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When People Come FirstCritical Studies in Global Health$
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João Biehl and Adriana Petryna

Print publication date: 2013

Print ISBN-13: 9780691157382

Published to Princeton Scholarship Online: October 2017

DOI: 10.23943/princeton/9780691157382.001.0001

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The Struggle for a Public Sector

The Struggle for a Public Sector

Pepfar in Mozambique

(p.166) 6 The Struggle for a Public Sector
When People Come First

James Pfeiffer

Princeton University Press

The President's Emergency Program for AIDS Relief (PEPFAR) has significantly transformed the global health landscape by injecting $15 billion into HIV/AIDS care and treatment programs in twenty countries between 2004–2010. In Mozambique, PEPFAR funds constituted nearly 60 percent of all health sector planned spending by 2008. While debates about PEPFAR's restrictions on condom promotion, sex worker education programs, and abortion/reproductive health have dominated critiques of the program, perhaps the single most important aspect of PEPFAR's rollout has largely escaped scrutiny in the wider global discussion: PEPFAR funding, by design, does not directly flow through the public sector. This chapter draws on the author's firsthand experience in Mozambique to describe the tension, conflict, and potentials created by new major aid flows to Africa.

Keywords:   President's Emergency Program for AIDS Relief, PEPFAR, global health, international aid, Mozambique

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