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

Decades-Old Program to Combat AIDS Faces Partisan Dispute Over Abortion

Introduction

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.

The President’s Emergency Program for AIDS Relief (PEPFAR)

Nancy Pelosi, the Democratic former House speaker, and George W. Bush, the Republican former president, do not agree on much. But earlier this year, they joined a high-powered gathering in Washington — with the Irish rock star Bono on video from Dublin — to mark the 20th anniversary of America’s biggest and, arguably, most successful foreign aid program.

Mr. Bush created that program, the President’s Emergency Program for AIDS Relief, in 2003. In the two decades since, PEPFAR, as it is known, 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.

Threat to PEPFAR

But now PEPFAR is in danger of becoming a victim of abortion politics — just as the State Department is reorganizing to make the program permanent.

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.

Republican Influence on Social Policy

The stalemate is the latest example of how Republicans are using their majority in the House of Representatives to impose their conservative views on social policy throughout the federal government. 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.

The fight over PEPFAR, a $7 billion-a-year program that operates in more than 50 countries, is similar, because it is a broadly bipartisan program that now appears at risk of being sucked into a partisan fight over cultural and social issues.

Abortion Restrictions and Democratic Opposition

PEPFAR continues to have wide support, including from Representative Michael McCaul of Texas, the Republican chairman of the Foreign Affairs Committee, which oversees the program and approve the reauthorization legislation. But so far, Mr. McCaul has not advanced it because of the objections of abortion foes, including his Republican colleague, Representative Christopher H. Smith of New Jersey, one of the leading anti-abortion voices in Congress who also helped draft the legislation creating PEPFAR.

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.

Outside Groups and Political Ratings

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, Bono called the impasse “madness,” and called on Congress to “protect the bipartisan commitment to keeping politics out of PEPFAR.”

Efforts to Resolve the Dispute

Mr. McCaul 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.

A senior White House official, speaking on the condition of anonymity to describe the negotiations, said on Thursday that the White House was “engaging closely with Congress at senior levels” in pursuit of a straight five-year reauthorization.

Importance of PEPFAR and Opposition Accusations

The program is an important legacy for Mr. Bush and other Republicans of his era, including Bill Frist, the former Senate majority leader, and Rick Santorum, a former senator from Pennsylvania.

“I look back on the things I did as a member of Congress, and feel like I was able, as the pro-life warrior in the United States Senate, to forge a compromise to get conservatives to support this,” Mr. Santorum said in an interview. “It’s been a great thing for our country, and it’s been a great thing for humanity.”

But in recent months, Mr. Smith, the New Jersey Republican, and right-wing groups have begun accusing the Biden administration of injecting progressive politics into the program.

Disagreements Over Program Language

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

SDGs, Targets, and Indicators

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 5: Gender Equality
• SDG 10: Reduced Inequalities
• SDG 17: Partnerships for the Goals

2. What specific targets under those SDGs can be identified based on the article’s content?

• SDG 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases.
• SDG 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.
• SDG 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies, and practices and promoting appropriate legislation, policies, and action in this regard.
• SDG 17.16: Enhance the global partnership for sustainable development, complemented by multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology, and financial resources to support the achievement of the sustainable development goals in all countries.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Indicator for SDG 3.3: Number of new HIV infections and AIDS-related deaths.
• Indicator for SDG 5.6: Proportion of women of reproductive age who have their need for family planning satisfied with modern methods.
• Indicator for SDG 10.3: Proportion of population reporting having personally felt discriminated against or harassed in the previous 12 months on the basis of a ground of discrimination prohibited under international human rights law.
• Indicator for SDG 17.16: Amount of financial resources mobilized to support the implementation of sustainable development goals.

Table: SDGs, Targets, and Indicators

Note: The indicators provided in the table are examples and may not cover all possible indicators for each target.

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Source: nytimes.com

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