Barnes said that a preliminary version of the federal budget included a substantial increase for the program.

The shortfall in some of the numbers arises from the careful planning and coordination of the program’s activities according to Robin Herman, HSPH spokeswoman. She said there were time-consuming negotiations on logistics among HSPH, the U.S. government and the three other grant recipients—Columbia University Mailman School of Public Health, Catholic Relief Services and the Elizabeth Glaser Pediatric AIDS Foundation—before the program could operate at full capacity.

Barnes said that, unlike previous AIDS relief organizations with multi-year implementations plans, the PEPFAR program was put on the ground within months of the grant announcement.

Barnes said that in Botswana, where 40 percent of all adults are HIV-positive and where all the AIDS clinics are government-run, Harvard PEPFAR is funding only administrative aspects of the clinics, such as data management services and the monitoring of operations.

In Nigeria and Tanzania, Harvard PEPFAR pays the costs of medication and also the labor costs for medical professionals in certain clinics.

Sarika P. Bansal ’06, who is president of the Harvard AIDS Coalition, did not specifically fault the Harvard program. But she criticized PEPFAR as a whole, pointing to its limited scope and lack of communication between donors and recipients. She also criticized the U.S. policy that denies funding for organizations that provide abortion counseling.

“In some ways it is a bit deceptive because they don’t go after the brunt of the disease burden,” Bansal said. Bansal also noted skyrocketing AIDS rates in countries that PEPFAR does not work in such as China, Russia and India.