Abstract

This paper investigates the impact of the President’s Emergency Plan for AIDS Relief (PEPFAR) on HIV incidence and treatment outcomes across 11 sub-Saharan African countries from 2004 to 2018. As one of the largest bilateral health aid initiatives globally, PEPFAR’s effectiveness in curbing HIV infections remains an important empirical question, particularly in regions with high youth and female HIV prevalence. Using a panel dataset and country fixed effects models, this study examines the relationship between PEPFAR aid per capita and two key outcomes: HIV incidence and access to antiretroviral therapy (ART). Results indicate that while PEPFAR funding has no significant impact on the general population, it substantially reduces HIV incidence among youth aged 15–24, especially young women. Additionally, male education is found to lower HIV prevalence in both men and women, highlighting the role of gender dynamics in HIV risk. The analysis also shows that PEPFAR significantly improves ART coverage for pregnant women, aligning with its targeted maternal and child health initiatives. However, broader treatment access remains unaffected, suggesting limitations of vertical aid programs in addressing systemic healthcare needs. These findings underscore the importance of directing resources toward vulnerable groups and incorporating gender-sensitive strategies. They also highlight the need for long-term investment in health systems to sustain progress. This study contributes to the literature on aid effectiveness and informs future global health policy on optimizing disease-specific interventions within broader development goals.

 

How to Cite:

Paing, S., Mohamed Azman, A., Clarke, A., Lazur, Z. & Wincey, A., (2025) “The Impact of PEPFAR on HIV Incidence and Treatment in Sub-Saharan Africa”, UCL Journal of Economics 4(1). doi: https://doi.org/10.14324/111.444.2755-0877.2076