The U.S. global AIDS program PEPFAR will continue to save lives and prevent HIV transmissions—at least until March 2025. When Congress approved federal funding bills for fiscal year 2024 last week, barely avoiding a government shutdown, it included a one-year extension for the President’s Emergency Plan for AIDS Relief (PEPFAR), reports Politico in a breakdown of the appropriation bills.

Launched in 2003 by Republican President George W. Bush, PEPFAR has saved an estimated 25 million lives, mostly in Africa. What’s more, it has enjoyed bipartisan support, leading Congress to reauthorize funding for the program in five-year increments.

But last year, PEPFAR became a victim of Republican culture wars and budget fights, with GOP lawmakers claiming that PEPFAR indirectly supports abortion. Because Republicans control the House of Representatives, extremists in the party have successfully held up funding for PEPFAR.

“Unfortunately, the political climate has prevented this from being the bipartisan issue that it normally is. So one year may be the best that they can get,” Max Rose, a former congressman and senior adviser at African Mission Health, told Semafor, which first reported on the reauthorization. “The fact that they are still striving for a one-year reauthorization shows that they are not willing to give up on this program.”

Pleased to see that PEPFAR will be extended for one year in the minibus we are considering this week,” Senator Dick Durbin (D–Ill) posted last week on X (formerly Twitter). “It is bewildering to me that some argued we shouldn’t reauthorize this historic lifesaving program, which has saved more than 25M lives.”

Conservative Republican attacks on PEPFAR led more traditional Republicans, such as former President Bush, to join HIV advocates and global leaders in decrying the funding cuts. In one instance, in a campaign to #SaveHIVFunding nationally and globally, HIV activists were arrested in September at the office of Kevin McCarthy, who was then the speaker of the house. And in October, a bipartisan group of organizations joined the George W. Bush Institute to release a letter to Congress highlighting the important of PEPFAR.

Through the budget controversies, PEPFAR has remained active, launching initiatives and participating in HIV events across the globe.

Today, Ambassador Nkengasong launched the #PEPFAR Nursing Leadership Initiative. PEPFAR is providing $8 million to support nurses at the forefront of the HIV/AIDS response in 7 African countries. Learn more:

Posted by The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) on Monday, March 25, 2024

PEPFAR celebrated 20 years on January 28, 2023. In a statement marking that milestone, Ambassador-at-Large John N. Nkengasong, MD, praised the program. “Through PEPFAR, we have saved 25 million lives, and 5.5 million babies have been born HIV-free. Over a million clients have received pre-exposure prophylaxis [PrEP] to prevent HIV infection,” wrote Nkengasong, who serves as the U.S. global AIDS coordinator and special representative for global health diplomacy at the U.S. Department of State. “Also because of PEPFAR, we have seen more than a 50% reduction in new HIV infections in women 15 to 24 years of age, and a 65% reduction in new infections among men in the same age range.”

He added, “Where only 50,000 people in sub-Saharan Africa were on HIV treatment in 2003, today, PEPFAR supports lifesaving antiretroviral treatment for over 20 million adults and children in Africa and beyond. The public health infrastructure PEPFAR built with our partner countries has been leveraged to support responses for COVID-19, Ebola, and other emerging infectious diseases.”

The PEPFAR section of federal website describes the AIDS program’s mission:

The Office of the U.S. Global AIDS Coordinator and Global Health Diplomacy leads, manages, and oversees the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Through PEPFAR, the U.S. government has invested over $100 billion in the global HIV/AIDS response, the largest commitment by any nation to address a single disease in history, saving 25 million lives, preventing millions of HIV infections, and accelerating progress toward controlling the global HIV/AIDS pandemic in more than 50 countries.


In other funding news, see “HIV Funding in President Biden’s Proposed Fiscal Year 2025 Budget.”