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The U.S. government supports programs to combat global HIV/AIDS through an initiative that is known as the President's Emergency Plan for AIDS Relief (PEPFAR). This initiative was originally authorized in the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 and focused on an emergency response to the HIV/AIDS pandemic to deliver lifesaving care and treatment in low- and middle-income countries (LMICs) with the highest burdens of disease. It was subsequently reauthorized in the Tom Lantos and Henry J. Hyde U.S. Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (the Lantos-Hyde Act). Evaluation of PEPFAR makes recommendations for improving the U.S. government's bilateral programs as part of the U.S. response to global HIV/AIDS. The overall aim of this evaluation is a forward-looking approach to track and anticipate the evolution of the U.S. response to global HIV to be positioned to inform the ability of the U.S. government to address key issues under consideration at the time of the report release.

Preaching Prevention examines the controversial U.S. Presidents Emergency Plan for AIDS Relief (PEPFAR) initiative to abstain and be faithful as a primary prevention strategy in Africa. This ethnography of the born-again Christians who led the new anti-AIDS push in Uganda provides insight into both what it means for foreign governments to export approaches to care and treatment and the ways communities respond to and repurpose such projects. By examining born-again Christians support of Ugandas controversial 2009 Anti-Homosexuality Bill, the books final chapter explores the enduring tensions surrounding the message of personal accountability heralded by U.S. policy makers.Preaching Prevention is the first to examine the cultural reception of PEPFAR in Africa. Lydia Boyd asks, What are the consequences when individual responsibility and autonomy are valorized in public health initiatives and those values are at odds with the existing cultural context? Her book investigates the cultures of the U.S. and Ugandan evangelical communities and how the flow of U.S.-directed monies influenced Ugandan discourses about sexuality and personal agency. It is a pioneering examination of a global health policy whose legacies are still unfolding.

The US Centers for Disease Control and Prevention, with funding from the US President's Plan for Emergency Relief, implements a virtual model for clinical mentorship, Project Extension for Community Healthcare Outcomes (ECHO), worldwide to connect multidisciplinary teams of healthcare workers (HCWs) with specialists to build capacity to respond to the HIV epidemic. The emergence of and quick evolution of the COVID-19 pandemic created the need and opportunity for the use of the Project ECHO model to help address the knowledge requirements of HCW responding to COVID-19 while maintaining HCW safety through social distancing. We describe the implementation experiences of Project ECHO in 5 Centers for Disease Control and Prevention programs as part of their COVID-19 response, in which existing platforms were used to rapidly disseminate relevant, up-to-date COVID-19-related clinical information to a large, multidisciplinary audience of stakeholders within their healthcare systems.

Since SARS-CoV-2 was first identified, the world has witnessed more than 641 million confirmed cases of COVID-19, resulting in more than 6.6 million deaths (1). CDC collaborates with partners in the interdependent global public health ecosystem to strengthen the systems needed for disease surveillance and reporting, diagnostic testing, outbreak and pandemic responses, and clinical service delivery, including treatment, immunizations, and infection prevention and control. [...]the Stop Transmission of Polio (STOP) Program, a collaboration between CDC, the World Health Organization, and the United Nations Children’s Fund (UNICEF) that has recruited, trained, and deployed international public health professionals since 1998 to strengthen national immunization systems for polio eradication and the control and prevention of all vaccine-preventable diseases, also supported COVID-19 response activities (8). Vietnam’s work to develop national guidelines, strengthen laboratory testing, and provide infection prevention and control training to hospital staff (13); Thailand’s COVID-19 testing in refugee camps and work to strengthen border health activities and point-of-entry assessments (14); Brazil’s investigation of the second wave of COVID-19 and the P.1 and B.1.162 variants (15); and Ukraine’s implementation of a COVID-19 mitigation strategy for a 2021 religious pilgrimage that drew tens of thousands of pilgrims to the city of Uman (16) were all enhanced through longstanding CDC partnerships.

We analyze the bank supply of credit under the Paycheck Protection Program (PPP). The literature emphasizes relationships as a means to improve lender information, which helps banks manage credit risk. Despite imposing no risk, however, the PPP supply reflects traditional measures of relationship lending: decreasing in bank size and increasing in prior experience, commitment lending, and core deposits. Our results suggest a new benefit of bank relationships: They help firms access government-subsidized lending. Consistent with this benefit, we show that the bank PPP supply, based on the structure of the local banking sector, alleviates increases in unemployment.

