AIDS relief funding in Kenya associated with decreased infant mortality

August 6, 2018, Yale University
AIDS relief funding in Kenya associated with decreased infant mortality
Credit: Dreamstime

Through the President's Emergency Fund for AIDS Relief (PEPFAR), the United States contributed over $248 million to programs in Kenya between 2004 and 2014, and at the same time, the incidence of child mortality dropped sharply.

But childhood mortality rates also dropped during the same period in many other sub-Saharan countries that did not receive PEPFAR ,

Until now, it had been unknown whether—or by how much—the significant investment actually improved health outcomes and survival rates.

New research by a team of scientists at Yale and Harvard evaluated whether PEPFAR's heavy investments in a Kenyan program to train expecting mothers in HIV prevention in more than 10,000 clinics contributed to reduced . They determined the funding was a significant determinant of the observed mortality drop.

"The United State has spent over a trillion dollars on PEPFAR programs around the world since 2004. This research adds considerable weight to the evidence that this money has been effectively spent to save millions of lives of babies, children and mothers," said Donna Spiegelman, Sc.D., the paper's senior author and the newly appointed Susan Dwight Bliss Professor of Biostatistics at the Yale School of Public Health. Spiegelman did this research while at the Harvard T.H. Chan School of Public Health, with her doctoral student there, Dale Barnhart. The research was presented at the International AIDS Society meeting in Amsterdam in July by Barnhart, and will be presented by Spiegelman at the Joint Statistical Meetings in Vancouver in August.

The researchers used advanced statistical methods to assess whether the amount of PEPFAR funding provided to different provinces in Kenya was associated with increased HIV testing among pregnant women, which is a critical first step in identifying which women need HIV-prevention training in a program known as Prevention of Mother to Child Transmission of HIV.

Ultimately, Spiegelman and her colleagues found that increased PEPFAR funding for the program was associated with both increased HIV testing at the Kenyan clinics and also reduced infant mortality.

Knowing that PEPFAR funding for the health programs has had a real impact on population health provides valuable information to U.S. policymakers who must allocate funds to PEPFAR each year. However, the study also illustrates how regional data on programmatic activities– such as regional funding levels–can be linked to other publicly available data sources in order to conduct rapid, robust program evaluations.

Without access to a package of health services, such as antiretroviral medicines and counseling on optimal breastfeeding practices, it is estimated that 25 percent of children born to HIV-positive mothers will become infected. In low-resource settings, 50 percent of these children die before their second birthday.

Kenya experienced a 32 percent increase in mortality in children under 5 between 1988 and 2003, prompting it to establish the Prevention of Mother to Child Transmission of HIV program, which was subsequently funded by PEPFAR.

Spiegelman said that the team hopes that the research will encourage PEPFAR and other international donors to collect more data on regional programmatic activities and encourage future researchers to consider dose-response models as a feasible and cost-effective option for program evaluations.

Explore further: 15 years later, PEPFAR continues to save lives

Related Stories

15 years later, PEPFAR continues to save lives

January 24, 2018
Experts from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, have penned a New England Journal of Medicine perspective recognizing the United States President's ...

Funding decline for a US government HIV/AIDS initiative raises concerns

May 3, 2016
A U.S. government agency whose mission is to help save the lives of people around the world living with HIV and AIDS has seen a steep drop in funding for an important part of its budget. The finding, from a UCLA study, could ...

Promoting abstinence, fidelity for HIV prevention is ineffective, study finds

May 2, 2016
The U.S. government has invested $1.4 billion in HIV prevention programs that promote sexual abstinence and marital fidelity, but there is no evidence that these programs have been effective at changing sexual behavior and ...

New IOM report highlights PEPFAR's successes

February 20, 2013
The President's Emergency Plan for AIDS Relief (PEPFAR) has saved and improved millions of lives worldwide and offered proof that HIV/AIDS services can be effectively delivered on a large scale even in countries with high ...

740,000 lives saved: Study documents benefits of AIDS relief program

May 15, 2012
The U.S. President's Emergency Plan for AIDS Relief, the government's far-reaching health-care foreign aid program, has contributed to a significant decline in adult death rates from all causes in Africa, according to a new ...

Recommended for you

HIV vaccine protects non-human primates from infection

December 14, 2018
For more than 20 years, scientists at Scripps Research have chipped away at the challenges of designing an HIV vaccine. Now new research, published in Immunity, shows that their experimental vaccine strategy works in non-human ...

Roadmap reveals shortcut to recreate key HIV antibody for vaccines

December 11, 2018
HIV evades the body's immune defenses through a multitude of mutations, and antibodies produced by the host's immune system to fight HIV also follow convoluted evolutionary pathways that have been challenging to track.

Eliminating the latent reservoir of HIV

December 7, 2018
A new study suggests that a genetic switch that causes latent HIV inside cells to begin to replicate can be manipulated to completely eradicate the virus from the human body. Cells harboring latent HIV are "invisible" to ...

New research highlights why HIV-infected patients suffer higher rates of cancer

December 5, 2018
AIDS patients suffer higher rates of cancer because they have fewer T-cells in their bodies to fight disease. But new research examines why HIV-infected patients have higher rates of cancer—among the leading causes of death ...

Focus on resistance to HIV offers insight into how to fight the virus

November 30, 2018
Of the 40 million people around the world infected with HIV, less than one per cent have immune systems strong enough to suppress the virus for extended periods of time. These special immune systems are known as "elite controllers." ...

Patients with rare natural ability to suppress HIV shed light on potential functional cure

November 27, 2018
Researchers at Johns Hopkins have identified two patients with HIV whose immune cells behave differently than others with the virus and actually appear to help control viral load even years after infection. Moreover, both ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.