Mar 20, 2024 - Health

Global AIDS program gets a lifeline in new spending deal

Illustration of a magnifying glass studying a red ribbon

Illustration: Sarah Grillo/Axios

A successful global AIDS program that was in limbo for months got a temporary reprieve this week when congressional negotiators agreed to a one-year renewal in the next government funding package.

Why it matters: It marked a temporary truce over the President's Emergency Plan for AIDS Relief, or PEPFAR, which is credited with saving 25 million lives since its inception in 2003 but recently became mired in abortion politics.

  • Conservative groups last summer charged the Biden administration was using it to promote abortion overseas.
  • Key program functions expired after the 2023 fiscal year ended in September, although money for the AIDS fight kept flowing through the annual appropriations process.

State of play: The latest agreement, first reported by Semafor, calls for PEPFAR to be reauthorized through March 2025.

  • Punting another reauthorization to next spring will help to get the program out of the fray of election-year politics, said Jen Kates, director of global health and HIV policy at KFF.
  • But doing so also accommodates Republicans, who want to defer action in the hope a potential GOP administration can make bigger changes to the program.

Between the lines: U.S. funding for PEPFAR has totaled more than $110 billion and customarily has been a bipartisan rallying point.

  • But conservatives argued that President Biden politicized the program by rescinding former President Trump's "Mexico City" policy, which included PEPFAR in a ban on federal dollars to overseas groups that provide abortion or abortion counseling.
  • The Biden administration and program advocates denied the charge and called for a full five-year reauthorization of the program.
  • A bipartisan group of 75 House members reiterated their support for the program last summer.

The bottom line: A one-year reauthorization may not change much but reinforces the U.S. commitment to the global AIDS fight amid a charged election-year environment.

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