Reform and Renewal: Five Recommendations for PEPFAR
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[Excerpt]
Recommendation Five: Leverage Digital Technologies and the Private Sector for Sustainability
Technological innovation and private sector partnerships offer significant opportunities to enhance PEPFAR's impact on global health. Artificial intelligence can play a transformative role to enhance program quality improvements by optimizing resource allocation, improving decisionmaking, predicting disease trends, and identifying service gaps in the HIV response.
Studies have demonstrated that electronic medical record (EMR)–based machine learning models can accurately predict likelihood of HIV acquisition, retention in care, and viral suppression. These models have been effectively utilized as clinical decision support tools to improve outcomes across the HIV care continuum.30 These insights enable governments and partners to allocate resources more efficiently, improving the timeliness and effectiveness of interventions, while also reducing costs associated with cycling in and out of care and health system costs linked to missed HIV diagnoses. AI-driven data models can also help identify at-risk populations, enabling the efficient, targeted deployment of HIV prevention modalities preventing lifelong reliance on treatment.
AI-driven solutions can empower national governments to enhance real-time, populationlevel monitoring of HIV program outcomes to quickly identify the most efficacious interventions, enabling faster identification of trends, disparities, and gaps in care. By automating data collection, analysis, and reporting, AI reduces reliance on manual data processing, leading to significant cost savings and allowing resources to be redirected toward direct service delivery and patientcentered interventions. Additionally, collaborations with healthcare innovators and pharmaceutical companies can leverage AI-powered digital health platforms to expand access to life-saving tools, such as long-acting HIV prevention and treatment technologies. These platforms streamline patient management, enhance telehealth services, and ensure continuity of care, particularly in remote or underserved regions where skilled human resources are even more scarce.
While AI-driven models have yet to demonstrate definitive cost efficacy at scale, they are rapidly evolving as promising tools for optimizing HIV program implementation. When integrated with PEPFAR’s large-scale funding and infrastructure, these technologies have the potential to enhance efficiency, reduce administrative burdens, and drive measurable impact across the HIV care continuum.
Private sector mobilization must be central to sustaining global health efforts by unlocking new funding sources and driving innovation to accelerate the HIV response. Strategic investments from development finance institutions, social impact funds, and technology partners are critical to scaling key interventions. PEPFAR can catalyze a robust private sector role, empowering countries to build resilient health systems that sustain HIV prevention and treatment gains long after direct funding ends.
The private sector plays a crucial role in driving innovation and sustaining global health progress. Its involvement is essential for accelerating HIV prevention and treatment advancements, particularly through emerging technologies like artificial intelligence and digital health platforms. Looking ahead, private sector leadership will be vital in developing next-generation solutions, including future vaccines. The success of Operation Warp Speed demonstrates how publicprivate partnerships can fast-track vaccine development. A similar initiative for HIV could revolutionize prevention and treatment, ensuring rapid innovation and broad access worldwide.
