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PEPFAR wins a short-term reprieve in the minibus

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Illustration: Sarah Grillo/Axios

The President's Emergency Plan for AIDS Relief will be reauthorized for one year as a part of the second government funding deal, sources said, signaling a temporary truce over the biggest effort by one nation to address a particular disease.

Why it matters: The agreement, struck during negotiations on the minibus, marks the first time the program won't been renewed for a five-year interval since its creation in 2003 and sets up another fight over its future in 2025.

The big picture: U.S. funding for PEPFAR has totaled more than $110 billion and customarily served as a bipartisan rallying point. The program is credited with saving 25 million lives since it was established under then-President George W. Bush.

  • But outside conservative groups last year began raising concerns that some of the funding could be used for abortion.
  • Congressional Republicans argued that President Biden made that possible by rescinding the so-called Mexico City policy enacted by former President Trump.
  • Trump had for the first time applied the policy — which bars NGOs overseas from receiving funding if they promote or perform abortions — specifically to the PEPFAR program.
  • The Biden administration has denied the charges and called for a full five-year reauthorization of the program.
  • A bipartisan group of 75 members reiterated their support for the program last summer.

Between the lines: The latest agreement — first reported by Semafor — calls for PEPFAR to be reauthorized one year from the date of enactment, to March 2025.

  • Punting the next reauthorization until 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.
  • "If it was just going to be reauthorized until the end of September, it puts it even more in the cross hairs of the election," said Kates.
  • It also achieves Hill Republicans' goal of waiting for a potential GOP administration to take over and alter the program.

Yes, but: So it goes that the extension probably won't keep PEPFAR out of the cross hairs for long.

  • If Trump is re-elected, he'd likely move fast to reinstate an expanded Mexico City policy that applies to PEPFAR.
  • Biden would likely maintain the status quo, but the program could still be caught in a funding fight, depending on which party controls which chamber of Congress.

At a minimum, a one-year reauthorization reinforces the U.S. commitment to the global AIDS fight amid a charged election year environment.

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