orphans and vulnerable children, as well as to ensuring equity, are presented below.


The U.S. Global AIDS Coordinator should ensure that adequate medications are available to place 2 million people on sustained antiretroviral therapy to achieve PEPFAR’s stated 5-year treatment target. To achieve this target, the Coordinator should also ensure that adequate linkages are established among prevention, treatment, and care programs and rapidly expand the availability of antiretroviral therapy to both children and adults. (5.1)


The U.S. Global AIDS Coordinator should continue to promote and support a community-based, family-centered model of care in order to enhance and coordinate supportive care services for people living with HIV/AIDS, with special emphasis on orphans, vulnerable children, and people requiring end-of-life care. This model should include integration as appropriate with prevention and treatment programs and linkages with other public-sector and nongovernmental organization services within and outside of the health sector, such as primary health care, nutrition support, education, social work, and the work of agencies facilitating income generation. (6.1)

Orphans and Other Vulnerable Children

The needs of orphans and other children made vulnerable by AIDS cover a wide spectrum that cuts across all of PEPFAR’s categories of prevention, treatment, and care and extends well beyond the health sector. It is essential for an HIV/AIDS response to address these needs adequately—not only to support these children in living healthy and productive lives, but also to protect them from becoming the next wave of the pandemic. The U.S. Global AIDS Initiative should continue to support countries in the development of national plans that address the needs of orphans and other children made vulnerable by AIDS, as well as to support the priorities delineated in these plans. To ensure adequate focus on and accountability for addressing the needs of orphans and other vulnerable children, the U.S. Global AIDS Coordinator should work with Congress to set a distinct and meaningful performance target for this population. This target should be developed in a manner that both builds on the improvements PEPFAR has made in its indicator for children served and enhances its ability to support comprehensive and integrated HIV/AIDS programming. (7.1)

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