament to PEPFAR’s unwavering commitment to preserving life. Indeed, 350 African faith leaders have reassured the US Congress, dispelling the misconceptions about PEPFAR’s mission with unequivocal clarity.

PEPFAR mirrors the essence of African values, most notably in our collective resolve to empower and safeguard our adolescent girls and young women.  It embodies the spirit of America’s partnership based on compassion. The DREAMS initiative is more than a program; it is a beacon of hope, offering the education, skills, and support needed to forge paths away from HIV and towards a future filled with promise.

As we look to the horizon, the journey with PEPFAR from emergency response to sustainable progress serves as a shining example of what humanity can achieve when united. 

Yet the road ahead remains long, with millions still in need of treatment and the threat of new infections and deaths looming large. Recent reports forewarn of the catastrophic consequences of halting our march now, with nearly a million more babies at risk of HIV infection and countless lives in the balance by 2030.

As leaders, both in Africa and in the US Congress, grapple with domestic and global challenges, the weight of millions of lives rests in their hands. 

Our heartfelt plea is for a simple, yet profound, continuation of PEPFAR’s mission – a beacon of American leadership, a testament to bipartisan solidarity, and above all, a lifeline for millions. Let us renew our vows, stand united, and march forward together, for the light at the end of the tunnel is within reach, but only if we continue to carry the torch of PEPFAR into the future.

Dr Jean Kaseya is the Director General of Africa Centre for Disease Control and Prevention.

Image Credits: PEPFAR, Africa CDC.