PEPFAR plays a critical role in responding to children affected by AIDS and is the single largest source of support for children affected by HIV and AIDS in the world. With a cumulative disbursement of close to $2 billion since 2004, PEPFAR funding is estimated to be six times the allocation of the Global Fund to Fight AIDS, Tuberculosis and Malaria for orphans and vulnerable children over the same time period.
At the request of the Office of the Global AIDS Coordinator (OGAC), a review was undertaken of the PEPFAR portfolio of programes supporting orphans and vulnerable children affected by HIV/AIDS. The review aimed to assess the strengths and weaknesses of current strategies and approaches with respect to children and the HIV epidemic, and recommend strategies and priorities for the future direction of the portfolio.
The order of magnitude of PEPFAR funds available at country level propels the various PEPFAR agencies into leadership roles. PEPFAR is able to leverage partners, interest, funds, and energy to do more for children. It is the opinion of the review team that given its size, strength, experience, and expertise, PEPFAR can and should provide leadership by setting focus, addressing the critical issues in a systematic manner, providing an evidence base for practice, scaling up sound practices, and maintaining an operational research agenda to guide future developments.