Remarks by U.S. Ambassador Natalie E. Brown at 2023 PEPFAR Uganda Science Summit
Hotel Africana, Kampala | February 1, 2023 (as prepared for delivery)
Good afternoon. I am delighted to join you today at the closing of this year’s annual PEPFAR Uganda Science Summit. It is particularly special because we are also commemorating PEPFAR’s 20th anniversary.
From its founding, PEPFAR Uganda has built the capacity of local partners to support and lead the HIV/AIDS response, with over 85% of all PEPFAR funding going through local implementing partners. Together, we have supported programs at
- health facilities and community clinics, including laboratories;
- trained healthcare workers;
- enhanced disease surveillance, supply chain, health and laboratory information systems;
- built community capabilities; and
- applied data analysis for decision making.
All of this feeds into the PEPFAR 2023 Science Summit on HIV and TB theme, “Following the Science and Sustaining the Gains as PEPFAR Turns 20,” which aligns well with the global PEPFAR@20 commemoration theme — “PEPFAR: 20 Years of Impact.” This occasion invites us to celebrate lives saved, health improved, and hope revived thanks to PEPFAR’s flagship antiretroviral therapy. The hot-off-the-press analysis entitled “Scale-up of HIV Antiretroviral Therapy and Estimation of Averted Infections and HIV-Related Deaths in Uganda between 2004 to 2022” shows how U.S. investments have worked in Uganda, the first country to provide PEPFAR-funded medications to any person in the world. The analysis, published alongside the commemoration of PEPFAR’s 20th anniversary, reveals that from September 2004 to September 2022, the number of persons with HIV infection in Uganda receiving PEPFAR-supported ART increased from about 26,000 to over 1,3 million. Powerfully, it shows us that U.S. investments in Uganda have helped avert 600,000 deaths and prevented 500,000 HIV infections—including 230,000 HIV-negative infants born to HIV-infected mothers. What a remarkable achievement and a remarkable role Uganda has played in this human health history!
The PEPFAR program is not just an HIV and TB program, but also a program that addresses inequity in access to health services. PEPFAR investments have helped countries respond to disease outbreaks and other public health emergencies better and in record times. We saw this during the recent COVID-19 and Ebola outbreaks when we leveraged PEPFAR human resources, laboratories, logistical systems—and especially partnerships, to support the Ministry of Health-led response.
Since my arrival here in Uganda, I have been privileged to travel around the country and interact first-hand with PEPFAR beneficiaries to appreciate how, through this PEPFAR program, we have collectively saved lives. I met Mr. John Robert Engole, the very first person in the world to receive PEPFAR-supported HIV treatment, right here in Kampala at Reach Out Mbuya. Now 53 years old, John is thriving as a parent, as a teacher, as a preacher so many years after starting treatment. Impressively, John continues to have a suppressed HIV viral load, showing that his HIV treatment is working well to preserve his health and to prevent him from transmitting HIV to others. What an extraordinary celebration of life and demonstration of the impact PEPFAR has had on so many lives.
Women and girls in Uganda have also shared their stories with me —how despite gender-based violence and other factors that put them at increased risk of getting HIV, they have been able to avoid acquiring HIV through PEPFAR. Those already infected with HIV are thriving on treatment, and their partners and children have remained HIV negative thanks to PEPFAR-supported Antiretroviral Therapy. This is wonderful news, but regrettably, data shows that adolescent girls and young women have the highest rate of new HIV infection in Uganda, three times that of their male counterparts, which means we must prioritize them in our ongoing fight.
A personal highpoint has been my interactions with teenagers from the National Young People and Adolescent Peer Support” or YAPS program that aims to strengthen peer support interventions for young people living with HIV, providing better health outcomes and quality of life. One young woman told me how she overcame stigma and is now helping fellow young people face life with confidence.
I have enthusiastically attended all three of the Young Positives or Y+ Beauty pageants that have been held while I have been in Uganda. This vibrant and entertaining pageant, designed and implemented by young people, is committed to changing the lives of young people living positively, and to changing how society views those living with HIV.
And this quote from a nurse at a PEPFAR-supported hospital deeply touched me—she said, “I really love my job…identifying HIV positive individuals and linking them to treatment helps stop HIV transmission, which benefits my children and my grandchildren when we achieve an AIDS-free generation.”
In a few minutes, you will hear how PEPFAR has impacted the lives of the kids right over there, who will share their talents. Hearing these stories of impact brings me joy and renewed energy – I hope it will do the same for you.
Each of these individuals and communities —the women, men, , adolescents, parents, health workers–are changing the narrative—and so are you! Now with PEPFAR@20, we need to rededicate ourselves to these people, PEPFAR’s beneficiary individuals and partner communities. Knowledge-sharing platforms like this one, the annual PEPFAR Science Summit, ensure that Ugandan HIV and TB science is rapidly shared and incorporated into evidence-based policies and people-centered services in Uganda and beyond.
As we look toward the year ahead, I would like to emphasize the importance of ensuring equity in HIV and TB research and service delivery. Members of key and priority populations, including the LGBTQI+ community and female sex workers are among a population frequently neglected and stigmatized across all levels of society. But we know that to avert new infections we cannot leave these fellow citizens behind. We must strive to keep ALL people in mind as we work to combat HIV and TB.
We must celebrate today but also commemorate the lives lost and commit to sustaining the responses to HIV and TB in Uganda and around the world. Globally, PEPFAR has registered considerable progress in a dozen high-HIV-burden countries, including Uganda, by making progress toward HIV epidemic control and the 95-95-95 UNAIDS treatment targets. But we continue to face challenges like the back-to-back disease outbreaks we have seen in Uganda since 2020 – including the COVID-19 pandemic, MPOX, and Ebola. So, we continue to leverage PEPFAR investments for disease response for global health security efforts, and we must also continue to innovate and creatively deliver HIV and TB services to underserved populations.
In closing, I would like to note that the U.S. Global AIDS Coordinator and Special Representative for Health Diplomacy Ambassador John Nkengasong has embarked on a journey to reimagine the HIV/AIDS response for the current epidemic. Platforms that generate evidence to improve programs, policies, and person-centered services are critical. I applaud the PEPFAR team for establishing and sustaining this Summit, through which science is rapidly and meaningfully translated into practice—in Uganda and around the world. The end of HIV/AIDS as a public health threat by 2030 is ambitious, but achievable. As President George W. Bush said in his 2003 State of the Union Address to the American people, “…seldom has history offered a greater opportunity to do so much for so many.” For the past 20 years we have, alongside our partners here in Uganda, done so much for so many in this country and around the world, and collectively, we have the power to do much more. Thank you.