Making PEPFAR: Slideshow

Global distribution of 7.7 million working physicians in 2004. The actual sizes of countries are increased or decreased in proportion to the number of physicians working in them. Note that Africa, in particular, is woefully deficient in medical care and in research facilities.  Credit: Worldmapper (#219)

Global distribution of 7.7 million working physicians in 2004. The actual sizes of countries are increased or decreased in proportion to the number of physicians working in them. Note that Africa, in particular, is woefully deficient in medical care and in research facilities. Credit: Worldmapper (#219)

Global distribution of HIV-infected persons ages 15 to 49 in 2003. The sizes of countries are increased or decreased in proportion to the number of persons with HIV living within them. Despite its deficiencies in the number of physicians, Africa is over-endowed with disease. Credit: Worldmapper (#227)

Global distribution of HIV-infected persons ages 15 to 49 in 2003. The sizes of countries are increased or decreased in proportion to the number of persons with HIV living within them. Despite its deficiencies in the number of physicians, Africa is over-endowed with disease. Credit: Worldmapper (#227)

Global distribution of the 2.6 million known deaths from AIDS that occurred in 2002. Credit: Worldmapper (#374)

Global distribution of the 2.6 million known deaths from AIDS that occurred in 2002. Credit: Worldmapper (#374)

Variation of annual AIDS death rates and numbers of patients using highly active antiretroviral therapy (HAART) by geographical region, 2001. Credit: UNAIDS

Variation of annual AIDS death rates and numbers of patients using highly active antiretroviral therapy (HAART) by geographical region, 2001. Credit: UNAIDS

President George W. Bush and Secretary of State Condoleezza Rice. Credit: The White House

President George W. Bush and Secretary of State Condoleezza Rice. Credit: The White House

Announcement of U.S. support for the Global Fund to Fight AIDS, Tuberculosis, and Malaria at the White House, May 2001, with President Bush and (at right) UN Secretary-General Kofi Annan. Credit: The White House

Announcement of U.S. support for the Global Fund to Fight AIDS, Tuberculosis, and Malaria at the White House, May 2001, with President Bush and (at right) UN Secretary-General Kofi Annan. Credit: The White House

Bono, leader of the musical group U2 and advocate for programs to combat HIV/AIDS, with President Bush. Credit: The White House

Bono, leader of the musical group U2 and advocate for programs to combat HIV/AIDS, with President Bush. Credit: The White House

Joshua Bolton, President Bush’s deputy chief of staff. Courtesy of Joshua Bolton

Joshua Bolton, President Bush’s deputy chief of staff. Courtesy of Joshua Bolton

Gary Edson, senior advisor to the president and deputy national security advisor. Credit: Wikimedia Commons/ Tomahawk83

Gary Edson, senior advisor to the president and deputy national security advisor. Credit: Wikimedia Commons/ Tomahawk83

Anthony (Tony) Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) at NIH, and major designer of PEPFAR. Credit: AIDS.gov

Anthony (Tony) Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) at NIH, and major designer of PEPFAR. Credit: AIDS.gov

Anthony Fauci with children in East Africa during a trip in 2002. Courtesy of Anthony Fauci

Anthony Fauci with children in East Africa during a trip in 2002. Courtesy of Anthony Fauci

Anthony Fauci and colleague visiting an AIDS ward in Uganda, 2002. Courtesy of Anthony Fauci

Anthony Fauci and colleague visiting an AIDS ward in Uganda, 2002. Courtesy of Anthony Fauci

Laura Bush (left) and Mark Dybul (right), who was the assistant to the NIAID director and later the director of PEPFAR. Credit: The White House

Laura Bush (left) and Mark Dybul (right), who was the assistant to the NIAID director and later the director of PEPFAR. Credit: The White House

Ralph Tate, an operations officer at NIAID. Courtesy of  Ralph Tate

Ralph Tate, an operations officer at NIAID. Courtesy of Ralph Tate

Percent of Cost Supported by the United States: One of the charts prepared by Ralph Tate in estimating costs for PEPFAR and sharing plans. Note the inclusion of China, India, and Russia at bottom of the chart; these countries were later removed from the plan. Courtesy of  Ralph Tate

Percent of Cost Supported by the United States: One of the charts prepared by Ralph Tate in estimating costs for PEPFAR and sharing plans. Note the inclusion of China, India, and Russia at bottom of the chart; these countries were later removed from the plan. Courtesy of Ralph Tate

