Conservatives target George W. Bush's AIDS-fighting program

One of the biggest accomplishments of George W. Bush’s presidency was PEPFAR, the President’s Emergency Plan for AIDS Relief. It is credited with saving millions of people around the world — and particularly Africa — from the scourge of HIV and AIDS and traditionally had bipartisan support in Congress. Not this year. Axios reported the program has been “caught up in abortion politics” with conservative Republicans alleging PEPFAR is used to support a “radical social agenda abroad.”

Bush himself weighed in on the fight this week with an op-ed in The Washington Post. “We are on the verge of ending the HIV/AIDS epidemic,” he wrote, appealing to pro-life conservatives. “There is no program more pro-life than one which has saved more than 25 million lives.” But The Associated Press reports that conservative groups believe the Biden administration is working to “integrate abortion with HIV/AIDS prevention” abroad, putting the program in the crosshairs. They want to ban money from going to any outfit that also provides abortion services.

That worries public health advocates. A “hobbled PEPFAR” would “dent a vision of ending the AIDS epidemic by 2030,” Western University’s Arjun V.K. Sharma wrote for Stat. PEPFAR is the “largest global health initiative ever dedicated to a single disease.” Now it’s in danger.

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'Nothing to do with global health'

The program may have had bipartisan support but “PEPFAR has always been controversial,” Tim Meisburger argued for The Heritage Foundation, a conservative think tank. HIV/AIDS is “primarily a lifestyle disease” that should be “suppressed through education, moral suasion, and legal sanctions.” Meanwhile, most political donations from U.S. employees of PEPFAR agencies and providers “have gone to Democratic candidates and causes” which makes PEPFAR “an entirely Democrat-run program.” Congress should “resist” the Biden administration’s effort to use the program “to promote abortion under the guise of sexual and reproductive health and transgenderism.”

PEPFAR has been “one of the most successful global health programs in modern history,” The New York Times editorialized. There were roughly 60,000 people on life-saving treatment in 2004 — last year that number was closer to 20 million. The Biden administration does send PEPFAR money to organizations that also provide abortion counseling. But that’s consistent with Bush’s original position that “the abortion battle had nothing to do with global health.”

“PEPFAR has meant that millions of HIV-positive children and adults who were near death have been brought back to life,” wrote Richard W. Bauer, a Roman Catholic priest who spent a quarter-century working at HIV clinics in Africa, also at The New York Times. Letting the program lapse — or even subjecting it to a mere short-term renewal that leaves it vulnerable — would not be pro-life. Instead it “would fail to honor the teaching that all human life is sacred and worthy of protection.”

'Benevolent U.S. global leadership'

“PEPFAR is a banner for benevolent U.S. global leadership,” The Washington Post editorialized. It “makes little sense” to disrupt that achievement with political bickering. Conservatives may want to put the program under the umbrella of the “Mexico City policy” — in place during Republican presidencies — that bars U.S. funding from going to foreign outfits that support abortion access. But GOP conservatives “surely can find another venue or legislative vehicle to fight the abortion battle.”

There are just two weeks left before PEPFAR’s five-year authorization expires, Politico reported. And some Republicans are clearly on board with continuing it. “It’s been a program that works,” said Sen. Lindsey Graham (R-S.C.). “I’m willing to make changes if it makes sense, but I want to get it reauthorized.” Aside from Bush, other former GOP elected officials — including one-time Senate Majority Leader Bill Frist of Tennessee and former Sen. Rick Santorum of Pennsylvania — have also joined the lobbying blitz. 

But they have a hard task ahead of them. The New Yorker reported that conservative groups like the Family Research Council; Susan B. Anthony Pro-Life America; and Heritage Action for America will penalize Republicans who vote for “unreconstructed” PEPFAR on their voter guides. Said one observer: “Things don’t look very promising.”