U.S. President's Emergency Plan for AIDS Relief approach to public health as a development process

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) is the largest commitment ever by any nation for an international health initiative dedicated to a single disease – a five year, $15 billion, multifaceted approach to combating the disease in more than 120 countries around the world. It is based on a development model which recognizes that a successful, sustainable response to the pandemic requires that not only technical public health issues be addressed, but that fundamental capacity building also occur in affected countries. This can only be achieved through a collaborative process that partners host country institutions with bilateral and multilateral organizations.

The PEPFAR program has adopted a collaborative model that begins with its own internal structure and governance and extends to both its local and international partners. This paper explores the benefits of the collaborative development model as a public health approach. It also identifies several of the operational challenges inherent in the approach. While it focuses on a large-scale international program, the issues and lessons learned are applicable to public health activities on a more local level as well.