KFF updates: Assessing PEPFAR’s health, economic and educational spillover effects

Assessing PEPFAR’s health spillover effects beyond HIV: An update

A new KFF analysis updates earlier work that assessed whether PEPFAR, the U.S. global HIV/AIDS program credited with saving 26 million lives, had health impacts beyond HIV. Specifically, the earlier analysis found that PEPFAR investments were associated with significant improvements in all-cause mortality and maternal and child health measures between 2004 and 2018, positive spillover effects that suggest the program has had a greater impact than for HIV alone; this was the case even though PEPFAR funding has been relatively flat for more than a decade. The current analysis updates these estimates through 2022 to capture additional years of data as well as the potential impact of the COVID-19 pandemic, which more broadly affected health and development. It similarly finds that PEPFAR was associated with continued health gains, especially for mortality outcomes. Moreover, where COVID-19 seems to have had a temporary impact, it did so across all countries, not just those receiving PEPFAR support. The findings suggest that more recent changes to the PEPFAR program by the Trump administration, including significantly scaling back funding and services with plans to further do so in the coming years, could not only have negative impacts on the HIV response, but dampen improvements in other health areas.

Assessing PEPFAR’s economic and educational spillover effects: An update

A new KFF analysis updates earlier work that assessed whether PEPFAR, the U.S. global HIV/AIDS program credited with saving 26 million lives, had impacts beyond health. Specifically, the earlier analysis found that PEPFAR investments were associated with a significant increase in the GDP per capita growth rate and reductions in the shares of girls and boys who were out of school between 2004 and 2018, positive spillover effects that suggest the program has had a greater impact beyond health alone; this was the case even though PEPFAR funding has been relatively flat for more than a decade. The current analysis updates these estimates through 2022 both to capture additional years of data as well as the potential impact of the COVID-19 pandemic, which severely affected the global economy and resulted in widespread school closures. It similarly finds that PEPFAR was associated with continued improvement in these non-health indicators. The findings suggest that more recent changes to the PEPFAR program by the Trump administration, including significantly scaling back funding and services with plans to further do so in the coming years, could not only have negative impacts on the HIV response, but dampen improvements beyond health.