With a matter-of-fact and unanimous approval of the PEPFAR Extension Act of 2018, a five-year renewal of the U.S. flagship program to combat HIV globally, the U.S. Senate Wednesday evening showed that what was once considered revolutionary, can now be considered routine. Perceptions that efforts to stop the spread of an incurable virus across countries of low income and limited technologies, and to save the lives it threatened were doomed to failure have been quelled by successes. The successes include the more than 2.4 million babies of mothers living with HIV born without the virus, and the more than 14.6 million people, including 700,000 children getting access to the life-saving treatment that prevents illness and transmission, all through support from the plan started as an emergency intervention.
The extension of PEPFAR, also passed earlier this month by the House, shows acknowledgement, as well, that its work is not over. Just a little more than half of the people who need treatment have it. A quarter of people living with the virus remain unaware of it. And while treatment has made living a long life with an incurable virus possible, tuberculosis, a curable disease, remains the leading killer of people with HIV.
But whether the acknowledgement of what needs to be done will be matched by the funding the work will require remains a question. With a $50 million increase for PEPFAR proposed by the Senate, and the $41 million increase for USAID’s TB program proposed by the House in the air, Congress, facing a Dec. 7 deadline, has yet to pass a funding bill for fiscal year 2019.