U.S. abortion opponents threaten to end live-saving global AIDS program

In its 20 years, Pepfar has saved 25 million lives

A decades-old program created by President George W. Bush to combat AIDS around the world is at risk of being sucked into a partisan dispute over abortion, with some Republicans threatening to block its renewal.

This is an abridged version of an article published July 28 in The New York Times:

AIDS Relief Program Under Threat as G.O.P. Insists on Abortion Restriction

Nancy Pelosi, the Democratic former House speaker, and George W. Bush, the Republican former president joined a high-powered gathering in Washington to mark the 20th anniversary of America’s most successful foreign aid program.  It is noted that Mr. Bush created that program, the President’s Emergency Program for AIDS Relief, in 2003. It has saved 25 million lives and served as a powerful tool for soft diplomacy, a symbol of America’s moral leadership in the world. It has had extraordinary support from a bipartisan coalition of liberals and Christian conservatives.

But now PEPFAR is in danger of becoming a victim of abortion politics. The program is set to expire at the end of September. But House Republicans are not moving forward with a bill to reauthorize it for another five years, because abortion opponents — led by a G.O.P. congressman who has long been a supporter of PEPFAR — are insisting on adding abortion-related restrictions.

They have focused in particular on abortion, a year after the Supreme Court overturned Roe v. Wade and, with it, the right to legal abortion. Earlier this summer, House Republicans loaded up the annual military policy bill that has long been bipartisan with provisions to limit abortion access and transgender care.

Representative Christopher H. Smith of New Jersey wants PEPFAR funding to include restrictions barring the program from partnering with organizations that provide abortion services.  Mr. Smith now says he will not agree to renew the program unless it is subject to the so-called Mexico City policy — enacted by Republican presidents but lifted by Democrats, including President Biden — that would bar the program from partnering with any organization that provides abortion services, no matter the source of the funding.

That is a non-starter for Democrats, who are demanding a “clean” five-year reauthorization — one with no added policy restrictions.

“We’ve done clean reauthorizations for 20 years,” said Representative Barbara Lee, Democratic of California and a chief sponsor of PEPFAR.  But there is a substantial stumbling block: Three influential outside groups that oppose abortion — the Family Research Council, the Heritage Foundation’s political action arm and Susan B. Anthony Pro-Life America — have sided with Mr. Smith and intend to “score” the vote when they compile their annual ratings of members of Congress. A vote for renewing PEPFAR without the anti-abortion language would be counted as a demerit, making it politically toxic for most Republicans.

The situation has alarmed champions of the program. In an email, [activist singer] Bono called the impasse “madness,” and called on Congress to “protect the bipartisan commitment to keeping politics out of PEPFAR.”

Representative Michael McCaul of Texas, the Republican chairman of the Foreign Affairs Committee, a Pepfar supporter, said he is “talking to supporters both inside and outside the government, and working with my colleagues on both sides of the aisle in the House and the Senate” to resolve the dispute. He has also been texting with Bono, who in turn has been in touch with congressional leaders on the matter.

Mr. Santorum publicly pleads for a “five-year, clean extension” in an opinion essay in the conservative outlet Newsmax. He said he intended to use Congress’s upcoming August recess to try to forge a compromise. While  Mr. Smith, the New Jersey Republican, and right-wing groups  accuses the Biden administration of injecting progressive politics into the program.

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In late May, a Heritage Foundation scholar published an essay in The Hill arguing that PEPFAR had become “increasingly politicized” and needed an overhaul. Mr. Smith followed in early June with “Dear Colleague” letter asserting that Mr. Biden had “hijacked PEPFAR.”

In an interview, he pointed to new language in a PEPFAR country and regional operational plan calling for the program to partner with organizations that advocate for “institutional reforms in law and policy regarding sexual, reproductive and economic rights of women.” He argued that was code for a plan to “integrate abortion with H.I.V./AIDS work.”

The document also says PEPFAR programs should “advance human rights and decriminalization for lesbian, gay, bisexual, transgender, queer, and intersex (L.G.B.T.Q.I.+) communities.” That did not sit well with the Family Research Council, whose chief lobbyist, Travis Weber, recently called PEPFAR “a massive slush fund for abortion and L.G.B.T. advocacy.” In an interview, he said he stood by those words.

“The assertion is made by critics is that organizations like P.S.I. are working with U.S. money and involved in abortion — and shouldn’t that be illegal?” said Karl Hofmann, the group’s president and chief executive. “I guess my answer is, those two facts are true, and it’s not illegal.”

But the prospects for a five-year extension seem bleak.

“We are in a very precarious place,” said Shepherd Smith, an evangelical Christian and a co-founder of Children’s AIDS Fund International, a nonprofit. He has organized other faith-based groups to issue a letter in support of reauthorization.  Christopher H. Smith persuaded fellow Republicans to insert language into a State Department spending bill that would allow PEPFAR to keep operating for a year without a new authorization, but subject to the anti-abortion restrictions. That measure, however, like many of the spending bills making their way through the Republican-led House, is unlikely to be acceptable to the Democratic-controlled Senate.

For more information, see the original New York Times article, “AIDS Relief Program Under Threat as G.O.P. Insists on Abortion Restriction”.