'Every generation has to step up’: Our HIV/AIDS Staff Reflect on PEPFAR’s Impact

“The first child that died in front of me suffered from AIDS,” says Ryan Phelps, a medical officer who works in USAID’s Office of HIV/AIDS. “This made me deeply sad, and livid. We all have instances that define who we are. Moments that leave marks that are no less permanent than a tattoo…or deep scar. That was when my PEPFAR story started.”?

That was in 2002, when less than 50,000 people in Africa received life-saving HIV treatment.?

“At that time, the discussion was about whether we even should invest in HIV prevention and/or treatment, and how we might be able to someday achieve the ‘ambitious’ target of one million on treatment,” says Ryan. Twenty years later, the President’s Emergency Plan for AIDS Relief (PEPFAR) supports over 20 million people on life-saving antiretroviral drugs.

For more than 20 years, USAID has played a critical role in the global HIV/AIDS response and since 2003 has been a key implementer of PEPFAR, which has helped over 50 countries curb their HIV epidemics.??

“Early in his fight with brain cancer, my grandfather gave me a special pin that had been awarded to him for his service in World War II. With it, he said, ‘Thank you for being engaged out in the world.’ When I ask myself how I can honor my grandfather’s legacy, there are very few things that could make me prouder than PEPFAR, and being part of it,” Ryan says. “My fondest PEPFAR memory is that moment I shared with my grandfather and being reminded that every generation has to step up in one way or another. The world indeed depends on it.”

Other USAID/PEPFAR staff lost close relatives to AIDS, which only served to strengthen their commitment to combat the disease.?

That is what took the life of Lilly Banda’s first son.?

“My greatest achievement with USAID and PEPFAR was to see how the programs grew in all areas,” says the family planning specialist and midwife in Malawi. “Having been a healthcare worker in Malawi, we could only manage opportunistic infections and wait for the person to die. It was so sad to see people coming in and there was nothing you could do. When these new programs arrived, to me it meant a lot. The PEPFAR program really was life-saving.”

Melaku Dessie, a data expert with USAID’s Office of HIV/AIDS, was born and raised in the town in Ethiopia hardest hit by the HIV epidemic.?

“People were not aware of the epidemic. There was no testing service, no antiretroviral treatment (ART), or even medicines treating opportunistic infections,” he says. “As a 10th grader in 1995, it was unimaginable to see that my dad was seriously sick and in bed without medicine. He died shortly thereafter. A few years later, in 2001, I also lost my mom to AIDS.”

Melaku reflects on the profound impact PEPFAR has had in his hometown. “Last December, I went to my hometown after seven years. I witnessed neighbors who luckily survived and received PEPFAR-supported medicines, who are living longer and supporting their family,” he explains.?

“Thanks to PEPFAR,” he continues, “people living with HIV have access to the best available medicines, laboratory services, information, and care at their doorsteps. People living with HIV/AIDS can now take care of themselves, their family, and their children.”

'Every generation has to step up' “USAID and PEPFAR have contributed immensely to South Africa's national response to HIV/AIDS. I recall the period where, as a nation, we were burying people daily due to HIV/AIDS,” says Nomea Masihelo, who recently retired from the USAID Southern Africa? Mission. “These days, people live longer, happy lives. We are indebted to PEPFAR's support to have over seven million people on HIV treatment today.”

Nomea continues, “My fondest memory of this work is the celebration of the 100,000th patient initiated on HIV treatment by one of our implementing partners, at a time when people were still dying from HIV. This is the moment that I knew PEPFAR was making a difference in South African lives.”

Advancing human rights, addressing inequalities, and ending HIV as a public health threat would not be possible without the dedicated staff whose continued commitment gets us closer to these goals every day.?

As we celebrate Public Service Recognition Week, we are beyond grateful to our staff who, despite many challenges, continue to forge ahead in helping to control the HIV/AIDS epidemic. As Ryan states: “To be sure, PEPFAR has changed over the last 20 years. This is due to a simple, undeniable fact: The world has changed because of PEPFAR.”

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The views and opinions in this article do not necessarily represent the views of USAID, PEPFAR, or the United States Government.

ABOUT THE AUTHOR: Becky Band Jain is a Communications Advisor with USAID’s Office of HIV/AIDS