For the first time in 20 years, Congress did not reauthorize the President’s Emergency Plan for AIDS Relief (PEPFAR), a global initiative started under former President George W. Bush to help combat the global HIV epidemic. PEPFAR reauthorization, which is typically reapproved every five years, was left out of appropriations legislation that passed this past September, and its absence meant that parts of the PEPFAR program expired on Sept. 30.
Democrats, including the Biden administration, were largely opposed to the lack of reapproved funding. “The fact that Congress did not reauthorize the program sends a message to partners around the world, especially in Africa, that we are backing down from our leadership in ending HIV/AIDS as a public health threat,” State Department spokesman Matthew Miller told reporters.
While the program will not shut down completely as some parts of it are permanently funded, the lack of formal approval speaks to the level of partisan politics now evident in the U.S. Many Republicans and conservative-leaning advocacy groups have voiced opposition to the continued funding of PEPFAR due to the claim that some of the program’s $6 billion to $7 billion annual budget goes to abortion providers.
In remarks made on the House floor, Rep. Chris Smith (R-N.J.), chairman of the House global health subcommittee that manages PEPFAR, said that the Biden administration “hijacked” PEPFAR to empower pro-abortion groups. Smith specifically pointed to the administration’s repeal of the Mexico City policy that prohibits U.S. aid money from going to organizations that perform abortions or provide referrals or information about abortion — even if they are not using U.S. aid money to do so.
“We ask that PEPFAR remain true to its original mission and respect our norms, traditions and values,” Smith said in his remarks. In May, a group of pro-life leaders sent a letter to Congress requesting that it not reauthorize the program again due to the claim that part of the program’s budget is being used to fund abortion-related activities around the world.
“The American people do not support using taxpayer dollars to fund abortion at home or abroad,” the leaders wrote. “For that reason, there exists long-standing precedent not to fund abortion, directly or indirectly, through U.S. foreign assistance. We are concerned that grants from the President’s Emergency Plan for AIDS Relief are used by nongovernmental organizations that promote abortions and push a radical gender ideology abroad.”
The Family Research Council, a U.S. evangelical activist group and think tank, also argued that PEPFAR money is being used “to promote a radical social agenda abroad,” including the promotion of abortion and LGBT ideology. “This is a gross misuse of PEPFAR funds and resources and does not ultimately serve PEPFAR’s mission of ending HIV/AIDS,” Arielle Del Turco, director of the council’s Center for Religious Liberty, stated in a policy brief.
Del Turco singled out several international organizations that have received PEPFAR funding over the last several years and have ties to possible abortion-related work. For example, Del Turco stated that Pathfinder International received more than $5 million in PEPFAR funding in the last two years and actively advocates for expanded abortion access.
Many Congressional Democrats, meanwhile, argued that Republicans were making a partisan issue out of the program and subsequently risking America’s reputation as a global leader in the fight against HIV.
“I’m concerned that they’re politicizing it,” Rep. Barbara Lee (D-Calif.), who co-authored the original legislation for PEPFAR in 2003, told The Hill. “We’re trying to keep it bipartisan. Probably just 20-25% of members serving today were here when we first authorized it, and they’re trying to find every which way to derail it.”
The current debate around PEPFAR, which reports to have saved more than 25 million lives across the world, marks the first time the program has not received bipartisan support since it was created 20 years ago.
While PEPFAR reauthorization was not included in the federal spending bill, Smith and some other House Republicans included a one-year reauthorization with strict anti-abortion language in the State, Foreign Operations, and Related Programs appropriations bill that passed the House but is unlikely to pass the Senate.
The debate around whether or not to reauthorize PEPFAR and for how long is likely to continue.
For more background, see the April 2003 issue of International Debates on “The World AIDS Crisis.”
