Development and Impact of the Global Plan.

The Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive (Global Plan) was transformative, helping drive a 60% reduction in new HIV infections among children in 21 priority countries in sub-Saharan Africa from 2009 to 2015. It mobilized unprecedented political, technical, and community leadership at all levels to accelerate progress toward its ambitious targets. This progress is well documented, many specific elements of which are explained in greater detail across this JAIDS supplement. What is often less well or widely understood are the critical aspects of the Global Plan that shaped its structure and determined its impact; the factors and forces that coalesced to form a deep and diverse coalition of contributing partners committed to catalyzing change and action; and the critical lessons that the Global Plan leaves behind, a living legacy to inform and improve ongoing efforts to achieve its ultimate goals.

Raising the bar: PEPFAR and new paradigms for global health.

The President's Emergency Plan for AIDS Relief (PEPFAR) has spurred unprecedented progress in saving lives from AIDS, while also improving a broad range of health outcomes by strengthening country platforms for the delivery of basic health services. Now, a new endpoint is in sight--an AIDS-free generation--together with the opportunity to change the trajectory of global health through the investments made and lessons learned in doing this work. Less than a decade ago, many experts counseled against scaling up antiretroviral treatment in the developing world. They feared that patients would be unable to adhere to their regimens, that resistant strains of the virus would evolve and prevail, and that the need to sustain daily treatment for millions of people in poor settings would overwhelm fragile health systems. Today, over 6.6 million men, women, and children are on treatment, and incidence is dropping in many of the hardest-hit countries. By adopting a targeted approach to address one of the most complex global health issues in modern history, and then taking it to scale with urgency and commitment, PEPFAR has both forged new models and challenged the conventional wisdom on what is possible. In this article, PEPFAR and its partners are examined through new and evolving models of country ownership and shared responsibility that hold promise of transforming the future landscape of global health.