Member Spotlight: Leila Nimtallah of First Focus on Children
The Global AIDS Policy Partnership is made stronger by the contributions of each one of our 70+ members. As part of our ongoing Member Spotlight blog series, we recently interviewed Leila Nimtallah, the Vice President of Advocacy and Mobilization at First Focus on Children and a convening member of GAPP.
Can you tell us a little bit about your organization?
I work for First Focus on Children and its sister organization, First Focus Campaign for Children. We believe that children are too often left behind in the public discourse, and we’ve worked to change that since 2005. Our mission is to prioritize children’s issues at the federal level in terms of funding and policy.
What specific issues does First Focus on Children prioritize, and how is your organization involved in the fight against HIV/AIDS?
First Focus on Children is very holistic in the way it looks at child well-being. We focus on issues from nutrition and food security to health, education, and early childhood. HIV/AIDS is a major focus for our global work; we prioritize HIV/AIDS and Orphan and Vulnerable children in the authorization and funding process.
Globally, we also prioritize early childhood development, basic education, clean water and sanitation, nutrition, maternal and child health, infectious disease prevention and control, and humanitarian funding.
Our signature project is the annual Children’s Budget Book, which looks at how much the U.S. government invests in children and child well-being both domestically and globally. We have consistently found that despite the fact that children make up 30-50 percent of many countries’ populations, they only receive about 9 percent of our foreign aid funding resources. Both domestically and globally, children are thought of last and receive the least.
How does PEPFAR factor into your work in children’s well-being?
PEPFAR has done really groundbreaking work for children, and, when that work began, it was way ahead of its time. The program provides much more than medical services for pediatric HIV/AIDS — through its Orphans and Vulnerable Children (OVC) set-aside, it addresses the unique socio-economic and health impacts of HIV on children. For example, it offers psychosocial support to children who are orphaned or otherwise vulnerable because of the virus. Children who are impacted by HIV/AIDS tend to struggle when it comes to meeting developmental milestones, and PEPFAR helps by supporting early childhood development and access to education and nutrition, as well as supporting their caregivers with access to livelihoods. These wrap-around interventions keep families together and protect vulnerable children from becoming HIV-positive, and if they are already HIV-positive, it connects them to treatment services to keep them alive and healthy.
Over the years, there have been a number of attempts to do away with the OVC set-aside from folks who think this kind of support for children isn’t needed anymore (they argue that people are living longer with HIV and no longer leaving behind orphans). This is untrue. There are still roughly 13 million children who’ve lost parents to HIV/AIDS — and PEPFAR reaches about 7 million of them (along with their caregivers). This is fantastic and groundbreaking work, but millions of children are still not being reached. Instead of ending OVC programs, we should be learning from their success and expanding their reach. Efforts to remove the 10 percent set aside for OVC within PEPFAR and the fact that pediatric treatment levels still lag far behind adults are just two more examples of how kids are being left behind.
Do you have any specific memories that reflect PEPFAR’s impact?
I’ve visited a few OVC programs that are funded by PEPFAR, and that’s something I will never forget. In my work, I pull from the inspiration of those young people I was able to meet — seeing their strength and their hope enabled me to bring some of that back to what I do here in D.C. Seeing the children and the families that are supported and doing really well, I felt privileged to have the opportunity to advocate for them here.
We’re now four decades into the HIV/AIDS epidemic. What gives you hope?
A lot of people say this, but the progress really is amazing. For those of us who remember the days when HIV was a death sentence, when there were millions of households headed by children because their parents had died from AIDS, when we were fighting for generic antiretroviral medications to be available in poor countries, it’s obvious that the status of the epidemic today is just light years away from that. We’ve lost millions of people along the way, but there’s hope of ending this disease.
It also gives me hope that this effort has been bipartisan from the start. The effort to end HIV/AIDS has brought out the best in humanity, but there’s so much more to do. We know how to end the epidemic, and we have to maintain that fantastic momentum that we have all created together.
What is the biggest challenge we still face in ending HIV/AIDS?
We have to overcome complacency. HIV/AIDS isn’t every nation’s fastest burning fire nowadays, but it is a huge health burden for low- and middle-income countries. Nations that are further along in ending the epidemic must keep working to help others. We have to keep educating elected officials about how far we’ve come and what needs to happen going forward.
Earlier this year, PEPFAR received a one-year reauthorization. Do you think a multi-year reauthorization is still essential?
Yes, for two reasons: first, the one-year reauthorization has created a lot of anxiety among our partners on the ground in Africa. Those implementing these programs need to be able to plan long-term, not year-to-year. The lack of a multi-year reauthorization makes a lot of people worry that PEPFAR is going to end, and it can undermine our long-term progress.
Second, a clean five-year reauthorization can help protect PEPFAR from the volatility of politics. When I’m traveling and I share with people that I’m American, I’m very proud of the fact that we’re the biggest donor globally in terms of HIV. We’ve been doing this now for two decades because it’s the right thing to do as well as the smart thing to do. That’s what PEPFAR is about, and we should do our best to keep it separate from our political agendas.
If you could speak directly to government decision-makers about the fight against HIV/AIDS or about PEPFAR, what would you say?
That they absolutely, positively must reauthorize PEPFAR. There should be no more of this one-year or two-year stuff, no more room for doubt. They need to reauthorize it cleanly for five years and do so continuously going forward, and ensure it is not subject to politics or to unfounded questions about whether it’s supporting activities that are illegal for it to support. These things are not happening. PEPFAR is perhaps the most successful global foreign assistance program that the United States has ever created, supported, and funded. We must continue to do so because it helps others and it’s good for us too.
Why do you think it’s important for organizations in the fight against HIV/AIDS to be a part of the Global AIDS Policy Partnership?
I’ve been part of GAPP for many years now, and I’ve learned a lot from HIV advocates during that time. GAPP has a very diverse coalition, and the members are incredibly smart, strategic, and courageous. Over the years, they’ve provided me with up to date intelligence and information and helped me become a better advocate, even in other spheres of my life. It’s extremely valuable to be a part of this coalition.