Percent of Prevention by Country: One of the charts prepared by Ralph Tate in estimating costs for PEPFAR and sharing plans. Courtesy of  Ralph Tate

Percent of Prevention by Country: One of the charts prepared by Ralph Tate in estimating costs for PEPFAR and sharing plans. Courtesy of Ralph Tate

Percent of Patients Under Care by Country: One of the charts prepared by Ralph Tate in estimating costs for PEPFAR and sharing plans. Courtesy of  Ralph Tate

Percent of Patients Under Care by Country: One of the charts prepared by Ralph Tate in estimating costs for PEPFAR and sharing plans. Courtesy of Ralph Tate

Percent of Patients Under ARV Care by Country: One of the charts prepared by Ralph Tate in estimating costs for PEPFAR and sharing plans. Courtesy of  Ralph Tate

Percent of Patients Under ARV Care by Country: One of the charts prepared by Ralph Tate in estimating costs for PEPFAR and sharing plans. Courtesy of Ralph Tate

Five Year Scale-up: Drugs, Prevention, and Care: An overview of Ralph Tate’s estimates of costs of prevention, antiretroviral drugs, and other kinds of care for PEPFAR countries. Courtesy of  Ralph Tate

Five Year Scale-up: Drugs, Prevention, and Care: An overview of Ralph Tate’s estimates of costs of prevention, antiretroviral drugs, and other kinds of care for PEPFAR countries. Courtesy of Ralph Tate

NIAID planning document that summarizes the kinds of facilities, health care workers, and services for different kinds of delivery sites for medical care, used as a framework for determining costs in each PEPFAR country. Courtesy of  Ralph Tate

NIAID planning document that summarizes the kinds of facilities, health care workers, and services for different kinds of delivery sites for medical care, used as a framework for determining costs in each PEPFAR country. Courtesy of Ralph Tate

An example of the kind of map used to plan delivery of PEPFAR services in target countries—in this case Uganda—with indicated prevalence of HIV infection in circled areas.  Courtesy of Ralph Tate

An example of the kind of map used to plan delivery of PEPFAR services in target countries—in this case Uganda—with indicated prevalence of HIV infection in circled areas. Courtesy of Ralph Tate

Another version of a map of facilities in Uganda that existed prior to PEPFAR and help to estimate needs for additional facilities. Courtesy of Ralph Tate

Another version of a map of facilities in Uganda that existed prior to PEPFAR and help to estimate needs for additional facilities. Courtesy of Ralph Tate

Robin Cleveland, a staff member and budget examiner at the Office of Management and Budget, who chaired a discussion of the plan for PEPFAR on November 13, 2002. Courtesy of Robin Cleveland

Robin Cleveland, a staff member and budget examiner at the Office of Management and Budget, who chaired a discussion of the plan for PEPFAR on November 13, 2002. Courtesy of Robin Cleveland

Peter Mugyenyi of the Joint Clinical Research Center in Uganda who was invited to the pivotal November 13, 2002, meeting at the OMB. Credit: NIH

Peter Mugyenyi of the Joint Clinical Research Center in Uganda who was invited to the pivotal November 13, 2002, meeting at the OMB. Credit: NIH

Paul Farmer, a professor at Harvard Medical School who was invited to the pivotal November 13, 2002, meeting at the OMB. Credit: Daniel Wallace/St. Petersburg Times

Paul Farmer, a professor at Harvard Medical School who was invited to the pivotal November 13, 2002, meeting at the OMB. Credit: Daniel Wallace/St. Petersburg Times

Jean William (Bill) Pape, a professor at Weill Cornell Medical College who was invited to the pivotal November 13, 2002, meeting at the OMB . Credit: NIH

Jean William (Bill) Pape, a professor at Weill Cornell Medical College who was invited to the pivotal November 13, 2002, meeting at the OMB . Credit: NIH

Eric Goosby, a professor at the University of California, San Francisco, School of Medicine (and later director of PEPFAR) who was invited to the pivotal November 13, 2002, meeting at the OMB. Credit: World Economic Forum

Eric Goosby, a professor at the University of California, San Francisco, School of Medicine (and later director of PEPFAR) who was invited to the pivotal November 13, 2002, meeting at the OMB. Credit: World Economic Forum

Nils Daulaire (center), an experienced global health advocate, who was invited to the pivotal November 13, 2002, meeting at the OMB. Credit: U.S. Mission, Eric Bridiers

