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Design Considerations for Evaluating the Impact of PEPFAR is the summary of a 2-day workshop on methodological, policy, and practical design considerations for a future evaluation of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) interventions carried out under the President's Emergency Plan for AIDS Relief (PEPFAR), which was convened by the Institute of Medicine (IOM) on April 30 and May 1, 2007. Participants at the workshop included staff of the U.S. Congress; PEPFAR officials and implementers; major multilateral organizations such as The Global Fund to Fight AIDS, Malaria, and Tuberculosis (The Global Fund), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the World Bank; representatives from international nongovernmental organizations; experienced evaluation experts; and representatives of partner countries, particularly the PEPFAR focus countries. The workshop represented a final element of the work of the congressionally mandated IOM Committee for the Evaluation of PEPFAR Implementation, which published a report of its findings in 2007 evaluating the first 2 years of implementation, but could not address longer term impact evaluation questions.
“Randy Shilts and Laurie Garrett told the story of the HIV/AIDS epidemic through the late 1980s and the early 1990s, respectively. Now journalist-historian-activist Emily Bass tells the story of US engagement in HIV/AIDS control in sub-Saharan Africa. There is far to go on the path, but Bass tells us how far we’ve come.” —Sten H. Vermund, professor and dean, Yale School of Public Health With his 2003 announcement of a program known as PEPFAR, George W. Bush launched an astonishingly successful American war against a global pandemic. PEPFAR played a key role in slashing HIV cases and AIDS deaths in sub-Saharan Africa, leading to the brink of epidemic control. Resilient in the face of flatlined funding and political headwinds, PEPFAR is America’s singular example of how to fight long-term plague—and win. To End a Plague is not merely the definitive history of this extraordinary program; it traces the lives of the activists who first impelled President Bush to take action, and later sought to prevent AIDS deaths at the whims of American politics. Moving from raucous street protests to the marbled halls of Washington and the clinics and homes where Ugandan people living with HIV fight to survive, it reveals an America that was once capable of real and meaningful change—and illuminates imperatives for future pandemic wars. Exhaustively researched and vividly written, this is the true story of an American moonshot.
HIV/AIDS is a catastrophe globally but nowhere more so than in sub-Saharan Africa, which in 2008 accounted for 67 percent of cases worldwide and 91 percent of new infections. The Institute of Medicine recommends that the United States and African nations move toward a strategy of shared responsibility such that these nations are empowered to take ownership of their HIV/AIDS problem and work to solve it.
While much progress has been made on achieving the Millenium Development Goals over the last decade, the number and complexity of global health challenges has persisted. Growing forces for globalization have increased the interconnectedness of the world and our interdependency on other countries, economies, and cultures. Monumental growth in international travel and trade have brought improved access to goods and services for many, but also carry ongoing and ever-present threats of zoonotic spillover and infectious disease outbreaks that threaten all. Global Health and the Future Role of the United States identifies global health priorities in light of current and emerging world threats. This report assesses the current global health landscape and how challenges, actions, and players have evolved over the last decade across a wide range of issues, and provides recommendations on how to increase responsiveness, coordination, and efficiency â€" both within the U.S. government and across the global health field.
Increased HIV screening may help identify more people with the disease, but there may not be enough resources to provide them with the care they need. The Institute of Medicine's Committee on HIV Screening and Access to Care concludes that more practitioners must be trained in HIV/AIDS care and treatment and their hospitals, clinics, and health departments must receive sufficient funding to meet a growing demand for care.
Over the past seven years, the Bush administration has launched a revolution in U.S. foreign aid. At no time since the administration of President Kennedy have there been more changes in the volume of aid, in aid's purposes and policies, in its organization, and in its overall status in U.S. foreign relations. George Bush's Foreign Aid: Transformation or Chaos? analyzes in detail the array of recent reforms of U.S. economic assistance and the difficult issues these reforms raise, while placing the changes and the manner of their implementation in a historical and political context. Lancaster draws out the challenges and opportunities this transformation of U.S. aid offer for the next administration to engage the emerging world of the 21st century.
In 2003, Congress passed the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act, which established a 5-year, $15 billion initiative to help countries around the world respond to their AIDS epidemics. The initiative is generally referred to by the title of the 5-year strategy required by the act-PEPFAR, or the President's Emergency Plan for AIDS Relief. PEPFAR Implementation evaluates this initiative's progress and concludes that although PEPFAR has made a promising start, U.S. leadership is still needed in the effort to respond to the HIV/AIDS pandemic. The book recommends that the program transition from its focus on emergency relief to an emphasis on the long-term strategic planning and capacity building necessary for a sustainable response. PEPFAR Implementation will be of interest to policy makers, health care professionals, special interest groups, and others interested in global AIDS relief.