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# 									PEPFAR Reports to Congress 2005-2022							

The United States President’s Emergency Plan for AIDS Relief

These reports were prepared by the Office of the United States Global AIDS Coordinator in collaboration with the United States Departments of State (including the United States Agency for International Development), Defense, Commerce, Labor, Health and Human Services (including the Centers for Disease Control and Prevention, the Food and Drug Administration, the Health Resources and Services Administration, the National Institutes of Health, and the Office of Global Health Affairs), and the Peace Corps.

## Eighteenth Annual Report to Congress (2022)

When President George W. Bush announced the creation of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in his 2003 State of the Union address, and the U.S. Congress quickly followed by passing the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 in strong bipartisan fashion, it fundamentally changed the course of public health history.

Since then, the U.S. government, with the strong, unwavering support of the U.S. Congress, has proudly invested nearly $100 billion in the global AIDS response through PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). On World AIDS Day 2021, President Biden announced that the U.S. government, through PEPFAR, has saved more than 21 million lives, and more than 20 PEPFAR-supported countries have now achieved epidemic control of HIV or reached the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 HIV treatment targets, even without a vaccine or a cure.

Reaching these goals was virtually unimaginable when PEPFAR began, and a series of other countries are also on pace to attain them soon. These are also critical milestones toward achieving the Sustainable Development Goal 3 target of ending the AIDS epidemic as a public health threat by 2030.

2022 Annual Report to Congress [12 MB]**(PDF)**

## Seventeenth Annual Report to Congress (2021)

When the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) was announced in 2003, an HIV diagnosis was a death sentence for many people around the world. Nearly two decades later, we have the opportunity to do something historic: control and ultimately end the HIV/AIDS epidemic as a public health threat.

At PEPFAR’s inception, this prospect seemed unimaginable. But over the ensuing years, with American leadership and generosity, the U.S. government has saved more than 20 million lives and prevented millions of HIV infections through PEPFAR, moving the HIV/AIDS epidemic from crisis toward control in more than 50 countries. Together with thousands of our partners around the globe, we have helped replace death and despair with vibrant life and hope. According to the Joint United Nations Programme on HIV/AIDS, AIDS-related deaths have been reduced by 60 percent and new HIV infections by 40 percent since their respective peaks in 2004 and 1998. Substantial declines have occurred in the past decade, during which AIDS-related deaths and new infections have decreased by 23 percent and 39 percent, respectively, largely driven by significant progress in eastern and southern Africa.

With strong and sustained bipartisan support across four U.S. presidencies and 10 U.S. congresses, the U.S. government has invested more than $85 billion in the global HIV/AIDS response through PEPFAR and as the largest donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria. This commitment represents the largest in history made by any nation to address a single disease.

2021 Annual Report to Congress [13 MB]**(PDF)**

## Sixteenth Annual Report to Congress (2020)

Seventeen years ago, when the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) began, an HIV diagnosis was a death sentence in many parts of the world. Now, we have the historic opportunity to make what once seemed impossible possible: controlling and ultimately ending the HIV/AIDS epidemic – community by community.

Since 2003, the U.S. government has saved more than 18 million lives and prevented millions of HIV infections through PEPFAR. Working together with our partners in more than 50 countries, we have moved the HIV/AIDS epidemic from crisis toward control. Globally, PEPFAR has helped replace death and despair with vibrant life and hope. According to the Joint United Nations Programme on HIV/AIDS, AIDS-related deaths have been cut by 55 percent and new HIV infections by 40 percent since their respective peaks in 2004 and 1997.

With strong bipartisan support across three U.S. presidents and nine U.S. congresses, the U.S. government has invested more than $85 billion in the global HIV/AIDS response through PEPFAR and as the largest donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria. This commitment represents the largest made by any nation to address a single disease in history.

2020 Annual Report to Congress [15 MB]**(PDF)**

## Fifteenth Annual Report to Congress (2019)

When the U .S . President’s Emergency Plan for AIDS Relief (PEPFAR) was launched in 2003, an HIV diagnosis was a death sentence in much of the world; entire families and communities were falling ill.

