A Decade of Saving Lives and Transformational Change in Rwanda

Last Friday, I was privileged to join six U.S. Senators in seeing the truly profound impact of U.S. global AIDS investments in Rwanda. We were also fortunate to be accompanied by Dr. Mark Dybul, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), Dr. Agnes Binagwaho, the Rwandan Minister of Health, and many other Rwandan partners.

As we entered the Kicukiro Health Centre in Kigali - a place I had first visited more than a decade ago - the transformation that had taken place was breathtaking. Where once three or four Rwandans - most who were dying of AIDS without access to antiretroviral therapy (ART) - had shared a bed, people were back on their feet, back at work, and healthy enough to take care of themselves, their families, and grow their economy.

At Kicukiro, we spoke with William, now 21-years-old, who had initially come to the clinic in 2003 and tested HIV-positive. Before beginning treatment, William often was ill, missed school, and wondered about what his future would hold. Thanks to the lifesaving ART supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) that he received at Kicukiro, William's health improved, he completed secondary school, and now he dreams of attending university and becoming a businessman.

We also met Consolee, a brave woman who discovered in 1996 that she was HIV-positive. In 1999, Consolee came to Kicukiro when she was pregnant with her first child. Thanks to the prevention of mother-to-child transmission services that she received during her pregnancy, Consolee had a beautiful, HIV-negative son. At that time, there was virtually no access to ART in the country. Without these medicines, a few years later, Consolee's health began to fail. She feared that she would leave her young son as an orphan (her husband had already died of AIDS-related causes). Fortunately, this was when PEPFAR-supported ART began to flow into Rwanda. Consolee was among the first to receive them at Kicukiro. Today, Consolee is healthy again, her son is about to complete primary school, and she has big plans for the future.

These individual stories are deeply inspiring; they give us hope. And, thankfully, they are no longer the exception. A decade ago, only 400 Rwandans had access to lifesaving ART. At that time, 3 in 10 babies born to an HIV-positive mother in Rwanda contracted the virus themselves. Today, because of PEPFAR, the Global Fund, and, most importantly, the extraordinary leadership of the Rwandan government and the Rwandan people - the picture has changed dramatically. This is not only the case in Rwanda, but also across much of sub-Saharan Africa.

As these Senators and I heard, more than 120,000 Rwandans now have access to ART - accounting for 93 percent of those who need it in the country. The rate of mother-to-child transmission of HIV in Rwanda has dropped to less than 2 percent. PEPFAR and the Global Fund have helped Rwanda to strengthen its health system - creating a robust capacity to prevent, diagnosis, and treat HIV, tuberculosis, and malaria. This system has also built a platform that Rwanda is leveraging to address the broader health needs of its people. As a result, new HIV infections and AIDS-related deaths have plummeted; TB and malaria morbidity and mortality have dropped sharply; and life expectancy has nearly doubled from the darkest days of the AIDS epidemic.

I am deeply gratified that these Senators took time out of their busy schedules to see just how much has changed in the past ten years - in large part because of their leadership, bipartisan support from their colleagues in the U.S. Congress, the strong commitment of Presidents George W. Bush and Barack Obama, and the overwhelming generosity of the American people.

As we move forward, both the challenge and the opportunity before us in Rwanda - as in much of sub-Saharan Africa - is to consolidate these unprecedented gains, to reach those who have not yet received services, and to chart a course toward sustainability. This requires a shared responsibility and continued collaboration among all partners - principally, the Government of Rwanda, the Rwandan people, PEPFAR, and the Global Fund.

The road ahead will not be easy, but neither was the path we traveled together over the past decade. For the first time in history, an AIDS-free generation is within our sights - in Rwanda and across Africa. I know that we can get there. But it will take all of us, pulling together to make it happen.