Image
Nurse weighing patient in family planning sector in Sofala.

Nurse weighing a patient in the family planning sector in Sofala. Photo credit: ECHO/Mozambique

Life-saving antiretroviral therapy (ART) stops the replication of the HIV virus inside a person infected with HIV, affording the body’s immune system time to recover and rebuild itself. While not curative, these medicines are powerful, with studies suggesting that people living with HIV (PLHIV) can achieve similar life expectancies as people without HIV, provided they are diagnosed quickly, have good access to medical care, and are able to adhere to HIV treatment. In addition, by lowering the amount of HIV virus in the body, antiretroviral drugs (ARVs) help reduce the chance that an HIV-positive individual transmits the infection to an HIV-negative partner. At the end of 2021, 38.4 million people were living with HIV worldwide. USAID supports over seven million people with life-saving HIV treatment. Ninety-four percent of these beneficiaries who received a viral load test are virally suppressed, meaning that these people living with HIV can live longer, healthier lives, and that they will not transmit the virus to others.

Since USAID’s first investments over 35 years ago in fighting HIV, there has been significant progress that has impacted the lives of millions of people living with HIV and their families. From cutting-edge therapeutics to innovative service delivery models to data analytics and strengthening health systems, USAID has been at the forefront to support comprehensive ART programs around the globe to ensure those who need it have access to lifesaving treatment and can achieve optimal health outcomes and high quality of life.

In spite of the many challenges posed by the HIV epidemic, global access to ART has increased substantially since 2003, with 28.7 million people accessing ART as of the end of 2021. Access to these lifesaving treatments has reduced the number of AIDS-related deaths by 64 percent since the peak in 2004 and new HIV infections have been reduced by 52 percent since their peak in 1997. Globally, 20.1 million people are supported by U.S. Government assistance under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The U.S. Government is the world’s largest donor to HIV and AIDS programs worldwide, having invested over $100 billion through PEPFAR in the HIV response, with much of that support managed by USAID.

USAID Impact

USAID-supported treatment programs ensure all newly diagnosed individuals are immediately placed on robust optimized HIV treatment regimens and are provided support to stay on lifelong treatment in order to achieve viral load suppression. Successful treatment and achieving viral load suppression also prevents transmission and continued progress towards epidemic control. Ensuring all clients have access to continuous, uninterrupted ART requires programs to be tailored to meet their needs and preferences. USAID does this through the implementation of best practices and innovative interventions to reduce barriers to HIV treatment and support services, including those most vulnerable, such as children and adolescents living with HIV, pregnant and breastfeeding women and their infants, and key populations.

USAID-supported ART programs focus on three key priorities to ensure lifelong continuity of treatment to ultimately achieve viral load suppression (VLS) and optimal health outcomes for all clients:

  1. Improving access to optimized ART for all PLHIV to achieve viral load suppression.
  2. Improving the quality of ART services to ensure clients can easily engage in treatment services and have access to lifelong continuous ART.
  3. Fostering the sustainability of lifelong HIV treatment services to ensure a robust and resilient health system that can maintain high-quality services and effectively respond to challenges and other new or emerging health threats.

To accomplish these priorities, USAID and its implementing partners have utilized a variety of innovative programmatic approaches. They include:

  • Implementing client-centered interventions such as multi-month dispensing and decentralized drug delivery to increase flexibility and reduce the burden on clients in order to access treatment more easily.
  • Using technologies like mobile phones and automated drug pick up points, to help support client adherence to medication and health care.
  • Pooling procurement and using generic antiretroviral medicines to lower the price of HIV medicines ten-fold in order to accelerate access to the most effective and robust HIV treatment regimens in resource-limited settings.
  • Task sharing and creative deployment of professional and lay health care workers to ensure clients can receive the highest quality services they need and where they prefer to use those services.
  • Developing robust information systems for clinical settings and for the management of commodities to improve the quality of care provided to clients.
Image
Psychosocial support officer offering counseling to a caregiver in Sofala.

Psychosocial support officer offering counseling to a caregiver in Sofala, Mozambique. Photo Credit: ECHO/Mozambique

2022 Achievements

Despite the significant impact of the COVID-19 pandemic on the livelihood and health of people across the globe and the disruptions to health systems and other critical infrastructure such as supply chain and logistics, USAID treatment programs maintained critical services and continued to advance HIV policy and technical priorities through innovative adaptations.

In FY22, USAID:

  • Provided HIV treatment services to nearly 7.2 million people living with HIV across 21 countries and three regional programs.
  • Initiated over 750,000 newly diagnosed people on lifesaving ART.
  • Continued scale-up of viral load testing, with 80 percent of eligible clients on ART having received a viral load test within the past 12 months (by the end of FY22).
  • Supported 38 countries to reach over 90 percent viral load suppression, and of those, 19 countries reached over 95 percent viral load suppression.
  • Continued to scale the transition to optimized HIV treatment regimens, including the current WHO-recommended first line regimen Tenofovir-Lamivudine-Dolutegravir (TLD).

Additional Resources