This is an average of the three domain scores below.
The U.S. Government (USG) received an 89 (B+) with transparency and a 94 (A-) without transparency in the HIV and AIDS domain across all actors in 2022. This grade reflected the continued commitment of the USG to support the President’s Emergency Plan for AIDS Relief (PEPFAR) to implement programs that were based in evidence, consistent with international human rights norms, and responsive to need. However, the majority of PEPFAR actions graded across actors in 2020 were gender accommodating and not gender transformative. All actors received low or moderate transparency scores for actions graded in the HIV and AIDS domain. Budget scores were relatively high across actors where budget data were available, and transparency of funding information was high for all actors except the Department of Defense (DoD). For the first time, funding information was available for the Department of Health and Human Services (HHS), which had a positive impact on overall scores. Consistent with previous years, the domain grade for HIV and AIDS was higher than the Maternal and Child Health and Family Planning domains across actors in 2022.
The White House received a 92 (A-) with transparency and a 95 (A) without transparency in the HIV and AIDS domain in 2022. The White House requested full funding for global HIV and AIDS programs through the Global Fund to Fight AIDS, Tuberculosis and Malaria as well as the President’s Emergency Plan for AIDS Relief (PEPFAR). Generally, actions graded in this domain meaningfully prioritized global HIV and AIDS programs, which supported the ability of U.S. global health assistance to promote SRHR in the HIV and AIDS domain. The White House demonstrated moderate levels of transparency across actions and funding information in this domain. In alignment with previous years, HIV and AIDS was the highest scoring domain for the White House in 2022.
Congress received a 96 (A) with transparency and a 99 (A+) without transparency in the HIV and AIDS domain in 2022. Congress appropriated full funding for the President’s Emergency Plan for AIDS Relief (PEPFAR) and The Global Fund to Fight AIDS, Tuberculosis and Malaria. Congress demonstrated high levels of action and funding transparency related to HIV and AIDS globally in 2022.
The Department of State received a 92 (A-) with transparency and a 99 (A+) without transparency in the HIV and AIDS domain in 2022. This domain grade was raised by the PEPFAR Five Year Plan, as well as the updated pre-exposure prophylaxis (PrEP) Ring Frequently Asked Questions (FAQs), which were both responsive to need, based in evidence, and aligned with human rights principles. However, subsequent edits to the Five Year Plan did not promote SRHR, and were not based in evidence or responsive to need, and thus negatively impacted the HIV and AIDS score. Actions graded in this domain were mostly gender accomodating, and could have included more gender transformative elements. In the budget evaluation, the Department of State allocated HIV and AIDS funds in accordance with country-level HIV incidence, which significantly promoted SRHR. Transparency was relatively low across actions but moderately high with regard to budget data in the HIV and AIDS domain.
USAID received an 88 (B+) with transparency and a 91 (A-) without transparency in the HIV and AIDS domain in 2022. Actions that promoted SRHR included the Approach to HIV and Optimized Programming Report and the Implementation Plan for the US Strategy to Prevent and Respond to Gender-Based Violence Globally. Overall, transparency was low for many actions graded in this domain because USAID did not indicate which content had been updated from previous versions. USAID scored high for transparency of funding data and disbursed HIV and AIDS funding was highly responsive to need in 2022.
HHS received a 78 (C+) with transparency and a 86 (B) without transparency in the HIV and AIDS domain in 2022. This domain grade was raised by the Global Health Equity Strategy which was evidence-based, aligned with human rights, and responsive to need. The newly released strategic plan for FY 2022-2026 and the General Terms and Conditions for Research and Non-Research neither promoted nor hindered sexual and reproductive health and rights (SRHR) because it was unclear whether these actions were relevant to the HHS’ global HIV and AIDS programs. The National Strategy for Combating Multi-Drug Resistant Tuberculosis moderately hindered SRHR as it did not mention the sex-disaggregation of data despite the fact that gender is a key aspect that informs tuberculosis intervention strategies. HHS had a high level of transparency for funding data for the first time this year. Funding data was available during the time of grading and HIV and AIDS funding was disbursed in a way that was highly responsive to need, which increased this actor’s grade in this domain in 2022.
DoD received a 65 (D) with transparency and a 74 (C) without transparency in the HIV and AIDS domain in 2021. The updates to the HIV in Military Service Members Policy to allow for enlistment of sero-positive Military Service members moderately promoted sexual and reproductive health and rights (SRHR). The other three actions that were graded lacked specific information about the contributions of the DoD’s global HIV and AIDS programs to global health security efforts, the United States government (USG) global water strategy, and the implementation of the Women, Peace, and Security (WPS) Agenda. The lack of detail in the actions along with the unavailability of budget information contributed to the low transparency score in the HIV and AIDS domain in 2022.