Nils Daulaire (center), an experienced global health advocate, who was invited to the pivotal November 13, 2002, meeting at the OMB. Credit: U.S. Mission, Eric Bridiers

"The Lazarus effect”: Some of the evidence for effective treatment of HIV/AIDS showed the dramatic transformations that could occur once a patient, such as the woman shown, had antiretroviral therapy.  Credit: Jonx Pillemer, The Persuaders, LLC. / joinred.com

"The Lazarus effect”: Some of the evidence for effective treatment of HIV/AIDS showed the dramatic transformations that could occur once a patient, such as the woman shown, had antiretroviral therapy. Credit: Jonx Pillemer, The Persuaders, LLC. / joinred.com

President Bush announcing the PEPFAR proposal at his State of the Union Address on January 28, 2003. Credit: The White House

President Bush announcing the PEPFAR proposal at his State of the Union Address on January 28, 2003. Credit: The White House

First Lady Laura Bush and Peter Mugyenyi during the State of the Union Address on January 28, 2003. Credit: The White House

First Lady Laura Bush and Peter Mugyenyi during the State of the Union Address on January 28, 2003. Credit: The White House

Major features of PEPFAR outlined in the State of the Union Address. Target countries are shaded red. Courtesy of Anthony Fauci

Major features of PEPFAR outlined in the State of the Union Address. Target countries are shaded red. Courtesy of Anthony Fauci

Randall Tobias, former CEO of Eli Lilly, taking charge of PEPFAR as its first administrator in 2003. Four years later he was succeeded by Mark Dybul, who was followed, in 2009, by Eric Goosby. Goosby left in October 2013. Credit: The White House

Randall Tobias, former CEO of Eli Lilly, taking charge of PEPFAR as its first administrator in 2003. Four years later he was succeeded by Mark Dybul, who was followed, in 2009, by Eric Goosby. Goosby left in October 2013. Credit: The White House

The Number of Patients Who Received  Antiretroviral Treatment through PEPFAR. Source: PEPFAR.gov

The Number of Patients Who Received Antiretroviral Treatment through PEPFAR. Source: PEPFAR.gov

Life Expectancy in Africa. Source:  UN Department of Economic and Social Affairs (2001)  World Population Prospects, the 2000 Revision. Courtesy of Wafaa M. El-Sadr

Life Expectancy in Africa. Source: UN Department of Economic and Social Affairs (2001) World Population Prospects, the 2000 Revision. Courtesy of Wafaa M. El-Sadr

Deaths in PEPFAR-Supported Countries in Africa. Source:  Bendavid et al. CROI 2012. Courtesy of Wafaa M. El-Sadr

Deaths in PEPFAR-Supported Countries in Africa. Source: Bendavid et al. CROI 2012. Courtesy of Wafaa M. El-Sadr

The PEPFAR logo, highly respected in Africa, little known in the United States.

The PEPFAR logo, highly respected in Africa, little known in the United States.

