The U.S. does not have a program to the scale of PEPFAR. De Lay points to communication difficulties between the federal government and states in coordinating a large-scale response as a reason a program of that size doesn’t exist domestically.
“You see a lot of diversity across the states as to how seriously they take their charge,” De Lay says.
In D.C., which has gained a national reputation as the HIV capitol, 2.7 percent of the population is living with the virus. The World Health Organization’s standard for a medical epidemic is 1 percent.
However, the District has also emerged as a leader in implementing HIV strategies and treatments.
In 2011, Mayor Vince Gray initiated a program to offer free HIV tests at a DMV location, as well as at the city services office in Southeast.
According to the the city’s latest epidemiology report, 89 percent of those diagnosed with HIV used the city’s care services in the last year.
Experts believe the world looks to the U.S. for new breakthroughs in treatments because of resources that allow programs like D.C.’s to exist.
“Also, they look to the United States for diagnostics, laboratory, making delivery to treatments safer and more effective,” De Lay says.
More than medical discoveries though, De Lay says in order to make an AIDS-free generation a reality, the grass roots commitment the U.S. has led to educate communities must continue.
“The U.S. is also seen as the founding of true AIDS activism, he says, “And, I think it will always be acknowledged for that.”