BREAKING: Some Republicans are against the full five-year extension of PEPFAR, which is being demanded by activists who are now occupying Speaker McCarthy’s office.
BREAKING: Activists are occupying @SpeakerMcCarthy’s office demanding a full 5 year reauthorization of PEPFAR, which some Rs are opposing. Background: https://t.co/nQVnCxPDE0 pic.twitter.com/wCZx4Z6wzu
— Alice Miranda Ollstein (@AliceOllstein) September 11, 2023
BACKSTORY: On October 1, the legislation governing the President’s Emergency Plan for AIDS Relief will expire.
The much-lauded program is becoming entangled in the abortion debate, and Congress is likely poised to blow past a Sept. 30 deadline to reauthorize the law controlling the United States’ global HIV/AIDS relief operations.
Funding for the program would only be available as long as Congress maintains federal funding, which is becoming less likely as members with conflicting demands start to return this week. However, legislators from both parties don’t see a clear way to bring the law back before the end of the year. The standoff poses a threat to transform an endeavor that has been credited with saving 25 million lives into an annual political battle, making it more difficult for organizations fighting HIV and AIDS to employ staff or start long-term projects, even though the program would continue to stutter along.
“For 20 years, we’ve passed clean reauthorizations on a bipartisan basis to keep this program running, and this September we’re at risk of it lapsing,” said Rep. Barbara Lee (D-Calif.), a coauthor of the law that created the President’s Emergency Plan for AIDS Relief during the George W. Bush administration.
Additionally, she is the leading Democrat on the Appropriations panel, which sets the program’s budget. When the House reconvenes in mid-September, she intends to launch a massive lobbying effort aimed at members who have been elected since the program’s inception in 2003, which is known as PEPFAR.
The Biden administration, PEPFAR’s administrators, and outside experts strenuously refute the allegations made by conservative campaigners and GOP members of the House that a portion of the organization’s almost $7 billion yearly funding goes to abortion providers.
Leader of the House’s global health subcommittee overseeing PEPFAR, Rep. Chris Smith (R-N.J.), is spearheading the opposition to extending the program until the anti-abortion provisions that the Biden administration removed in 2021 are put back in place. These limitations would prevent organizations that receive funding from PEPFAR from discussing or even providing abortions using monies from other sources.
Smith told POLITICO that over the August recess, he worked with Sen. Cindy Hyde-Smith (R-Miss) and other conservatives on Capitol Hill to lobby other Republicans in both chambers. He claimed that two of their arguments struck a chord with members. The first is that PEPFAR will continue to get financing even if the program’s governing legislation expires, and the second is that the Biden administration has “hijacked” the initiative to promote access to abortion abroad.
“That’s the gee-whiz moment that’s happening when I have conversations with people who do believe in the sanctity of life,” Smith said. “I’m encouraged that within two or three minutes of a conversation people would say, ‘That’s not what we signed up for. We signed up to go after HIV and AIDS aggressively and effectively, not to have a diversion of priority to abortion on demand.’”
A larger GOP push to drag more federal programs into the abortion wars coincides with the debate over the historic program aimed at combating AIDS and HIV, the virus that causes it, in the poor countries. For example, House Republicans have inserted anti-abortion language into almost every aspect of the appropriations process, threatening to bring the Senate and White House to a standoff that would result in a government shutdown. Additionally, due to the Pentagon’s new policy of compensating service members who travel to another state to receive abortions and other reproductive treatments, Senator Tommy Tuberville (R-Ala.) has been preventing senior military promotions for months.
It is “unlikely” that Congress will renew PEPFAR before September 30 due to “ongoing confusion” among senators on the program’s intersection with abortion, a spokesman for Sen. Jim Risch (R-Idaho), the top Republican on the Foreign Relations Committee, which supervises it, acknowledged to POLITICO. The spokesman cited a number of clauses that might be removed as a result, including one stipulating that at least 10% of program proceeds be directed toward aiding AIDS orphan children.
Organizations that receive PEPFAR funding for initiatives in Africa, Asia, and the Caribbean caution that if Congress does nothing, the program will be vulnerable to the shaky budget battles on Capitol Hill, convey the message that the United States is no longer committed to the fight against HIV and AIDS, lose influence in areas where it competes with China and Russia, and have “human consequences” on the ground. A UNAIDS survey estimates that 39 million individuals globally are HIV positive, with 1.3 million new cases reported last year.
“Taking the foot off the gas at this point is so incredibly ill-advised,” said Asia Russell, the executive director of the Health Global Access Project. “The Biden administration got elected asserting that it would be the administration to put the global HIV response back on track to defeat HIV as a public health threat by 2030. And this would completely derail and break that political commitment.”
The administration will continue to collaborate with both parties to “maintain the bipartisan legacy” and approve a five-year PEPFAR extension before the current authorization expires at the end of September, according to Adrienne Watson, a National Security Council spokesperson, in an email.
Supporters of the program, such as Senate Foreign Relations Chair Bob Menendez (D-N.J.), told POLITICO that they hope to accomplish this through a stand-alone program vote.
“Based on my conversations with some Republicans on the committee, they would be in support of moving PEPFAR forward,” he said in late July. “And I think if it was put up for a vote, it would have broad bipartisan support.”
However, a number of Hill employees and outside organizations stated that they expect this endeavor to fail and that the program’s best chance is to ride along with an anticipated omnibus spending measure in December, which would allow Republicans to vote in favor of it as part of a larger package rather than alone. Still unclear, though, is whether an omnibus will pass given the deadlock over abortion rights.
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