I share many of the Heritage Foundation’s concerns over the current administration’s approach to the President’s Emergency Plan for AIDS Relief — a program for which, in a sane world, George W. Bush would have been given the Nobel Peace Prize. But I’m not convinced now is the time to end it or have a debate about dramatically restructuring it; as former senator Rick Santorum and his former chief of staff Mark Rodgers recently put it:
We agree that the PEPFAR could be administered better under another agency and that the staff are too left-leaning, but that reasoning would require the elimination of every government program.
We share the report’s concern over the Biden administration’s new guidance and are hopeful that they will, like all prior administrations, resist destroying the careful compromises of 2002.
Those compromises include such important guidelines that conservatives fought for, such as the ABC (Abstinence first, Be Faithful and then Contraception when needed) approach to prevention efforts.
While we sympathize with some of the concerns raised by our fellow conservatives, without a clean authorization, there will be no reauthorization.
That means the administration will have a free hand to do what it wants with the money appropriated. The right solution is to do what the Trump administration did with fanfare, pass a clean extension and leave the compromises in place for now.
But we do want to address the issue of abortion in particular.
No funds can be or ever have been used to pay for abortion on demand.
The Hyde amendment is in effect, and has been, since PEPFAR began.
We understand why anti-abortion organizations, Post-Dobbs vs. Jackson Women’s Health Organization, would like to see the Mexico City policy put on PEPFAR, but with Democrats controlling the Senate and the Biden administration the pen, it won’t happen during this Congress.
A five-year, clean extension that carries us into the next administration may be the best outcome for everyone concerned.
Especially for the millions of people living with — not dying from — AIDS, and who thank Americans for keeping them alive daily.
As you may have seen, a Catholic priest made a pro-life case for continuing the program in the New York Times this week:
After working in Tanzania, I went on to manage two major PEPFAR-sponsored programs through the Catholic church in Namibia and Kenya, and at no point was abortion part of our work or our mission. If anything, we prevented women with H.I.V. from seeking abortions, by using PEPFAR funding and treatment to provide hope that they could deliver H.I.V.-negative babies.
Two laws, the Helms and Siljander Amendments, make it illegal to use taxpayer dollars to fund abortion in global aid programs or to lobby for or against abortion overseas, and PEPFAR programs are administered with significant oversight to ensure compliance with those laws. For years, the Office of the Inspector General has reviewed PEPFAR’s practices and has never discovered misappropriation of funds for abortion. Nor have outside researchers and experts. An evangelical anti-abortion leader in global health, Shepherd Smith, conducted his own assessment this year and reported that he found “no factual evidence” to support the “rumor” that PEPFAR has funded or in any other way promoted abortion.
Over the last 20 years, this ambitious program has saved 25 million lives in 55 countries, most of which are in Africa. AIDS deaths have dropped by 64 percent since 2004 in those countries. With a focus on comprehensive care, involving a patient’s family and community, PEPFAR has provided critical treatment and support to orphans, vulnerable children and their caregivers. It has enabled 5.5 million babies to be born without H.I.V. by preventing mother-to-child transmission of the virus. PEPFAR also has fortified education systems, helping girls stay in primary school, and stimulated economic growth in recipient countries.
Churches have championed PEPFAR since the early days of the program, and faith-based organizations, like the clinics and institutions where I served, play a major role in the development and administration of the program. In fact, faith-based institutions deliver 30 percent to 70 percent of health care services in low- and middle-income countries in Africa, according to one estimate. Faith leaders from the United States and around the world, including those who oppose abortion, have recently written letters calling for reauthorization. These leaders recognize that jeopardizing the future of PEPFAR disrespects the sanctity of human life.
The abortion issue is critical, and those original guidelines must be insisted on. Beyond abortion, this debate does seem like a place where we should avoid making the perfect the enemy of the good.