Reducing the spread of HIV/AIDS is a priority for U.S. Africa Command because of the disease's destabilizing effect to African nations, according to AFRICOM's civilian deputy Ambassador J. Anthony Holmes, August 17, 2011.

U.S. Africa Command hosted its first HIV/AIDS Program Management Training, implemented by the Department of Defense HIV/AIDS Prevention Program (DHAPP), August 15-19. The event brought together program managers from more than 30 African nations to coordinate planning and funding of national HIV/AIDS programs among African militaries.

Addressing concerns that budget cuts by the U.S. Department of Defense would affect the national HIV/AIDS initiatives in African countries, Holmes told attendees their programs are high priorities. He added that DOD budget cuts should not directly affect their national programs, since they are funded separately through two different agencies, including and the Defense Health Program (DHP), and the President's Emergency Plan for AIDS Relief (PEPFAR), which accounts for approximately 90 percent of DHAPP's funding.

Because the majority of funding comes from PEPFAR, not from Defense Department funding, these military-to-military HIV/AIDS programs will not be compared with other hard military priorities when budget trade-offs are made. Rather, it will be compared to other HIV/AIDS programs within the U.S. government.

"In a time of budget crisis, we, the military, have to focus on highest priorities and core missions, and a lot of secondary priorities and peripheral issues will be getting less money, or in a few cases will be eliminated completely," Holmes stated. "But I want to assure you that the DHAPP program and the military-to-military HIV/AIDS program is not in that category."

Holmes also told the group that DHAPP's long history and measureable success "constitute an irrefutable case to be made to those allocating funding."

One such success story was told by Eugene Zimulinda, DOD PEPFAR manager in Rwanda, who said that the program has helped to increase awareness among troops, build capacity, increase infrastructure development, and improve HIV/AIDS treatment and care in military communities.

"In my country, before the PEPFAR program, DHAPP, the prevalence rate [of infection] was above 10 percent," he said. "As I speak, the prevalence now is just 4 percent. I attribute this to our activities thanks to the DHAPP program."

Zimulinda emphasized the importance of raising awareness among military members, whose rates of infection are as high, and often higher, than the civilian population.

"As you all know, force readiness depends on the health of the military," he said. "And a proactive response is required to ensure that advances through access of activities are prioritized for the active duty force."

The effects of HIV/AIDS extend much further than the health implications, according to AFRICOM officials. The epidemic also threatens national security by reducing military readiness, limiting deployments, and hindering a military's ability to support regional response and peacekeeping activities.

"We at the [AFRICOM] headquarters view the spread of HIV/AIDS and the HIV/AIDS problem broadly," said Captain Edward A. Bradfield, U. S. Africa Command's regional chief for West and Central Africa. "It's not just a social or a health issue but also one that bears on national security."

U.S. Africa Command's Command Surgeon Colonel (Doctor) Bob Miller identified three major focus areas relating to HIV/AIDS: force health protection, education, and working with African partners to build medical capacity and capabilities. "Our (Office of the Command Surgeon) motto, 'Stability Through Health,' sets the stage for everything. We truly believe those two are linked," he said.

"At the end of the day, if we're helping everyone--children, pregnant women, military, the whole population--then we're achieving that goal of creating stability through health."

U.S. Africa Command supports African militaries in establishing HIV/AIDS prevention programs through its Partner Military HIV/AIDS Program (PMHAP), which provides strategic guidance and oversight to the DoD HIV/AIDS Prevention Program (DHAPP). Together, these programs aim to reduce the spread of HIV/AIDS among military personnel in African nations.

During fiscal 2010, U.S. Africa Command's programs reached over 409,000 African troops and family members with prevention messages, and provided counseling and testing services for 210,000 service members and their families. In addition, 1,100 peer educators and 3,000 health care workers have received HIV/AIDs training. Over 37,000 individuals are on antiretroviral treatment as a result of these collaborative efforts. The fight against HIV/AIDs in Africa is having an impact. A leader of a southern African country remarked that, three years ago, he was conducting burials every day for an HIV-related death; however, today he conducts one burial every eight to ten days.

Additional indicators of program success include: 2,431 males have been circumcised as part of HIV prevention efforts; 84,731 eligible adults and children were provided with at least one care service visit; 52,101 HIV-positive adults and children received at least one clinical service visit; and 34,018 HIV-positive persons received cotrimoxazole prophylaxis.

"We're winning this battle," said Richard Shaffer, director of DHAPP. "There are now militaries which have less HIV in them than they did when we started this program. There are militaries whose HIV rates should have gone up but didn't since we started this program. There are militaries that have been in conflict, and when the conflict stops, their HIV rates aren't going up. There are militaries who are being able to provide additional healthcare support to not only the military members but also the surrounding civilian communities because of this program."

Throughout the week, attendees listened to briefings on HIV/AIDS prevention, counseling and testing, and new advances in care and treatment, and participated in seminars to discuss program planning, budgeting, and reporting.

PMHAP, implemented through DHAPP, is a key agency of the President's Emergency Plan for AIDS Relief (PEPFAR), the U.S. response to the global HIV/AIDS pandemic. Through PEPFAR and the Office of the Secretary of Defense, prevention programs have been established in over 40 African nations.