Over the past 16 years, death and despair have been overwhelmingly replaced with vibrant lives and hope . Through the American people’s generosity, the United States has saved more than 17 million lives and prevented millions of HIV infections. Working together with our partners, we have accelerated progress toward controlling the HIV/AIDS pandemic – community by community, county by county, and country by country. PEPFAR has maintained strong bipartisan support across three U.S. presidents and nine U .S . congresses.

In December 2018, the PEPFAR Extension Act of 2018 was signed into law to extend provisions of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 for an additional five years through 2023. This marks another significant milestone in PEPFAR’s history of lifesaving work – which is enabled through the U.S. Congress’ unwavering commitment to the program and the American people’s compassion and generosity that make PEPFAR possible, never veering from the core focus and ensuring that every U .S . taxpayer dollar is optimally focused for impact.

2019 Annual Report to Congress [7 MB]

## Fourteenth Annual Report to Congress (2018)

Thanks to American leadership, we are at an unprecedented moment in the global HIV/AIDS response. For the first time in modern history, we have the opportunity to control a pandemic without a vaccine or a cure. We have the tools to do this, but the key will be delivering comprehensive implementation on a larger scale to reach people already living with HIV and prevent new infections. Controlling the HIV/AIDS pandemic will lay the groundwork for eventually eliminating or eradicating HIV, which will be possible through continued and future scientific breakthroughs in vaccine development and cure research.

In 2003, when the United States President’s Emergency Plan for AIDS Relief (PEPFAR) was launched, these possibilities were unimaginable. Today, with strong bipartisan support of the U.S. Congress and through three administrations, PEPFAR has saved millions of lives, prevented millions of new HIV infections, and changed the very course of the HIV/AIDS pandemic.

Dedicated to transparency, accountability, and efficiency, the U.S. government – through PEPFAR – supports lifesaving HIV treatment for more than 13.3 million people globally, has enabled more than 2.2 million babies to be born HIV free, and assists more than 6.4 million orphans, vulnerable children, and their caregivers. Today, as we celebrate 15 years of saving living through American generosity and partnerships, PEPFAR is firmly poised to help end the pandemic as a public health threat.

2018 Annual Report To Congress [9 MB] | Supplemental Tables [95 KB]

Reports of Previous Years

## Thirteenth Annual Report to Congress (2017)

Since its inception in 2003, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has received strong bipartisan support in Congress and through administrations, including two reauthorizations with significant majorities. The United States is unquestionably the world’s leader in responding to the global HIV/AIDS crisis. Originally conceived as a compassionate effort to save the lives of those in countries hardest hit by HIV/AIDS with urgently needed treatment and care, PEPFAR is now also undertaking the challenge of actually controlling the pandemic.

PEPFAR’s critical program and business processes entail targeting investment using granular, site-level data; working with partners to deliver mission-critical services while increasing performance and efficiency; and intensive quarterly monitoring of the entire program. With a strong focus on transparency, accountability, and efficiency, these efforts have made PEPFAR a model for development programs everywhere – achieving significantly more impact in a budget-neutral environment.

PEPFAR has transformed the global HIV/AIDS response and is currently supporting nearly 11.5 million people with life-saving antiretroviral treatment, exceeding our 2016 target of 11.4 million. This is a 50 percent increase since 2014. With PEPFAR support, nearly 2 million babies have been born HIV-free to pregnant women living with HIV – almost twice as many as in 2013 – and their mothers have been kept healthy and alive to protect and nurture them. Considering there were fewer than 50,000 people on treatment in sub-Saharan Africa when PEPFAR began, the magnitude of this work becomes clear.

Strong, capable and committed, PEPFAR has the tools and the drive to finish the mission at hand – to end the epidemic as we know it.

2017 Annual Report To Congress [10 MB] | Supplemental Tables [303 KB] |  Brochure [3 MB]

## Twelfth Annual Report to Congress on PEPFAR (2016)

The bold and visionary leadership by President George W. Bush and the United States Congress that created the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) – a legacy that President Barack Obama has embraced and on which he has significantly expanded – has fundamentally transformed the global HIV/AIDS response.

