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President's Emergency Plan for AIDS Relief (PEPFAR)

T-shirt at an AIDS event

In Ethiopia, HIV prevalence is estimated at 1.5 percent overall and in urban prevalence is 4.2 percent. These rates are largely driven by a lack of awareness, mobility and risky behavior in most-at-risk populations. We build upon PEPFAR’s successes, focusing on developing sustainable country programs through key programmatic areas: prevention, support for those affected by HIV and AIDS, care and treatment, and health systems.

The PEPFAR prevention program in Ethiopia focuses on prevention of mother-to-child transmission, persons engaged in high-risk behaviors, and discordant couples. It also addresses critical gender issues that exacerbate the HIV problem, including early marriage, sexual coercion, and cross-generational sex. The prevention of mother-to-child transmission program provides support to the Government of Ethiopia to prioritize integration of HIV and AIDS within maternal and child health services and extends integration through the deployment of over 3,000 urban health extension workers. PEPFAR also continues to strengthen coordination of HIV counseling and testing programs in urban, peri-urban, and selected rural “hot-spots.”

Prevention of mother to child transmission of the HIV/AIDs virus is one of the priorities for USAID's PEPFAR projects

USAID

It is estimated that there are 4.2 million orphans in Ethiopia, of which 18 percent were orphaned due to HIV/AIDS. Orphans and vulnerable children are at increased risk for neglect, abuse, malnutrition, poverty, illness and discrimination, and as they get older, they are more vulnerable to HIV infection. PEPFAR employs a comprehensive and multi-sectoral approach that builds on community and family support structures to care for and track the welfare of affected children. PEPFAR works with the Government of Ethiopia in the nine regions and two city administrations to provide comprehensive and coordinated quality services for 300,000 highly vulnerable children each year.

PEPFAR care, treatment and support activities focus on infrastructure improvement, training, and commodity support including the distribution of basic health care services, nutritional care and support to people living with HIV/AIDS. PEPFAR also supports the national laboratory system, including the procurement of laboratory reagents and supplies for antiretroviral therapy, monitoring, infrastructure support, quality assurance, and site supervision for the National Referral Laboratory and nine regional labs.

Support for health systems strengthening and human resources for health emphasizes: leadership and management of service delivery; human and organizational capacity-building; expansion of private sector engagement; and expanding pre-service training in support of the national plan. PEPFAR continues to work with the National HIV/AIDS Prevention and Control Office to design a community-based system to capture community-level sector inputs into HIV/AIDS activities.

Activities Include

PREVENTION

HIV Prevention for Vulnerable Adolescent Girls: Address social norms that contribute to the transmission of HIV by averting HIV transmission in girls who are married to older men, divorced, or girls who migrate to Addis Ababa.
Behavioral Prevention: Sustain the achievement of the national target to reduce new HIV infections by 90 percent. Prevent new HIV infections among at-risk populations and strengthen linkages to care and support services in towns and commercial hotspots along or linked with major transportation corridors.

TREATMENT AND CARE

Ethiopia Health Infrastructure Program: Design and construct Government of Ethiopia standard health centers and regional warehouses, and renovate health centers experiencing serious infrastructure problems in facilities with high antiretroviral therapy patient loads and in areas of high HIV prevalence.
Food and Nutrition Technical Assistance III: Provide technical assistance in nutrition training at national and regional levels. Provide technical assistance in reviewing and updating national HIV/AIDS nutrition policy and guidelines. Provide therapeutic and complementary feeding for adults and children infected and affected by HIV/AIDS. Advance the nutritional status and quality of life of food-insecure people living with HIV/AIDS and receiving home-based care, antiretroviral therapy, and prevention of mother-to-child transmission services. Support economic strengthening activities for HIV-affected households that are also food-insecure. See also: Nutrition
Yekokeb Berhan Program for Highly Vulnerable Children: Reduce vulnerability among children and their families by strengthening systems and structures to deliver quality essential services and increase resiliency, building on strengths at the family, household, community, and government levels.