ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA.
J Acquir Immune Defic Syndr. 2012 Aug 15;60 Suppl 3(Suppl 3):S96-104. doi: 10.1097/QAI.0b013e31825eb27b.
Since its inception in 2003, the US President's Emergency Plan for AIDS Relief (PEPFAR) has been an important driving force behind the global scale-up of HIV care and treatment services, particularly in expansion of access to antiretroviral therapy. Despite initial concerns about cost and feasibility, PEPFAR overcame challenges by leveraging and coordinating with other funders, by working in partnership with the most affected countries, by supporting local ownership, by using a public health approach, by supporting task-shifting strategies, and by paying attention to health systems strengthening. As of September 2011, PEPFAR directly supported initiation of antiretroviral therapy for 3.9 million people and provided care and support for nearly 13 million people. Benefits in terms of prevention of morbidity and mortality have been reaped by those receiving the services, with evidence of societal benefits beyond the anticipated clinical benefits. However, much remains to be accomplished to achieve universal access, to enhance the quality of programs, to ensure retention of patients in care, and to continue to strengthen health systems.
自 2003 年成立以来，美国总统艾滋病紧急救援计划（PEPFAR）一直是全球扩大艾滋病毒护理和治疗服务的重要推动力，特别是在扩大获得抗逆转录病毒治疗方面。尽管最初对成本和可行性存在担忧，但 PEPFAR 通过利用和协调其他供资方、与受影响最严重的国家合作、支持地方自主权、采用公共卫生方法、支持任务转移战略以及关注加强卫生系统，克服了挑战。截至 2011 年 9 月，PEPFAR 直接支持了 390 万人开始接受抗逆转录病毒治疗，并为近 1300 万人提供了护理和支持。接受这些服务的人在预防发病和死亡方面获得了益处，其社会效益超出了预期的临床益处。然而，要实现普及服务、提高项目质量、确保患者持续接受护理以及继续加强卫生系统，仍有许多工作要做。
