Global Health: U.S. AIDS Coordinator Addressing Some Key Challenges to Expanding Treatment, but Others Remain;Report to the Congress

摘要

The President's Emergency Plan for AIDS Relief (PEPFAR), announced January 2003, aims to provide 2 million people with antiretroviral (ARV) treatment in 14 of the world's most severely affected countries. In May 2003 legislation established the position of the U.S. Global AIDS Coordinator in the State Department. GAO was asked to (1) identify major challenges to U.S. efforts to expand ARV treatment in resource-poor settings and (2) assess the Global AIDS Coordinator's response to these challenges. GAO recommends that the Secretary of State direct the U.S. Global AIDS Coordinator to monitor agencies' efforts to coordinate with host governments and other stakeholders; work with the USAID Administrator and HHS Secretary to resolve contracting capacity constraints and any negative effects from agency differences on procurement, foreign taxation of U.S. assistance, and auditing of non-U.S. grantees; specify the activities that PEPFAR can support in national treatment programs that use ARV drugs not approved for purchase by the Coordinator's Office; and work with national governments and international partners to address underlying economic and policy factors creating the crisis in human resources for health care. State, HHS, and USAID concurred with the report's conclusion and said work is underway to address the majority of challenges and issues raised.