Since 2003, with the extraordinary investment of Congress, PEPFAR has helped halt the relentless escalation of new HIV infections and mortality rates across the globe. PEPFAR has saved millions of lives and prevented millions more HIV infections by providing core HIV prevention and treatment services, changing the very course of the HIV pandemic.

At its core, PEPFAR is a reflection of the compassion of the American people. It has become an iconic brand of U.S. government engagement in health, development, and diplomacy. By setting and being held accountable to clear metrics, PEPFAR has proven that it is possible to demonstrate clear outcomes and impact. And this work is far from done.

2016 Annual Report To Congress [8 MB] | Supplemental Tables [281 KB]

## Eleventh Annual Report to Congress on PEPFAR (2015)

The true success of PEPFAR continues to re­veal itself in the compassion and commit­ment to serve those most in need; the knowl­edge that we can deliver cutting-edge prevention, care, and treatment in the most resource-limited places in the world with dignity and respect; and the willingness of governments, civil society, and a diverse group of stakeholders to work together until we end AIDS. In the far reaches of countries that have been hardest hit by the epidemic, PEPFAR is a demonstration of the compas­sion of the American people. It has be­come an iconic brand of U.S. government engagement in health, development, and diplomacy. PEPFAR’s contribution to ending the HIV/AIDS epidemic is far from over. As President Barack Obama said: “This is a global fight and it’s one that America must continue to lead…Looking back at the history of HIV/AIDS, you’ll see that no other country has done more than this country, and that’s a testament to our lead­ership as a country. But we can’t be compla­cent.” The hard-won gains of the last decade can easily be lost without increased and fo­cused commitment and thoughtful steward­ship of our investments to ensure maximum impact. The good news is that we have the knowledge, tools, and experience we need to get the job done. If we stay the course and work together, we can indeed achieve the dream of an AIDS-free generation.

2015 Annual Report To Congress [2 MB] | Supplemental Tables [273 KB]

## Tenth Annual Report to Congress on PEPFAR (2014)

What a difference a decade makes. Landmark scientific advances, many supported by the United States, coupled with success in implementing effective programs have put an AIDS-free generation within sight. The Blueprint for Creating an AIDS-Free Generation, demonstrates PEPFAR’s strong and sustained commitment to fighting this deadly disease. Last year Congress passed the bi-partisan, bi-cameral PEPFAR Stewardship and Oversight Act of 2013 (P.L. 113-56), which the President signed into law on December 2, 2013. This law extends critical authorities of the PEPFAR program through FY2018, and strengthens oversight and reporting over the PEPFAR program.

2014 Annual Report To Congress [204 KB] | Supplemental Tables

## Ninth Annual Report to Congress on PEPFAR (2013)

In 2013, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) will mark nearly ten years of success with an extraordinary year of achievements. None of this would have been possible without the vision and leadership of President Bush, President Obama, and the bipartisan support of Congress. A decade ago AIDS was wiping out an entire generation in Africa; today, PEPFAR’s efforts and those of its many partners have brought the world to a new era—a time when new HIV infections and AIDS-related deaths are on the steep decline, and an AIDS-free generation is both U.S. policy and a goal within our reach.

2013 Annual Report To Congress [199 KB] | Supplemental Tables

## Eighth Annual Report to Congress on PEPFAR (2012)

The story of PEPFAR – the President’s Emergency Plan for AIDS Relief – has demonstrated the remarkable generosity of the American people. Congress’ continuing bipartisan support for PEPFAR, and President Barack Obama’s continuing stewardship of the program originally launched by President George W. Bush, have shown the world that this is a vital, durable element of our foreign policy. 2011 was a crucial chapter in the global response, providing many reasons for hope about the future. As has been true throughout the past decade, the commitment of the American people was central to virtually all of the year’s breakthroughs.

2012 Annual Report To Congress [126 KB] | Supplemental Tables

## Seventh Annual Report to Congress on PEPFAR (2011)

From the day it was first announced eight years ago, the story of PEPFAR – the President’s Emergency Plan for AIDS Relief – has demonstrated the remarkable generosity of the American people. Congress’ continuing bipartisan support for PEPFAR, and President Barack Obama’s continuing stewardship of the program originally launched by President George W. Bush, have shown the world that this is a vital, durable element of our foreign policy. 2010 was a crucial chapter in the global response, providing many reasons for hope about the future. As has been true throughout the past decade, the commitment of the American people was central to virtually all of the year’s breakthroughs.

