In 2003, U.S. President George W. Bush announced the creation of the President’s Emergency Plan for AIDS Relief (PEPFAR) during his State of the Union address. The initiative, driven by Dr. Anthony Fauci, pledged $15 billion over five years to fight HIV/AIDS globally, with a strong focus on the most affected regions, particularly sub-Saharan Africa and the Caribbean. At the time, the epidemic was killing over 8,000 people a day, and access to antiretroviral treatment was minimal in many parts of the world.

PEPFAR marked a turning point in the global HIV/AIDS…