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TechnoratiAt a 22-bed clinic run by Living Hope, a church-based charity near Cape Town, 85 percent of patients now survive and only 15 percent die. A few years ago, it was the opposite, says Pat Ball, a retired teacher from North Carolina, and a volunteer at Living Hope.
The acclaimed mothers2mothers organization has expanded from about 40 locations around Cape Town to nearly 500 in seven African countries thanks to PEPFAR cash. Its network of more than 1,000 HIV positive women are trained as "mentor mothers" and paid to counsel the newly infected and ensure they and their babies stay healthy. Thanks to the growing provision of AIDS drugs to pregnant women, few babies in the m2m network are now born with AIDS, says co-founder Gene Falk.
In big South African government clinics, there is palpable optimism that AIDS infected newborns could become history.
Children are especially vulnerable as they are harder to diagnose and quickly pass the point beyond which medication can help.
In a sunny room furnished with toys and a play kitchen at the Soweto Hospice in Johannesburg, dying children are given a chance to enjoy what remains of their life.
"We want to give them their childhood back," said Louisa Ferreira, director of the nine-bed pediatrics unit funded by PEPFAR. "The hospice is not about death. It's about life."
PEPFAR says its programs have helped care for nearly 4 million orphans and vulnerable children.
One of them is Frans Dobola, who at age 13 lost his parents to AIDS. Heartbeat, an organization helping AIDS orphans with $750,000 in PEPFAR grants, trained a neighbor to act as his foster mother, provided a daily meal, and an after-school program.
Dobola, 20, now works at Heartbeat, in a township near the South African capital, Pretoria, and dreams of a job in computers. Meanwhile, he grows beets and tomatoes at the after-school center's garden and gives poetry and dance lessons.
"I am giving back to the community what they gave me," he says, smiling.
South Africa is also the biggest single recipient of PEPFAR money — $590 million last year, more than it received during the entire eight-year Clinton administration, according to U.S. ambassador Eric Bost.
After years of denial about the AIDS crisis by former President Thabo Mbeki, the new government is finally serious about tackling the epidemic.
Francois Venter, an outspoken doctor who heads a PEPFAR-funded program at the University of the Witwatersrand in Johannesburg, says because of its emphasis on measurable targets, "PEPFAR is different."
"A lot of previous donor projects were touchy-feely, fuzzy," says Venter, adding that U.S. funding helped boost the number of South Africans on medication to 700,000.
But with 2.5 South Africans becoming newly infected for every one put on treatment, Venter says that prevention remains a "black hole."
Supporters and critics alike agree that prevention is the weakest link in global AIDS initiatives. When he launched PEPFAR, Bush said he wanted to prevent 7 million new infections but it is hard to tell whether that goal has been met.
PEPFAR says its funds have provided drugs to 250,000 pregnant women to prevent them passing on the AIDS virus in the womb. In countries like Uganda, babies born with the AIDS virus still account for 15-25 percent of new infections and so the increase in therapy to stop mother-to-child transmission offers one of the few rays of hope in an otherwise bleak prevention outlook. Continue »
David Ben-Ariel »
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