The President’s Emergency Plan for AIDS Relief (PEPFAR) was launched in 2003 to combat global HIV/AIDS and it was specifically launched in Malawi in 2006.  PEPFAR immediately began work to advance treatment options in Malawi as well as to raise awareness, increase prevention efforts, and strengthen health systems nationwide.

The U.S. government has invested over $1.8 billion dollars in Malawi’s HIV response through PEPFAR.  Through collaboration with the Ministry of Health, UNAIDS, Global Fund, CSO, and other key partners over the last 20 years, PEPFAR has supported key achievements in prevention, treatment, and system strengthening.

Today, Malawi is on the cusp of achieving the UNAIDS 95-95-95 Targets, in which 95% of all people living with HIV know their status; 95% of these people are on treatment; and 95% of those on treatment are virally suppressed.  In Malawi, approximately 94% of People Living with HIV (PLHIV) are aware of their status, of whom 98% are on antiretroviral therapy (ART), and 94% of those on ART are virally suppressed (UNAIDS Spectrum Estimates, 2023).

Malawi has reduced its HIV prevalence by half, to less than 8% of individuals aged 15-49, and is now seeing nearly one third of the number of new infections it saw ten years ago and half the number of AIDS-related deaths in Malawian communities (https://www.unaids.org/en/resources/documents/2023/2023_unaids_data).  Due in part to our long-term investments in health in Malawi, life expectancy has increased from 44 years in 2000 to 65 years in 2020.

PEPFAR is expanding HIV interventions for children, adolescents and young women aged 15-29, men, and the newly identified sub-population of people who inject drugs for high impact.  Program activities will aim to increase access to HIV testing, and referral for prevention or treatment.  PEPFAR is procuring long-acting Cabotegravir injectable Pre-exposure prophylaxis (PrEP) (CAB-LA).  Malawi is one of the first countries outside of the U.S. to offer injectable PrEP with joint support from the Bill and Melinda Gates Foundation.  Improving access to quality client-centered care, scaling access to viral load monitoring, as well as access to near-real time data and health systems strengthening will continue to be priorities for the program.

PEPFAR remains the largest commitment by any nation to address a single disease in the world.