Disparities in dietary behaviors have been directly linked to the food environment, including access to retail food outlets. The Coronavirus Disease of 2019 (COVID-19) pandemic has led to major changes in the distribution, sale, purchase, preparation, and consumption of food in the United States (US). This paper reflects on those changes and provides recommendations for research to understand the impact of the pandemic on the retail food environment (RFE) and consumer behavior. Using the Retail Food Environment and Customer Interaction Model, we describe the impact of COVID-19 in four key areas: (1) community, state, tribal, and federal policy; (2) retail actors, business models, and sources; (3) customer experiences; and (4) dietary intake. We discuss how previously existing vulnerabilities and inequalities based on race, ethnicity, class, and geographic location were worsened by the pandemic. We recommend approaches for building a more just and equitable RFE, including understanding the impacts of changing shopping behaviors and adaptations to federal nutrition assistance as well as how small food business can be made more sustainable. By better understanding the RFE adaptations that have characterized the COVID-19 pandemic, we hope to gain greater insight into how our food system can become more resilient in the future.

As the climate changes, human livelihoods will increasingly be threatened by extreme weather events. To provide adequate disaster relief, states extensively rely on multilateral institutions, in particular the United Nations (UN). However, the determinants of this multilateral disaster aid channeled through the UN are poorly understood. To fill this gap, we examine the determinants of UN disaster aid using a dataset on UN aid covering almost 2,000 climate-related disasters occurring between 2006 and 2017. We make two principal contributions. First, we add to research on disaster impacts by linking existing disaster data from the Emergency Events Database (EM-DAT) to a meteorological reanalysis. We generate a uniquely global hazard severity measure that is comparable across different climate-related disaster types, and assess and bolster measurement validity of EM-DAT climate-related disasters. Second, by combining these data with social data on aid and its correlates, we contribute to the literature on aid disbursements. We show that UN disaster aid is primarily shaped by humanitarian considerations, rather than by strategic donor interests. These results are supported by a series of regression and out-of-sample prediction analyses and appear consistent with the view that multilateral institutions are able to shield aid allocation decisions from particular state interests to ensure that aid is motivated by need.

At the request of Congress, the Institute of Medicine (IOM) will evaluate U.S. global programs to address HIV/AIDS. This book outlines the IOM's strategic approach for this evaluation.

Pandemics have historically had a significant impact on economic inequality. However, official inequality statistics are only available at low frequency and with considerable delay, which challenges policymakers in their objective to mitigate inequality and fine-tune public policies. We show that using data from bank records it is possible to measure economic inequality at high frequency. The approach proposed in this paper allows measuring, timely and accurately, the impact on inequality of fast-unfolding crises, like the COVID-19 pandemic. Applying this approach to data from a representative sample of over three million residents of Spain we find that, absent government intervention, inequality would have increased by almost 30% in just one month. The granularity of the data allows analyzing with great detail the sources of the increases in inequality. In the Spanish case we find that it is primarily driven by job losses and wage cuts experienced by low-wage earners. Government support, in particular extended unemployment insurance and benefits for furloughed workers, were generally effective at mitigating the increase in inequality, though less so among young people and foreign-born workers. Therefore, our approach provides knowledge on the evolution of inequality at high frequency, the effectiveness of public policies in mitigating the increase of inequality and the subgroups of the population most affected by the changes in inequality. This information is fundamental to fine-tune public policies on the wake of a fast-moving pandemic like the COVID-19.

We assess the role of race in loans made through the Paycheck Protection Program (PPP). The PPP program, created by the U.S. government as a response to the Covid-19 pandemic, provides loans to small businesses so they can keep employees on their payroll. We argue that the historical record and PPP program design choices made it likely that many Black-owned businesses received smaller PPP loans than White-owned businesses. Using newly released data on the PPP program, we find that Black-owned businesses received loans that were approximately 50% lower than observationally similar White-owned businesses. The effect is marginally smaller in areas with more bank competition and disappeared over time as changes to the PPP program were implemented allowing for entry by fintechs and other non-traditional lenders.Plain English SummaryWe find that Black-owned businesses received loans through the Paycheck Protection Program that were approximately 50 percent lower than White-owned businesses with similar characteristics. However, this difference in loan size shrank over time as more non-bank lenders such as fintechs were allowed to participate in the program and began approving PPP loans. Loan size differences were also slightly smaller in zip codes containing a larger number of bank branches. These results are consistent with prior research which shows lending discrimination by commercial banks against Black borrowers. It is also consistent with studies showing that greater access to and competition among banks and other lenders can reduce discrimination. In light of these results we recommend that policy makers account for existing racial inequalities within banking or other systems in their program design to produce more equitable outcomes.