2011 Annual Report To Congress [2 MB] | Supplemental Tables

## Sixth Annual Report to Congress on PEPFAR (2010)

The sixth Annual Report includes tables with results achieved by PEPFAR programs during Fiscal Year (FY) 2009, across the range of prevention, treatment and care programs. FY 2009 was the first year of the second phase of PEPFAR, and these results should be read together with the Five-Year Strategy for PEPFAR, available at www.pepfar.gov/strategy/, which outlines the high-level direction of the program for this second phase.

2010 Annual Report To Congress [2 MB]

## Celebrate Life: Fifth Annual Report to Congress on PEPFAR (2009)

The fifth Annual Report celebrates life. In countless communities around the world, through partnerships with the American people, courageous individuals in nations devastated by HIV/AIDS are choosing life, saving the lives of their fellow countrymen and women, and creating hope for a future free of HIV/AIDS. Through the power of these partnerships, the American people and the dedicated men and women in nations devastated by HIV/ AIDS have proven that the seemingly impossible is possible.

2009 Annual Report To Congress [6 MB] | Fact Sheet [1 MB] | Highlights Brochure [3 MB]

## The Power of Partnerships: Fourth Annual Report to Congress on PEPFAR (2008)

The fourth Annual Report underscores the importance of the close working relationship between the American people and host nations in the fight against the HIV/AIDS pandemic. The success of the Emergency Plan is firmly rooted in partnerships between the American people and the people of the countries in which it is privileged to serve — governments, non-governmental organizations including faith- and community-based organizations, and the private sector. Through these partnerships, PEPFAR is building systems and empowering individuals, communities and nations to tackle HIV/AIDS.

2008 Annual Report To Congress [6 MB] | Highlights Brochure [5 MB]

## The Power of Partnerships: Third Annual Report to Congress on PEPFAR (2007)

The third Annual Report describes how partnerships between host nations and the American people through President Bush’s Emergency Plan for AIDS Relief (PEPFAR) are beginning to turn the tide of the HIV/AIDS pandemic. The Emergency Plan is part of a broader renaissance in partnerships for international development. Under the leadership of President George W. Bush, and with the bipartisan support of Congress, this renaissance – with a particular focus on Africa – has represented both a massive commitment of treasure and a change of heart. The United States is changing the paradigm for development, rejecting the flawed ?donor-recipient? mentality and replacing it with an ethic of true “partnership.”

2007 Annual Report To Congress [8 MB]

## Action Today, A Foundation For Tomorrow: Second Annual Report to Congress on PEPFAR (2006)

The second Annual Report recognizes the Emergency Plan’s unprecedented contribution during fiscal years 2004 and 2005 to help combat one of the worst pandemics in human history. The Emergency Plan’s efforts to build high quality, sustainable programs in fiscal year 2005 took place through bilateral programs in 123 countries, and in additional countries through support for multilateral efforts. Bilateral programs include a special emphasis on 15 focus countries in Africa, the Caribbean, and Asia that together account for approximately one-half of the world’s 40 million HIV infections. Many doubted that HIV/AIDS programs could ever be successful on a broad scale in the world’s poorest nations. After two years of the Emergency Plan, it is clear that high-quality programs can work – and are working – in many of the world’s most difficult places.

2006 Annual Report to Congress

## Engendering Bold Leadership: First Annual Report to Congress on PEPFAR (2005)

The first Annual Report describes the rapid progress of the President’s Emergency Plan from the first appropriation of funds from the Congress on January 23, 2004 through September 30, 2004. In fiscal year 2004, the United States committed $2.4 billion to the Emergency Plan. That total included more than $865 million to support national scale-up of integrated prevention, treatment, and care programs in the 15 focus countries. The remaining $1.54 billion was used to support HIV/AIDS programs in 96 additional countries, international research, and other HIV/AIDS efforts, including the Global Fund to Fight AIDS, Tuberculosis and Malaria.

2005 Annual Report to Congress

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