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. Table of Contents Front Matter Summary Part I: Introduction 1 Background 2 Evaluation Scope and Approach Part II: PEPFAR Organization and Investment 3 PEPFAR Organization and Implementation 4 U.S. Funding for the PEPFAR Initiative-Main Messages 4 U.S. Funding for the PEPFAR Initiative Part III: PEPFAR Programmatic Activity 5 Prevention-Main Messages 5 Prevention 6 Care and Treatment-Main Messages 6 Care and Treatment 7 Children and Adolescents-Main Messages 7 Children and Adolescents 8 Gender-Main Messages 8 Gender 9 Strengthening Health Systems for an Effective HIV/AIDS Response-Main Messages 9 Strengthening Health Systems for an Effective HIV/AIDS Response Part IV: Future of U.S. Government Involvement in the Global Response to HIV/AIDS 10 Progress Toward Transitioning to a Sustainable Response in Partner Countries-Main Messages 10 Progress Toward Transitioning to a Sustainable Response in Partner Countries 11 PEPFAR's Knowledge Management-Main Messages 11 PEPFAR's Knowledge Management Appendixes Appendix A: Statement of Task Appendix B: Recommendations Appendix C: Evaluation Methods Appendix D: Committee, Consultant, and Staff Biographies