At the time that PEPFAR was conceived of and then established during the George W. Bush administration, the world was witnessing first-hand the destruction of an entire generation of individuals in the prime years of their lives and the reversal of remarkable health and development gains, particularly in sub-Saharan Africa and to a lesser extent in other developing nations. Rates of new HIV infections were rising rapidly, and hospitals, communities, and families were often too under-resourced and overwhelmed to cope with the enormity of this burden. At that time in 2003, despite the availability of life-saving antiretroviral therapy (ART) in most countries in the developed world, in southern Africa and other regions of the developing world, an HIV diagnosis meant a virtual death sentence, since few had access to such drugs.
Today, as we mark the 10th anniversary of PEPFAR, the situation has changed dramatically. MORE


![Women wait outside the maternity ward in Mweso, Congo's hospital May 12, 2010. [AP File Photo]](http://blogs.state.gov/images/Dipnote/behind_the_scenes/2011_0429_congo_women_m.jpg)