The 21st century has witnessed unprecedented increases in funding for global health, driven mainly by efforts to address the HIV/AIDS epidemic. The US President's Emergency Plan for AIDS Relief (PEPFAR) is the largest single donor, having allocated approximately $13 billion for AIDS prevention, treatment, and care in developing countries and contributed $3 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria since the plan's inception in 2003.1 For the next 5 years, the president is seeking a $30 billion appropriation for PEPFAR while Congress is proposing to increase the appropriation to $50 billion and add funding for malaria and tuberculosis programs. In contrast, the World Health Organization (WHO) smallpox eradication program, conducted from 1967 through 1979, cost less than $2 billion (adjusted for inflation).2
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