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Suggested Citation:"Index." Institute of Medicine. 2007. PEPFAR Implementation: Progress and Promise. Washington, DC: The National Academies Press. doi: 10.17226/11905.
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Index

A

ABC approach, 100, 120, 123, 135137, 228229

Abstinence, sexual, 64, 67, 100, 113, 120121, 123.

See also ABC approach

Accountability

directions of, 46

PEPFAR funding and, 2, 11, 12, 82, 101

role of program monitoring and evaluation, 46

treatment delivery and, 144

Adherence to treatment, 141, 149150

African Network of Religious Leaders Living with or Personally Affected by HIV/AIDS, 135

Age patterns of HIV infection, 23, 52

Antiretroviral therapy

access for marginalized groups, 156157

adherence, 141, 149150

attribution for successful implementation, 144145

behavioral surveillance, 135

clinical care services and, 172

costs, 9899

current delivery, 18, 145146, 153, 268

effectiveness, 155

eligibility, 148, 154

follow-up, 149

future challenges, 164, 246, 252253

generic drugs, 9, 10, 159, 160

guidelines, 146147, 148, 154

harmonization of procurement, 158160

host country program design, 147148

human resources for delivery of, 14, 255256, 257258

initiation, 149

integration with prevention and care activities, 155, 200

laboratory services, 161

nutritional support, 157158

obstacles to delivery, 141

patient evaluation for, 148

patient preparation for, 148149, 154

pediatric care, 155156

PEPFAR accomplishments, 5, 141, 164, 245

PEPFAR five-year performance targets, 4, 58, 144

PEPFAR funding, 9899, 252

PEPFAR policies and programs, 141, 143

pregnancy during, 196197

to prevent mother-to-child HIV transmission, 113, 127, 245, 268

quality standard, 910, 142, 158159, 160

recommendations for improving availability, 13, 142, 153

Suggested Citation:"Index." Institute of Medicine. 2007. PEPFAR Implementation: Progress and Promise. Washington, DC: The National Academies Press. doi: 10.17226/11905.
×

research needs, 155, 265

resistance monitoring, 150151, 154

stigma reduction, 150

supply chain management, 162164

training for health care workers, 145146, 258

utilization, 141, 145

Attributions for success, 144145

B

Bacterial vaginosis, 53

Behavioral surveillance, 7, 113, 114, 132, 133, 134, 135

Bill and Melinda Gates Foundation, 41

Blood safety, 115, 128129, 137

Breastfeeding, 125126

C

Capacity building initiatives, 252259

Care services

budget allocations, 67, 99, 106107

challenges, 200201

classification, 172173

community-based, family-centered, 178180, 201

comprehensive, 172, 174175, 178, 179, 191

contracting for, 178

definition and scope, 169, 171172

delivery mechanisms, 169

effectiveness, 173

harmonization of, 201

health care worker training, 169, 176, 188190

home-based, 70, 177, 182, 191192, 193194

integration with prevention and treatment efforts, 13, 99100, 134136, 142, 155, 170, 200, 202

major HIV/AIDS program elements, 48

needs of women and girls, 196197

nondiscrimination in, 14, 82, 9192

opportunities for improvement, 190

pain management, 194195

palliative care, 171172, 194195, 200201

PEPFAR delivery, 169, 173176, 181188, 201202, 245246

PEPFAR five-year performance targets, 2526, 58, 169, 173

PEPFAR transition to sustainability, 190

planning, 180181

preventive interventions in, 116, 169, 182184

program performance evaluation, 265

psychosocial, 177, 192193

quality assessment, 202

recommendations for, 13, 170, 200

stigmatization effects, 5657

volunteer workers, 193194

See also Counseling and testing

Centers for Disease Control and Prevention, 8485, 104, 263

Child caregivers, 55

Children

AIDS mortality, 145

antiretroviral therapy utilization, 141, 145

immunization, 230

infection patterns and trends, 125

pain management, 195

sources of infection, 125

testing for infants, 187188, 230

treatment, 152153, 155156

See also Mother-to-child transmission of HIV;

Orphans and other vulnerable children

Communication mechanisms and practices, 8687, 9798

Community-based approach

capacity building, 253254

care services, 201

characteristics, 178

current service delivery, 4647

goals, 47

network model, 177, 178179

prevention of mother-to-child transmission, 126

recommendations for, 13, 170, 200

services for orphans and other vulnerable children, 215, 219222

Community health worker model of care, 189

Comorbid infections

in children, 156

implications for treatment, 157

opportunistic infections, 184

prevalence, 157

preventive interventions, 182184

See also Malaria;

Tuberculosis

Suggested Citation:"Index." Institute of Medicine. 2007. PEPFAR Implementation: Progress and Promise. Washington, DC: The National Academies Press. doi: 10.17226/11905.
×

Condom promotion, 122123, 228229, 261.

