Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, USA.
Health Aff (Millwood). 2012 Jul;31(7):1397-405. doi: 10.1377/hlthaff.2012.0193.
In its first five years, the President's Emergency Plan for AIDS Relief (PEPFAR)--the largest commitment ever by any nation to combat a single disease--succeeded in getting 2.1 million people on antiretroviral treatment and 10.1 million people in care; prevented an estimated 237,600 HIV infections in infants; and saved an estimated 3.28 million adult years of life. Much of the global program's success can be attributed to early decisions to implement new structures and approaches designed to meet its ambitious targets quickly, overcome bureaucratic inertia, and ensure continued progress. A unified US government program was created with a single coordinator. There was a focus on quick ramp-up, strategic partnerships, and sustainable local ownership. Accountability and performance were emphasized. These new approaches played critical roles in translating the unprecedented resources and political support for PEPFAR into improved health for millions of people. Successful aspects of the way in which PEPFAR was organized and implemented, along with less successful or deficient ones, offer lessons for any large, complex international health initiative.
在其成立的头五年里，总统艾滋病紧急救援计划（PEPFAR）——这是有史以来任何一个国家在对抗单一疾病方面做出的最大承诺——成功地让 210 万人接受了抗逆转录病毒治疗，1010 万人接受了关怀；估计预防了 23.76 万例婴儿的 HIV 感染；并挽救了约 328 万成年人的生命。该全球计划的大部分成功可以归因于早期做出的决策，这些决策旨在快速实现其雄心勃勃的目标、克服官僚主义的惰性，并确保持续取得进展。创建了一个统一的美国政府计划，由一名协调员负责。该计划侧重于快速扩充、战略伙伴关系和可持续的地方自主权。强调问责制和绩效。这些新方法在将 PEPFAR 前所未有的资源和政治支持转化为数百万人的健康改善方面发挥了关键作用。PEPFAR 的组织和实施方式中的成功方面，以及不太成功或存在缺陷的方面，为任何大型、复杂的国际卫生倡议提供了经验教训。
