Supporting PEPFAR: A Global Health Program in Jeopardy
How Opposition from House Republicans Threatens a Lifesaving Initiative
Twenty years ago, the Republican president, George W. Bush, took a historic step by establishing a groundbreaking global-health program. However, this year, House Republicans are actively working to undermine its success and endanger countless lives. It’s a bewildering contradiction, especially coming from a party that proclaims itself as pro-life.
In 2003, a staggering 30 million Africans were afflicted with AIDS, with an alarming 3 million of them being under the age of 15. In some nations, over a third of the adult population was infected. Shockingly, only 50,000 individuals were receiving the proper medication out of the estimated 4 million in desperate need.
During his 2003 State of the Union address, President Bush recognized the urgent need to address this crisis. He proposed the Emergency Plan for AIDS Relief (PEPFAR), a humanitarian endeavor beyond any previous international efforts. President Bush appealed to Congress for a commitment of $15 billion over the course of five years, allocating nearly $10 billion in new funding. This initiative aimed to turn the tide against AIDS in the hardest-hit regions of Africa and the Caribbean. In the annals of history, PEPFAR represents the largest commitment made by any nation towards combating a single disease.
President Bush’s call to action was met with resounding support. In 2007, Congress doubled America’s initial commitment, approving an additional $30 billion for HIV/AIDS prevention, care, and treatment over the subsequent five years. By that point, approximately 1.2 million lives had been saved and 1.7 million people around the world had received life-saving treatment through PEPFAR. This massive endeavor was described by Bush as “The Lazarus Effect,” a term coined by Africans to illustrate the transformative impact of the program.
The success of PEPFAR transcended party lines and garnered support from subsequent administrations, including those led by Obama, Trump, and Biden. Over the span of two decades, this program has saved over 25 million lives in more than 50 countries. Currently, more than 20 million individuals, including women, men, and children, are receiving critical antiretroviral treatment. PEPFAR has provided aid to over 7 million vulnerable children, caregivers, and orphans. It has also prevented HIV transmission from mother to child in 5.5 million newborns. Moreover, the program has trained 340,000 healthcare workers to deliver and enhance HIV care.
PEPFAR, unlike many other programs, has consistently enjoyed bipartisan reauthorization every five years, receiving support from various religious groups and politicians across the ideological spectrum. In an increasingly polarized era, PEPFAR has been a shining example of an initiative immune to political divisiveness.
However, the impending September 30 deadline for the next five-year reauthorization for PEPFAR is under threat as right-wing groups and members of Congress, including Representative Chris Smith, form the opposition. Their primary objection alleges that the program promotes abortion—an outright falsehood. Contrary to their claims, U.S. law strictly prohibits the use of taxpayer funds for abortions in global-aid programs. No reputable sources have found any evidence of PEPFAR being utilized to promote abortion-related activities. Furthermore, the program operates with more stringent oversight and reporting requirements than other global-health initiatives.
Father Richard Bauer, a pro-life advocate who dedicated 25 years to working in HIV clinics in Kenya, Tanzania, and Namibia, condemned these baseless insinuations in The New York Times. Drawing from his firsthand experience managing PEPFAR-sponsored programs through the Catholic Church, he emphasized that abortion was never part of their mission. Instead, PEPFAR funding and treatment offered hope to HIV-positive women, enabling them to deliver HIV-negative babies.
Doug Fountain, the executive director of Christian Connections for International Health, an organization supporting African efforts against HIV/AIDS, dismissed the abortion criticism as unfounded. Fountain stated that individuals making these claims lacked field experience and highlighted that faith communities in implementing countries would have raised concerns if abortion support was present. The fact that no such outcry exists speaks volumes.
The misleading claims about PEPFAR financing abortion are not new, but they are gaining greater traction in disseminating misinformation and disinformation. Critics of PEPFAR, using maliciously untrue rhetoric, are attempting to weaken the program. While they currently push for a one-year authorization, their overarching goal is to dismantle it gradually. If the United States, which has served as a global leader in supporting PEPFAR, withdraws its commitment, other nations will inevitably follow suit.
These right-wing critics demand changes that would sabotage PEPFAR, such as subjecting it to the Mexico City Policy. This policy requires foreign NGOs to certify that they will not promote abortion as a family planning method to receive U.S. global-health assistance. Astonishingly, throughout most of PEPFAR’s existence, it has operated independently of the Mexico City Policy. Opponents of the program, desperate to undermine it, promise to consider a vote for PEPFAR reauthorization as a vote for abortion rights, potentially endangering Republicans who face primary challenges. The intent is clear: These individuals are using solutions that do not apply to a nonexistent problem, needlessly sounding alarm bells and jeopardizing one of America’s most successful and compassionate programs.
The most generous interpretation of their motivations is that these groups and individuals, who ostensibly champion the sanctity of life, are woefully uninformed about how PEPFAR operates…
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