See also ABC approach

Congress, U.S.

PEPFAR budget allocations, 2, 12, 82, 101

in PEPFAR transition to sustainability, 67, 249

Coordination

communication mechanisms, 8687

Country Teams, 89, 8586

development of national action framework, 45, 8889

global efforts to improve, 43

goals, 254

impediments to, 9

international donors, 9, 43, 86, 8889

Leadership Act requirements, 24, 68, 84

rationale, 85, 254

recommendations for U.S. Global AIDS Coordinator, 9, 82

of U.S. HIV/AIDS efforts, 3, 66, 71, 8485

See also Harmonization of efforts

Corruption, 49

Counseling and testing

barriers to, 197198

classification in continuum of care, 115116, 169, 172, 173176

components, 186

ethical concerns, 197

gender differences, 197

integration of services, 134

PEPFAR performance, 173176, 245

to prevent sexual transmission of HIV, 120, 135

preventing mother-to-child transmission of HIV, 125126, 127

purpose, 185187

scaling up, 169, 188, 198

settings for, 186

strategies for improving, 198

testing for infants, 187188, 230

wait for test results, 198

Country Operational Plan and Reporting System, 93

Country Operational Plans, 8789, 9394, 102

Country Teams

accountability, 12, 82, 101

budget allocations and restrictions, 11, 12, 14, 15, 16, 73, 95, 99

communication mechanisms and practices, 8687

coordination and harmonization efforts, 89, 81, 8586, 8789, 91

financial management, 102

flexibility in prevention program design, 136, 262

funding, 104106

organizational structure and operations, 71

planning cycle, 9394

policy guidance, 9293

research activities, 95

strategies for improving performance of, 262

support for, 71, 262

technical support, 94

D

Data collection

antiretroviral therapy delivery and outcomes, 144, 150, 155

behavioral surveillance, 7, 113, 114, 132, 133, 134, 135

birth registration, 222

burden of, for health care facilities, 144

care-related training, 188

condom promotion, 122

Country Operational Plan and Reporting System, 93

Demographic and Health Surveys, 133

obstacles to, 133

PEPFAR activities and support, 133, 266

PEPFAR network model of service delivery, 6870

for PEPFAR performance evaluation, 17, 2931, 81, 95, 267

PEPFAR transition to sustainability, 1

for prevention program design, 7, 131, 132134

quality improvement activities, 9596

recommendations for, 7, 134

sentinel surveillance, 133

services for orphans and other vulnerable children, 205, 235

See also Research

Diet and nutrition, 183184

antiretroviral therapy and, 157158

preventive interventions, 183184, 231

Suggested Citation:"Index." Institute of Medicine. 2007. PEPFAR Implementation: Progress and Promise. Washington, DC: The National Academies Press. doi: 10.17226/11905.
×

