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Ambassador Mark Dybul
United States Global AIDS Coordinator

December 1, 2008

Mark Dybul
After several years as PEPFAR Coordinator I am still amazed at the achievements that our partner nations have made with the support of the American people in the fight against HIV/AIDS. In 2003, just 50,000 people in sub-Saharan Africa were receiving antiretroviral treatment. Today, five years after the inauguration of the President’s Emergency Plan for AIDS Relief (PEPFAR), PEPFAR has fulfilled its commitment to support treatment for two million people, the vast majority of whom reside in sub-Saharan Africa. The President promised to lead the fight against HIV/AIDS when he signed PEPFAR into law. And today we celebrate the lives saved as a result of this initiative.

Brian, from Baltimore, MD writes:
Can you explain how PEPFAR is caring for people affected by AIDS?Thank for all of the work you have done on behalf of the American people.

Mark Dybul
PEPFAR has a comprehensive approach to care and supports host nations in meeting the needs of orphans and vulnerable children affected by the pandemic, as well as people living with HIV/AIDS. At the beginning of PEPFAR five years ago, we were charged with care for 10 million people in the 15 focus countries. As of September 30, 2008, nearly 9.7 million people affected by HIV/AIDS in PEPFAR’s 15 focus countries had received compassionate care, including nearly 4 million orphans and vulnerable children. It is safe to say that as of today, the U.S. also has met the goal of supporting care for 10 million people affected by HIV in the focus countries. Globally, the U.S. is supporting care for over 10.1 million, including over 4 million children.

Randy, from Washington, DC writes:
Why has PEPFAR been so successful? What are the biggest challenges ahead?

Mark Dybul
PEPFAR reflects the principles of President Bush’s New Era of development: country ownership, good governance, results-based programs and accountability, and economic growth. These reflect the internationally-agreed Monterrey Consensus and Paris Declaration. The fact that we’ve been able to partner with the countries where we work and support them in achieving results in their countries has been fundamental to our success.

The current economic crisis may cause some to look inward to only work on problems in this country, but as President Bush and Secretary Rice have emphasized, this would be a serious mistake. Our work abroad, with PEPFAR and other development initiatives, not only benefits countries around the world, but also advances the United States’ economic, security and moral interests.

Philip, from United Kingdom writes:
AmbassadorDo you believe the spread of AIDS can be controlled globally, or is this only possible in the more developed nations of the world?

Mark Dybul
Philip, the success of PEPFAR to date shows that success is possible even in some of the poorest nations. Let me digress to an interesting point: within developing countries, HIV/AIDS is not only a disease of the poorest of the poor. HIV/AIDS often affects those who have risen or are rising economically. It is those people who have mobility and resources to engage in risky behavior. As a result, the people who are losing the fight to HIV/AIDS are often in professions like education and health care.

But I do believe we can succeed in fighting this pandemic. Again, the results announced today should be a source of hope that, together, we can win the fight against HIV/AIDS.

Connie, from Sarnia, Ontario, Canada writes:
What can I do to help you and the President and our country (I was born and raised in CentralSoutheast Michigan,U.S.A.)to help all of our brothers and sisters around the world suffering with AIDS?

Mark Dybul
Connie, you are already helping. The American people, through their tax dollars that fund PEPFAR, have saved millions of lives around the world. The support I have seen from the American people has been remarkable. Of course, there remains much to do. If you are interested in engaging the fight against HIV/AIDS there are many organizations involved in fighting this pandemic around the world that are in need of both funding and people to carry out their good deeds. You can volunteer with or donate to these organizations, and you can also help by raising awareness about HIV/AIDS within your own communities, including faith communities. If you are interested in learning more about PEPFAR and the countries in need – please visit our Web site at

2nd, from Winter Haven, Fl writes:
What age group has the highest percentage of new AIDS cases? What are you doing to educate young people?

Mark Dybul
The demography of HIV varies among different developing nations, but in many, the highest percentage of new HIV cases are in those in their late teens and twenties – those who should be among the most productive members in society. As a result, many countries have suffered horribly, and large portions of whole generations have been decimated. In order to prevent this, we reach young people with age- and culturally-appropriate messages as soon as we can. The best approach to treatment, care and all the other challenges posed by HIV/AIDS is to prevent infection in the first place so that people do not need HIV treatment or care. We try to make sure these messages reach young people as effectively as we can. Long before PEPFAR was initiated, African nations with generalized epidemics had already developed their own highly successful national HIV prevention strategies that reflected the “ABC” approach to behavior change (Abstain, Be faithful, correct and consistent use of Condoms where appropriate). To aid in our efforts, we have formed public-private partnerships to help “modularize” and adapt successful prevention programs so that the components found to be most effective and easy to transfer to other geographic areas can be rapidly replicated, adapted, and scaled up.

Jiesheng, from Birmingham, United Kingdom writes:
What steps has the US taken in working with the global community in reaching Goal 6 of the Millennium Development Goals (Combat HIVAIDs, malaria and other diseases?)

Mark Dybul
Thanks for asking about this – my other answers have focused on our U.S. bilateral HIV/AIDS programs, but your question gives me a chance to highlight the Global Fund to Fight AIDS, Tuberculosis and Malaria. This is an important part of our approach, and it also provides a mechanism for other countries that don’t have the bilateral programs the U.S. has to contribute to the effort against the three diseases. President Bush provided the founding contribution to launch the Fund, and the U.S. remains by far its largest supporter, contributing approximately 30% of its resources. Today the Fund announced the latest results that have been achieved through the programs it supports, and the U.S. will continue to support this important mechanism – and to urge other countries to utilize it as a way to increase their own commitments. Again, thanks for the good question.

Mark Dybul
Thank you all so much for your questions and support. Development has been a huge area of success for the American people over the last eight years under President Bush's leadership – the results released earlier this morning attest to this. We stand today at a critical juncture – recalling where we were 30 years ago, yet so encouraged and hopeful as a result of the substantial progress made in the last few years.

The principles of the new era of development that I spoke about earlier reflect the compassion and generosity of the American people, and a deep belief and in the dignity and worth of every human being. In this time of economic duress, it is crucial that we stand by these beliefs – and remember that although times are tough, there are others who are worse off. You should be proud that, in partnership with host nations, the American people have lifted millions of people up and saved their lives. On this World AIDS Day 2008, let's continue to work in partnership to serve one another and to achieve an HIV free generation – and in so doing, change the world.

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