activities that emphasize in-country local participation and expertise can also enhance local capacity and contribute to country ownership.

C. To maximize the use of knowledge created within PEPFAR, OGAC should develop systems and processes for routine, active transfer and dissemination of knowledge both within and external to PEPFAR. As one component, OGAC should institute a data-sharing policy, developed through a consultative process. The policy should identify the data to be included and ensure that these stipulated data and results generated by PEPFAR or through PEPFAR-supported activities are made available in a timely manner to PEPFAR stakeholders, external evaluators, the research community, and other interested parties.

PEPFAR would benefit from building on its most successful current mechanisms for sharing data, information, and knowledge to develop more systematic documentation and dissemination; there is a particular need to more effectively facilitate the direct transfer of experiences, best practices, and lessons learned across countries, implementing partners, and sites.


PEPFAR is an unprecedented initiative implemented on behalf of the U.S. citizenry, with vast bilateral investment from the U.S. government. Its dynamism can be seen in its evolving scope and implementation, the changing context in which it operates, and its deepening interrelationship with health diplomacy. PEPFAR’s support for HIV prevention, care, and treatment has had major positive effects on the health and well-being of individual beneficiaries, on institutions and systems in partner countries, and on the overall global response to HIV. In addition to the positive effects of PEPFAR’s support for services, PEPFAR is generally recognized as providing good technical assistance; being a flexible donor that fills gaps and supports innovation within country structures; contributing to addressing the challenging nature of concentrated epidemics; advancing global expectations for performance measurement and accountability; and contributing to the global knowledge base. PEPFAR has also contributed to shaping global health policy and action for HIV and potentially other areas of health and development.

The committee’s overall assessment is that PEPFAR has played a transformative role with its contribution to the global response to HIV. In the course of this evaluation, the committee heard repeatedly across countries the pride, gratitude, and appreciation expressed by partner country govern-

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