services for orphans and other vulnerable children, 223, 224

Discrimination, 5657

as obstacle to harmonization, 9192

participation of stigmatized groups in PEPFAR, 14, 82, 92

E

Educational system

HIV/AIDS impact in, 4950

teacher mortality, 49, 236

vulnerabilities of orphaned children, 5455, 222223, 235

Elderly caregivers, 55

End-of-life care, 13, 179180, 200

Epidemiology, 1718, 23, 3738, 4950

age patterns, 23, 52

behavioral surveillance, 113, 114, 132, 133, 134

child infections, 125

focus countries, 62

gender differences, 5253

recommendations for surveillance, 7, 114, 134

Equitable access, 14, 82, 9192

Evaluation of national AIDS/HIV programs

current system for, 9091

obstacles to, 91

services for orphans and other vulnerable children, 225226

Three Ones principles of harmonization, 4546, 90

Evaluation of PEPFAR implementation and performance

care services, 173, 202, 265

challenges, 3132

conceptual approach, 2628

data sources for, 2931, 9091

dissemination of findings, 266267

family capacity strengthening, 218219

goals, 4, 17, 26, 32, 244

harmonization as basis for, 45, 2728, 267

human resources allocation, 15

indicators, 101102, 267

integration of services, 260

Leadership Act requirements, 7, 2627, 6667

outcomes attribution, 101

outcomes data, 17, 81

prevention effectiveness, 113, 264

prevention of mother-to-child transmission, 127128

program management, 81, 102103, 263

recommendations for, 17, 244, 266

research needs, 264266

services for orphans and other vulnerable children, 205, 208, 209, 235, 265266

Evidence-based practice

future of PEPFAR, 12

HIV transmission prevention, 7

Extranet, PEPFAR, 8687, 266267

F

Faith-based organizations, 6364, 67, 148, 163, 177, 178, 190, 208, 214, 219, 228, 260261

Family-centered care, 4647, 179

in care programs, 201

financial burden, 217218

gender differences in caretaking burden, 5354

recommendations for, 13, 170, 200

services for orphans and other vulnerable children, 215, 217219

Family planning, 196197

Focus countries, 25, 6466

characteristics, 5862

funding, 25, 58, 7273, 104106, 107109

orphans and other vulnerable children in, 211212

See also Host-country programs and policies

Food and Drug Administration, U.S., 9, 10, 88, 158, 159160

Framework for the Protection, Care, and Support of Orphans and Vulnerable Children Living in a World with HIV and AIDS, 212, 214, 215217

Funding

ABC programs, 228229

for capacity building, 252

care services, 67, 99, 106107, 173

causes of HIV and distribution of, 137

centrally funded programs, 105106

coordination within U.S. government, 8485, 86

Suggested Citation:"Index." Institute of Medicine. 2007. PEPFAR Implementation: Progress and Promise. Washington, DC: The National Academies Press. doi: 10.17226/11905.
×

data collection for PEPFAR evaluation, 3031

distribution by category, 106107

flexibility in program and intervention design and, 2, 100101, 136

focus country distribution, 25, 58, 7273, 104106, 107109

global efforts, 4043

for health worker training, 14, 258

Leadership Act budget allocations, 67

Partnership for Supply Chain Management, 162

PEPFAR distribution, 4041, 58, 7173, 98101, 104109

PEPFAR financial management evaluation, 102103

per capita, 108109

prevention activities, 115, 136137

provisions of Leadership Act, 6364

recommendations for improving, 2, 12, 82, 101

research, 95, 263

services for orphans and other vulnerable children, 67, 208, 210, 217, 228229

U.S. Global AIDS Initiative, 25, 104

Future challenges and opportunities, 267268

antiretroviral therapy, 164, 246

capacity building, 252259

care services, 200201

human resource supply, 1415, 51, 255

integration of services, 12, 134, 259261

research needs, 17, 57, 244, 264266

services for orphans and other vulnerable children, 237

See also Sustainability, PEPFAR transition to

G

Gender differences

antiretroviral therapy utilization, 141, 145, 151

infection patterns, 52

prevention program considerations, 130131

treatment delivery considerations, 151

volunteer counseling and testing, 197

See also Women and girls

Girls. See Women and girls

Global AIDS Coordinator, U.S.

current research effort, 16

as learning organization, 16

performance evaluation, 16

recommendations for, 6, 7, 9, 10, 13, 14, 17, 82, 89, 92, 114, 134, 142, 153, 160, 170, 200, 206, 234, 244, 248, 266

responsibilities, 3, 24, 66, 7071, 84

role in harmonization and coordination, 9, 82, 89

Global AIDS Initiative, U.S.

accomplishments, 5, 17, 243, 245

budget allocations, 25, 104

current implementation, 4, 25

future prospects, 109

gender issues, 250

origins and purpose, 3, 24

recommendations for, 6, 7, 8, 10, 13, 15, 17, 114, 134, 142, 160, 234, 244, 250, 259, 266

research role, 1516, 17, 263

transition to PEPFAR sustainability, 243

See also President’s Emergency Plan for AIDS Relief (PEPFAR)

Global Fund to Fight AIDS, Tuberculosis and Malaria, 4, 25, 41, 62

Global Implementation Support Team, 43

Global Partners Forum for Children Affected by HIV/AIDS, 212

Global Task Team, 43

H

Harmonization of efforts

antiretroviral drug purchase, 158160

care services, 201

definition, 1.

