Taking the Next Step Towards Ending HIV – Op-ed by U.S. Ambassador to Ghana Virginia Palmer

PEPFAR Team with Ambassador Palmer in a picture to kick start PEPFAR 20th Anniversary.

Twenty years ago on May 27, 2003, President George W. Bush signed the President’s Emergency Plan for AIDS Relief (PEPFAR) into law.  In the 20 years since, the PEPFAR program has partnered with host governments to save 25 million lives in 50 countries across the globe, including Ghana.  Gifty, a 52-year-old woman in the Ahafo region, is one of those lives.  She started getting sick and couldn’t understand why. She was ostracized by her family and community and even called a witch. Her business suffered. Her brother tried to help and get medicine – without even telling her what it was or what she had. The medicine ran out and her condition worsened. She became almost blind and was deathly ill. Then, a PEPFAR- funded HIV case manager came to her house.  After counseling, Gifty was tested for HIV and immediately put on treatment.  Today, her condition has turned around. She was able to restart her trading activities, selling at the local market without attracting discrimination or stigma.

Today, we mark 20 years of this work and recommit ourselves to the next goal: eliminating HIV as a public health threat by 2030.Since 2003, the United States has invested over $100 billion in the global response to HIV/AIDS.  Even without a vaccine or a cure, the PEPFAR program has saved millions of lives and provided treatment for 20 million people living with HIV.   We helped limit the transmission of HIV from mothers to their children; five million children were born HIV negative to their HIV positive mothers because of the lifesaving medications PEPFAR and partners provided through the years.

This work has been done hand in hand with partners like the Ghana AIDS Commission, the National AIDS Control Program under the Ghana Health Service and the Ministry of Health, the Global Fund, and UNAIDS, not to mention non-governmental and civil society organizations.  Last year alone, PEPFAR funds supported the testing of 147,000 Ghanaians for HIV and helped to ensure that 33,000 Ghanaians are successfully following medical treatment.  PEPFAR strengthened not only the technical expertise needed to bolster HIV control, but also our joint capacity to tackle shared health challenges like COVID-19 and other infectious diseases.

Twenty years ago, HIV infection was a death sentence, but today it is a treatable disease that can be managed with appropriate medications.  The number of AIDS-related deaths, 2 million just in 2004 at the epidemics peak, has been cut in half and continues to decline.    The numbers were dramatically decreased through effective policy and Programs such as test and treat, prevention of mother to child transmission, and community-based approaches that reject the stigma of HIV infection together achieved this near miracle.

Lifesaving anti-retroviral (ART) drugs can effectively suppress the virus and give those living with HIV the opportunity to live full lives and not spread the virus to others.   ART drugs can suppress viral loads to the point where they are undetectable – and when viral loads are undetectable, they are untransmissible.  These lifesaving drugs effectively break the cycle of infection, ensuring that HIV+ people can live full lives without the risk of infecting others.

But hard work remains.  There is still no vaccine or cure for HIV.  Even as we adopt cutting-edge science, we must work together to develop innovative solutions, distribute lifesaving drugs, fight stigma, support people living with HIV, and continue our efforts to educate people about the risks and how to prevent HIV infection.

In December 2022, we commemorated World AIDS Day with the global theme “Equalize.” We know that equitable access to health care is an important part of gaining control of the HIV/AIDS epidemic here in Ghana.  Ghana has taken the bold step to define its Universal Health Coverage Vision for 2030: “All people in Ghana have timely access to high quality health services irrespective of their ability to pay at the point of use.”  As Ghana recovers from a serious economic crisis, we hope the government will continue to uphold equitable access to health care services and its commitment to achieving Universal Health Coverage.

Let’s continue our work together to erase barriers to quality HIV service access, such as stigma and discrimination, gender-based violence, and policies that further marginalize individuals – including the LGBTQI+ community, racial and ethnic minorities, and women and girls.

We will prevent new infections by addressing the problem head on.  We will achieve HIV epidemic control by embracing – not stigmatizing – those living with HIV.  We will achieve this goal by rejecting policies that encourage people to avoid testing, hide their sexual orientation, or conceal their HIV status.  We will achieve this goal by encouraging young people to use condoms and practice safe sex.  We will achieve this goal by strengthening health systems.  We can achieve this goal together.