PEPFAR’s first iteration failed to invest in strengthening civil society organizations’ long-term response to HIV/AIDS, in large part because the program was designed to respond to immediate health care needs. Now that the program is more established, and community-based health sector organizations are typically much better prepared to respond to epidemics within marginalized populations such as MSM, PEPFAR should focus on investing in such institutions, as well as in educational and legal groups that are equally critical to assuring long-term success.
The Centers for Disease Control and USAID should, in coordination with the State Department, place more emphasis in future funding cycles on awarding grants to organizations operating in PEPFAR-funded countries, since these groups have specific experience working with marginalized populations in those countries. These agencies should also allocate PEPFAR funds as necessary to building capacity among these organizations to ensure sustainability. These groups are needed as long-term partners in the fight against HIV/AIDS, and the United States and other funding partners need to build their capacity for this ongoing work.
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