See also Three Ones principles of harmonization

equitable access to programs and, 9192

evaluation of PEPFAR implementation, 45, 2728, 267

impediments to, 9, 88, 9192

outcomes measurement and, 101

PEPFAR commitment to, 4, 25, 81, 87

PEPFAR transition to sustainability, 12, 810, 247248

recommendations for, 10, 142, 160

Suggested Citation:"Index." Institute of Medicine. 2007. PEPFAR Implementation: Progress and Promise. Washington, DC: The National Academies Press. doi: 10.17226/11905.
×

services for orphans and other vulnerable children, 221222

U.S. role, 9

See also Coordination

Health care system capacity, 5051

eligibility for PEPFAR, 198199

facilities, 253

future challenges, 252253

integration rationale, 199

national coordination, 254

network model, 177

PEPFAR public health benefits, 254255

recommendations for expanding, 15, 244, 259

wrap-around services, 199

Health care workers

care services, 169, 188190

doctor-to-population ratio, 58

injection practices, 63

in PEPFAR focus countries, 58

prevention of medical transmission of HIV, 128130

quality improvement activities, 9596

recommendations for recruitment and training, 15, 244, 259

risk of HIV transmission, 257

supply concerns, 1415, 51, 255

training, 5

volunteers, 193194, 259

See also Human resources;

Training in HIV/AIDS care

Highly-active antiretroviral therapy, 184

Home-based care, 70, 177, 182, 191192, 193194

Host-country programs and policies

access, 92

antiretroviral drug purchases, 158160

antiretroviral therapy, 146, 147148

attributions for successful service delivery, 144145

capacity building, 252

current Global AIDS Initiative implementation, 4

customization of support for, 2, 12, 62, 82, 8788, 136, 147

data collection for PEPFAR evaluation, 2930, 267

expansion of services under PEPFAR, 5

global coordination of donor actions and, 85, 8889

harmonization, 1, 810, 45, 8788

health care system capacity, 5051, 253

human resource development, 15

national AIDS authority, 45, 8990

operational plans, 8789, 9394

outcomes research, 17

ownership of program planning and execution, 45

services for orphans and other vulnerable children, 224226

strategic planning guidelines for, 46

See also Coordination;

Evaluation of national AIDS/HIV programs;

Focus countries

Human resources

future challenges, 160, 255

major HIV/AIDS program elements, 48

recommendations for expanding capacity, 15, 259

retention of personnel, 256257

strategies for improving, 255256

task shifting, 1415, 189, 257258

See also Health care workers;

Training in HIV/AIDS care

I

Infection patterns and trends, 1718, 23, 3740, 268

children orphaned as a result of, 210212

gender patterns, 52

socioeconomic outcomes, 4950

See also Transmission of HIV infection

Informed consent, 197

Infrastructure support for AIDS/HIV programs, 51, 62

Inheritance law, 196

Injection drug use

medical transmission of HIV, 129130, 137

prevention of HIV transmission in, 88, 124125, 137

Integration of services

challenges, 134, 259261

goals, 2, 12, 25, 259260

opportunities for, 134135, 260

outcomes evaluation, 102

PEPFAR performance evaluation, 260

rationale, 12, 134, 135, 198200, 202, 259

Suggested Citation:"Index." Institute of Medicine. 2007. PEPFAR Implementation: Progress and Promise. Washington, DC: The National Academies Press. doi: 10.17226/11905.
×

recommendations for, 13, 142, 170, 200

services for orphans and other vulnerable children, 224

wrap-around services and, 199

Interagency Technical Working Groups, 94

International Infectious Diseases Control Act, 62

K

Kerry-Frist Global AIDS bill, 6263

L

Laboratory services, 161

Leadership Act. See United States Leadership against HIV/AIDS, Tuberculosis, and Malaria Act

Learning organization, 16, 9498, 109, 262

M

Malaria, 50, 183, 200

Marginalized populations

access to care, 9192, 156157

recommendations for PEPFAR programs and policies, 14, 82, 92

See also Discrimination;

Stigmatization of HIV-positive persons

Medications

expanded scope of practice for health workers, 189190

impediments to harmonization of international efforts, 9, 88

obstacles to procurement, 51

pain management, 194195

quality standard, 12, 910, 88, 142, 158159, 160

See also Antiretroviral therapy

Microbicides, 123

Millennium Development Goals, 212

Model of care, 13, 189, 200.

