By: Doug Fountain, Executive Director, Christian Connections for International Health, with Dr. Samuel Mwenda, General Secretary, Christian Health Association of Kenya, and Dr. Tih Pius Muffih, Director of Health Services, Cameroon Baptist Convention Health Services

The President’s Emergency Plan for AIDS Relief (PEPFAR) became a beacon from the U.S. to the world; a light that ameliorated the darkest days of the HIV/AIDS epidemic. But its fate is in question.

Nineteen years ago today, my family and I arrived in Uganda to work at a local University. Among the many joys we anticipated was connecting with Grace, a student, who had visited our church in the U.S. Nobody could tell us where she was and why she hadn’t responded to our messages. I vividly remember a mutual friend coming to our door, informing us our friend had just died from AIDS. We had no idea she was sick; it was kept a secret from us, the University, and her church. She suffered in silence, with no medicine and no hope. I was angry — in our community, was there no light for her in this dark time?

This year marks PEPFAR’s 20th Anniversary. This is something that all people, especially Christians and people of faith, should celebrate. PEPFAR is one of the most successful health and social investments made by the U.S., responsible for saving more than 25 million lives. Because of PEPFAR, more than 20 million people receive regular life-saving treatment, and more than five million babies were born HIV-free to mothers living with HIV. PEPFAR has provided care to over seven million orphans, vulnerable children, and their caretakers.

Like many faith-based organizations (FBOs), Christian health programs meet the needs of underserved people, those who live in remote areas, or both. These programs care for people affected by AIDS and prevent the spread of HIV by promoting health and improving timely access to quality health services. For many of us who have worked for decades in HIV/AIDS, we owe a lot to the partnership with PEPFAR.

Part of PEPFAR’s success is the early inclusion of and partnership with the faith community. From rallying support to authorize PEPFAR in 2003 to implementing programs addressing stigma, encouraging testing, providing medications, providing hope, and preserving human dignity, organizations like the Christian Health Association of Kenya (CHAK), and the Cameroon Baptist Convention Health Services (CBCHS) quickly rose as integral to PEPFAR’s journey. We wanted to share our perspectives about PEPFAR when it is up for reauthorization.

Since 2004, PEPFAR support in Kenya has helped prevent new HIV infections, reduced HIV/AIDS-related deaths, changed the lives of thousands of orphans and vulnerable children, and provided life-saving treatment and care to millions of Kenyans living with HIV.

FBOs were among the first responders to the AIDS pandemic despite an extremely gloomy outlook. Today, through PEPFAR funding, FBOs provide life-saving services to thousands of marginalized and disadvantaged people living with HIV/AIDS.

Dr. Joseph Wahome Mukundi, Acting Chief Officer of Health, Meru County, Kenya, waves a flag at an event marking the graduation of 101 HIV-Exposed Infants from a program supported by USAID and PEPFAR. All the graduating infants were confirmed to be HIV-negative at 18 months.Credit: CHAK

Through PEPFAR funding, CHAK reaches 92,750 poor and vulnerable Kenyans living with HIV, providing lifesaving antiretroviral therapy (ART) in 238 health facilities. CHAK supports 8,574 orphans and vulnerable children and has reached 77,591 women attending antenatal care with services to prevent mother-to-child transmission. The CHAK HIV/AIDS program is designed to accelerate progress toward epidemic control.

The impact of CHAK’s contribution to HIV/AIDS services in Kenya proves that engaged faith communities are vital for long-lasting gains in the health and well-being of all communities most impacted by HIV. Renewing PEPFAR would enable faith-based organizations such as CHAK to reach more highly at-risk groups with lifesaving services.

In Cameroon, PEPFAR funding through the CBCHS helped reduce prevalence from 8.7 percent in the Northwest and 8.6 percent in the Southwest to 4.3 percent by 2015. PEPFAR investments were subsequently extended all ten regions of the country, feeding a decline in HIV prevalence from 5.5 percent in 2015 to less than 2 percent in 2023. A substantial drop in HIV-related stigma and discrimination accompanied the decline in HIV prevalence. 

The CBCHB, an FBO, was Cameroon’s first PEPFAR implementing partner. This partnership laid the foundation for further PEPFAR and global funding to fight other disease outbreaks. PEPFAR funding helped Cameroon fight the COVID-19 pandemic by offering testing opportunities, transporting samples to testing centers, and protecting health workers. 

FBOs are excellent implementing partners to Ministries of Health and funding organizations because they work closely with the local communities and have earned their trust. The people of Cameroon report they are “truly grateful to the U.S. Congress for approving PEPFAR funding to Cameroon; we pray the U.S. Congress increases its funding to receiving countries and extends its reach to new populations.”

The life-saving work of CHAK and CBCHS is evidence that PEPFAR is working as intended when President George W. Bush launched the program 20 years ago. By reauthorizing the program, Congress will reaffirm the American values that every individual has worth and dignity. A clean reauthorization of PEPFAR will stoke that flame to shine all the brighter, providing hope for countless others like Grace.  

Doug Fountain is Executive Director of Christian Connections for International Health (CCIH), a global network of Christian organizations and individuals committed to advancing health and wholeness operating in more than 90 countries. The Christian Health Association of Kenya coordinates health services for 501 health facilities throughout Kenya, and the Cameroon Baptist Convention Health Services works in over 119 health facilities. Grace, mentioned above, is not our friend’s real name.