2005 and February 2006, the committee visited 13 of the 15 focus countries to directly observe implementation activities. The committee was not able to visit Côte d’Ivoire or Haiti because of security concerns, but it did hold conference calls with country teams and implementing partners in these countries. The committee synthesized the observations, findings, and conclusions that emerged as common across the country visits and triangulated these syntheses with information from other documents and interviews in order to make conclusions about significant components of PEPFAR I implementation (IOM, 2007).

The first IOM evaluation concluded that PEPFAR had made good strides toward meeting its performance targets in the first 2 years and that it had laid a foundation for reaching the longer-term goals of the Leadership Act. The committee also recognized PEPFAR’s contribution to the research, communication, dissemination, and global evidence base of HIV/AIDS information. The evaluation emphasized the need for PEPFAR to transition from an emergency response to a program that fosters the sustainability that will be needed to achieve long-term goals while still expanding HIV/AIDS services, and it noted that PEPFAR had significantly improved capacity-building efforts to support this transition (IOM, 2007).

The 2007 IOM evaluation’s recommendations can be summarized in the following main messages. PEPFAR should (1) address long-term factors by expanding prevention strategies including for key populations, improving the status of women and girls, and strengthening workforce capacity; (2) develop a strategy to institutionalize its role as a learning organization and to expand the knowledge base by conducting and publishing research; (3) harmonize its policies and activities with international and national stakeholders, particularly for strategic planning and monitoring and evaluation; (4) remove budget allocation requirements, which the evaluation report concluded had limited PEPFAR’s ability to tailor its activities to the specific needs of each country and to coordinate with national plans; (5) establish performance targets for the care of orphans and vulnerable children; and (6) expand, improve, and integrate services using evidence-based strategies and supporting adequate availability of ARVs, the use of local capacity, and provision of community-based, family-centered services (IOM, 2007).

Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008

The U.S. Congress passed the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (the Lantos-Hyde Act of 2008) on July 30,



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