See also Network model

Mortality, 23, 38, 39

children, 145, 182183

demographic patterns, 4950

preventive interventions, 182183

Mother-to-child transmission of HIV

access to antiretroviral therapy to prevent, 18, 113, 127, 268

incidence, 125

PEPFAR interventions to prevent, 5, 113, 118, 126128, 137, 245

prevention strategies, 125126, 197

risk, 125

N

National Institutes of Health, 263

Needle exchange programs, 124

Network model, 6870, 145, 176178

New Partners Initiative, 106

Nongovernmental organizations, 178

services for orphans and other vulnerable children, 208, 218, 226

See also Faith-based organizations

Nurses, 189190

Nutrition. See Diet and nutrition

O

Office of U.S. Global AIDS Coordinator

budget allocations, 99, 100

financial management, 103, 105106

as learning organization, 94, 262263

policy guidance, 9293

quality improvement activities, 266

research funding, 95, 263

responsibilities, 4, 84

role in coordinating programs and donors, 85, 86

service for orphans and other vulnerable children, 214215, 217, 233

structure and operations, 71, 83, 84

Opportunistic infections, 184

Orphans and other vulnerable children

access to services, 222224

birth registration, 222

challenges to care delivery, 217

community-based responses, 219222

core services model, 205, 222

creating supportive environment for, 226

definition, 207, 231234

direct support, 208209

education, 222223

evaluation of service delivery, 205, 208, 209, 235, 265266

evolution of care goals and strategies, 212217

family-based care, 217219

Suggested Citation:"Index." Institute of Medicine. 2007. PEPFAR Implementation: Progress and Promise. Washington, DC: The National Academies Press. doi: 10.17226/11905.
×

Framework for the Protection, Care, and Support of Orphans and Vulnerable Children Living in a World with HIV and AIDS, 212, 214, 215217

funding for services and programs, 67, 208, 210, 217, 228229

HIV/AIDS-associated vulnerabilities, 5455

HIV infection prevention among, 227230

indirect support, 208, 209

institutional care, 220

integration of services for, 224

opportunities for improving services, 231237

PEPFAR care services and strategies, 210, 218219, 221222, 225226, 227229, 231, 245246

PEPFAR targets, 13, 205, 206, 208209, 214215, 234

population patterns and trends, 18, 54, 210212, 268

preventive care services, 230231

recommendations for service delivery, 13, 170, 200, 206, 234

scale-up efforts, 205

scope of services for, 207

service needs, 13, 206, 234, 268

social welfare workforce issues, 235237

supplemental direct support, 208, 209

support for national government services, 224226

training for service to, 210

vulnerabilities of young girls, 231

P

Pain management, 172, 194195

Palliative care, 171172, 194195, 200201

Partnership for Supply Chain Management, 106, 162164

PEPFAR. See President’s Emergency Plan for AIDS Relief

PEPFAR ExtraNet, 8687, 266267

Performance targets, PEPFAR

care services, 2526, 58, 169, 173

origin of, 67

for orphans and other vulnerable children, 13, 205, 206, 208209, 214215, 234

prevention, 4, 25, 58, 113, 117

progress to date, 17

treatment delivery, 4, 25, 58, 144, 153

Plus-up plans, 102

Poverty reduction, 214

President’s Emergency Plan for AIDS Relief (PEPFAR)

accomplishments, 5, 17, 81, 109, 245246

allocation of funds, 7173, 104109

annual meetings, 9697

annual report, 98

blood safety activities, 115, 128129, 137

budget, 4041, 58, 71, 98101

commitment to harmonization, 4, 25, 81, 87

communication mechanisms and practices, 9798

coordination with other donors, 43, 81, 85

data collection activities and support, 133

evaluation. See Evaluation of PEPFAR implementation and performance

Extranet, 8687, 266267

five-year performance targets, 4, 17, 2526, 58, 67, 113, 117, 144, 153, 169, 173

focus countries. See Focus countries

fragmented service delivery, 199200

guiding principles, 25

host country relationships, 81, 88, 90

Institute of Medicine evaluation, 3, 4, 2631

as learning organization, 9498, 109, 262

network model of service delivery, 6870, 176178

organizational structure and operations, 4, 71, 81

origins, 3

participation of stigmatized groups in, 82

policy documents, 9293

quality improvement support, 96

research role, 16, 17, 261262, 263

strategic objectives, 6768

transition to sustainability. See Sustainability, PEPFAR transition to

Suggested Citation:"Index." Institute of Medicine. 2007. PEPFAR Implementation: Progress and Promise. Washington, DC: The National Academies Press. doi: 10.17226/11905.
×