Global distribution of 7.7 million working physicians in 2004. The actual sizes of countries are increased or decreased in proportion to the number of physicians working in them. Note that Africa, in particular, is woefully deficient in medical care and in research facilities.  Credit: Worldmapper (#219)
Global distribution of HIV-infected persons ages 15 to 49 in 2003. The sizes of countries are increased or decreased in proportion to the number of persons with HIV living within them. Despite its deficiencies in the number of physicians, Africa is over-endowed with disease. Credit: Worldmapper (#227)
Global distribution of the 2.6 million known deaths from AIDS that occurred in 2002. Credit: Worldmapper (#374)
Variation of annual AIDS death rates and numbers of patients using highly active antiretroviral therapy (HAART) by geographical region, 2001. Credit: UNAIDS
President George W. Bush and Secretary of State Condoleezza Rice. Credit: The White House
Announcement of U.S. support for the Global Fund to Fight AIDS, Tuberculosis, and Malaria at the White House, May 2001, with President Bush and (at right) UN Secretary-General Kofi Annan. Credit: The White House
Bono, leader of the musical group U2 and advocate for programs to combat HIV/AIDS, with President Bush. Credit: The White House
Joshua Bolton, President Bush’s deputy chief of staff. Courtesy of Joshua Bolton
Gary Edson, senior advisor to the president and deputy national security advisor. Credit: Wikimedia Commons/ Tomahawk83
Anthony (Tony) Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) at NIH, and major designer of PEPFAR. Credit: AIDS.gov
Anthony Fauci with children in East Africa during a trip in 2002. Courtesy of Anthony Fauci
Anthony Fauci and colleague visiting an AIDS ward in Uganda, 2002. Courtesy of Anthony Fauci
Laura Bush (left) and Mark Dybul (right), who was the assistant to the NIAID director and later the director of PEPFAR. Credit: The White House
Ralph Tate, an operations officer at NIAID. Courtesy of  Ralph Tate
Percent of Cost Supported by the United States: One of the charts prepared by Ralph Tate in estimating costs for PEPFAR and sharing plans. Note the inclusion of China, India, and Russia at bottom of the chart; these countries were later removed from the plan. Courtesy of  Ralph Tate
Percent of Prevention by Country: One of the charts prepared by Ralph Tate in estimating costs for PEPFAR and sharing plans. Courtesy of  Ralph Tate
Percent of Patients Under Care by Country: One of the charts prepared by Ralph Tate in estimating costs for PEPFAR and sharing plans. Courtesy of  Ralph Tate
Percent of Patients Under ARV Care by Country: One of the charts prepared by Ralph Tate in estimating costs for PEPFAR and sharing plans. Courtesy of  Ralph Tate
Five Year Scale-up: Drugs, Prevention, and Care: An overview of Ralph Tate’s estimates of costs of prevention, antiretroviral drugs, and other kinds of care for PEPFAR countries. Courtesy of  Ralph Tate
NIAID planning document that summarizes the kinds of facilities, health care workers, and services for different kinds of delivery sites for medical care, used as a framework for determining costs in each PEPFAR country. Courtesy of  Ralph Tate
An example of the kind of map used to plan delivery of PEPFAR services in target countries—in this case Uganda—with indicated prevalence of HIV infection in circled areas.  Courtesy of Ralph Tate
Another version of a map of facilities in Uganda that existed prior to PEPFAR and help to estimate needs for additional facilities. Courtesy of Ralph Tate
Robin Cleveland, a staff member and budget examiner at the Office of Management and Budget, who chaired a discussion of the plan for PEPFAR on November 13, 2002. Courtesy of Robin Cleveland
Peter Mugyenyi of the Joint Clinical Research Center in Uganda who was invited to the pivotal November 13, 2002, meeting at the OMB. Credit: NIH
Paul Farmer, a professor at Harvard Medical School who was invited to the pivotal November 13, 2002, meeting at the OMB. Credit: Daniel Wallace/St. Petersburg Times
Jean William (Bill) Pape, a professor at Weill Cornell Medical College who was invited to the pivotal November 13, 2002, meeting at the OMB . Credit: NIH
Eric Goosby, a professor at the University of California, San Francisco, School of Medicine (and later director of PEPFAR) who was invited to the pivotal November 13, 2002, meeting at the OMB. Credit: World Economic Forum
Nils Daulaire (center), an experienced global health advocate, who was invited to the pivotal November 13, 2002, meeting at the OMB. Credit: U.S. Mission, Eric Bridiers
"The Lazarus effect”: Some of the evidence for effective treatment of HIV/AIDS showed the dramatic transformations that could occur once a patient, such as the woman shown, had antiretroviral therapy.  Credit: Jonx Pillemer, The Persuaders, LLC. / joinred.com
President Bush announcing the PEPFAR proposal at his State of the Union Address on January 28, 2003. Credit: The White House
First Lady Laura Bush and Peter Mugyenyi during the State of the Union Address on January 28, 2003. Credit: The White House
Major features of PEPFAR outlined in the State of the Union Address. Target countries are shaded red. Courtesy of Anthony Fauci
Randall Tobias, former CEO of Eli Lilly, taking charge of PEPFAR as its first administrator in 2003. Four years later he was succeeded by Mark Dybul, who was followed, in 2009, by Eric Goosby. Goosby left in October 2013. Credit: The White House
The Number of Patients Who Received  Antiretroviral Treatment through PEPFAR. Source: PEPFAR.gov
Life Expectancy in Africa. Source:  UN Department of Economic and Social Affairs (2001)  World Population Prospects, the 2000 Revision. Courtesy of Wafaa M. El-Sadr
Deaths in PEPFAR-Supported Countries in Africa. Source:  Bendavid et al. CROI 2012. Courtesy of Wafaa M. El-Sadr
The PEPFAR logo, highly respected in Africa, little known in the United States.
Related: Making PEPFAR