See also Care services;

Country Teams;

Future challenges and opportunities;

Prevention;

Treatment

Prevalence, 23, 38

in focus countries, 62

integration with prevention and care activities, 99100

recommendations for surveillance, 7, 114, 132134

Prevention

abstinence programs, 64, 67, 100, 113, 120121, 123

among injection drug users, 124125

in care services, 116, 169, 182184

comprehensive behavioral interventions, 123

condom use promotion, 122123

counseling and testing services for, 186

data collection and management for, 7, 131, 132134, 137

education campaigns for, 123

evidence-based practice, 7

future of PEPFAR, 1, 7

gender issues, 130131

integration with care and treatment efforts, 13, 134136, 142, 155, 170

Leadership Act budget allocation, 67

major HIV/AIDS program elements, 48

medical transmission of HIV, 128130

microbicide use, 123

mother-to-child transmission of HIV, 5, 18, 113, 118, 125128, 137, 197, 245

nondiscrimination in, 14, 82, 92

opportunistic infections, 184

outcome measures, 113, 117118, 264

PEPFAR accomplishments, 5, 7, 118130

PEPFAR activities, 115117, 137

PEPFAR budget allocations, 99, 106107, 136137

PEPFAR five-year performance targets, 4, 25, 58, 113, 117

program performance evaluation, 113

recommendations for improving, 7, 114, 134

restrictions on funding, 88, 100101, 136

role of counseling and testing, 135

scope of activities, 115117

services for orphans and other vulnerable children, 227231

sexual transmission of HIV, 118, 120123

strategic planning, 7, 113

strategies for improving, 131, 137

Private sector funding for HIV/AIDS initiatives, 41

Protease inhibitors, 150

Psychosocial services, 177, 192193

Public education

HIV prevention, 123

HIV transmission in injection drug use, 125

PEPFAR accomplishments to date, 5

See also Educational system

Q

Quality improvement, 9596, 266

R

Religious beliefs, 63.

See also Faith-based organizations

Research

antiretroviral therapy effectiveness, 155, 265

Country Team activities, 95

funding, 95

goals, 2, 1516

implications for program planning and implementation, 57

needs, 17, 57, 244, 264266

pediatric therapy, 153

PEPFAR role, 16, 17, 261262, 263

recommendations for, 17, 244, 266

stigma, 5657

See also Data collection

S

SAVE program, 135

Sex workers, 14, 92, 124, 131, 156

Sexual transmission of HIV

ABC prevention strategy, 100, 120, 123, 135137, 228229

gender differences, 53

Suggested Citation:"Index." Institute of Medicine. 2007. PEPFAR Implementation: Progress and Promise. Washington, DC: The National Academies Press. doi: 10.17226/11905.
×

patterns, 137

prevention program budget allocation, 137

prevention program design, 131

prevention program effectiveness, 118, 120123

recommendations for surveillance, 7, 114, 134

See also Abstinence, sexual

Social security programs, 225

Socioeconomic conditions

disease outcomes and, 50

impact of HIV/AIDS, 4950

PEPFAR focus countries, 58

poverty reduction, 214

vulnerabilities of orphaned children, 5455

State Department, U.S., 72, 73, 104

Stigmatization of HIV-positive persons, 5657, 82

antiretroviral therapy and, 150

See also Discrimination;

Marginalized populations

Sustainability, PEPFAR transition to

capacity building initiatives for, 252259

challenges, 243

harmonization and coordination of efforts for, 810, 247248

integration of services for, 12

network model for, 177

PEPFAR commitment to, 248

prevention strategies in, 7

rationale, 18, 246248, 268

recommendations for, 67, 244, 248

strategies for, 12, 190

women’s issues in, 8, 249252

workforce concerns, 1415

T

Three Ones principles of harmonization, 43, 87

action framework, 45, 8789

coordinating authority, 45, 8990

monitoring and evaluation, 4546, 9091

origins, 44

purpose, 44

Traditional healers, 195, 200

Training in HIV/AIDS care

antiretroviral therapy, 145146, 258

current efforts, 14

for home-based care, 192

PEPFAR accomplishments, 5, 176, 246, 258

PEPFAR network model of service delivery, 6870

recommendations for, 15, 244, 259

services for orphans and other vulnerable children, 210, 237

spending, 14, 258

for supportive care, 169, 188190

twinning strategy, 258

Training in HIV/AIDS prevention

blood safety procedures, 129

injection safety, 129130

mother-to-child transmission, 128

Transmission of HIV infection

causes, 137

in focus countries, 62

risk for health care workers, 257

See also Injection drug use;

Mother-to-child transmission of HIV;

Prevention;

Sexual transmission of HIV

Treatment

budget allocations, 67, 99, 106107

child patient, 152153, 155156

clinical care services and, 172

human resources for, 160

integration with prevention and care activities, 13, 99100, 134136, 142, 155, 170

major HIV/AIDS program elements, 48

nondiscrimination in, 14, 82, 9192

PEPFAR definition, 141, 143

PEPFAR five-year performance targets, 4, 25, 58, 144, 153

PEPFAR policies, 141, 145

recommendations for improving, 13, 142

voluntary counseling and testing in, 186

women’s access, 52

See also Antiretroviral therapy;

Care services

Tuberculosis, 141, 156, 157, 173, 176

prevention, 183, 185

treatment, 185

Suggested Citation:"Index." Institute of Medicine. 2007. PEPFAR Implementation: Progress and Promise. Washington, DC: The National Academies Press. doi: 10.17226/11905.
×

U

Unemployment levels, 58

United Nations, 41, 43, 46, 48, 212, 214, 220

United States

current HIV/AIDS program budget, 2, 12, 4041

interagency coordination, 8485

leadership role, in HIV/AIDS programs, 18

role in harmonization and coordination, 9

See also specific government entity;

specific government program

United States Leadership against HIV/AIDS, Tuberculosis, and Malaria Act (Leadership Act)

amendments, 6364

budget allocations, 67, 7173

evaluation of PEPFAR and, 4, 7, 2627, 6667

origins and purpose, 3, 6, 24, 6263, 64, 246

palliative care provisions, 173

performance targets, 67

research goals, 261

restrictions on funding, 63, 64, 88

services for orphans and other

vulnerable children, 67, 208, 210

significant HIV/AIDS provisions, 24, 64

See also President’s Emergency Plan for AIDS Relief (PEPFAR)

Urban populations, 51

U.S. Agency for International Development, 8485, 104, 263

U.S. Leadership against HIV/AIDS, TB and Malaria Act of 2002, 6263

V

Voluntary counseling and testing. See Counseling and testing

W

Women and girls

access to care, 52, 249250

burden of HIV/AIDS, 5354

caregiving role, 193, 196, 217, 218

HIV/AIDS manifestations, 53

infection patterns, 52, 53

infection risk, 5253

Leadership Act provisions, 63

PEPFAR programs and services, 8, 249

prevention program considerations, 130131

recommendations for services, 8, 244, 250

significance of, in PEPFAR transition to sustainability, 8, 249252

supportive care for, 196197

vulnerabilities of young girls, 231

See also Gender differences

World Bank, 41

World Health Organization

antiretroviral therapy guidelines, 144, 146147, 148, 154

health care workforce management, 257

medication quality standards, 12, 910, 142, 158159, 160

palliative care, 171, 172

Wrap-around services, 199, 201

Suggested Citation:"Index." Institute of Medicine. 2007. PEPFAR Implementation: Progress and Promise. Washington, DC: The National Academies Press. doi: 10.17226/11905.
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In 2003, Congress passed the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act, which established a 5-year, $15 billion initiative to help countries around the world respond to their AIDS epidemics. The initiative is generally referred to by the title of the 5-year strategy required by the act--PEPFAR, or the President's Emergency Plan for AIDS Relief.

PEPFAR Implementation evaluates this initiative's progress and concludes that although PEPFAR has made a promising start, U.S. leadership is still needed in the effort to respond to the HIV/AIDS pandemic. The book recommends that the program transition from its focus on emergency relief to an emphasis on the long-term strategic planning and capacity building necessary for a sustainable response. PEPFAR Implementation will be of interest to policy makers, health care professionals, special interest groups, and others interested in global AIDS relief.

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