The President’s Emergency Plan for AIDS Relief, a bipartisan program signed into law by President George W. Bush 20 years ago, is one of the most effective foreign assistance programs the U.S. has undertaken. PEPFAR has secured lifesaving antiretroviral treatment for 20.1 million people, ensured 5.5 million babies were born HIV-free to mothers living with the virus, trained 340,000 health care workers to deliver HIV care, and supported 7 million orphans, vulnerable children and their caregivers.
In a disastrous act of self-sabotage, Congress has, thus far at least, failed to renew PEPFAR. And now its future is in jeopardy.
Yet, in a disastrous act of self-sabotage, Congress has, thus far at least, failed to renew PEPFAR. And now its future is in jeopardy.
As a member of the Senate Foreign Relations Committee, I’ve had the opportunity to travel the world to see firsthand how this initiative saves lives and transforms vulnerable communities. I’ve also witnessed Republicans and Democrats in Congress working together over the years — putting aside political differences — to ensure the program is fully funded and to secure its future.
PEPFAR’s irrefutable success and its history of bipartisan support may prompt you to ask: Why hasn’t this Congress reauthorized it?
The answer is that, tragically, PEPFAR has become the latest casualty in America’s culture war on abortion. A conservative foundation falsely accused the Biden administration of using it “to promote its domestic radical social agenda overseas” — a claim with no basis in fact.
It’s no secret congressional Democrats and Republicans are deeply divided. Both parties are further apart ideologically today than at any time in nearly half a century. However, since its inception in 2003, PEPFAR has served as the model for bipartisan cooperation. It was established by a Republican president and enacted with near-unanimous congressional support, reauthorized three times over the span of four presidential administrations, and has consistently secured the bipartisan backing of members of Congress across the ideological spectrum.
And PEPFAR’s broad coalition of support extends far beyond the federal government.
Faith leaders worldwide have spoken out on the importance of the lifesaving program and the urgent need for a five-year reauthorization. In many cases, faith-based organizations are the soldiers on the front lines in the war against HIV/AIDS, partnering with local communities to carry out the program. In a plea to members of Congress to prevent the program from expiring, 44 faith organizations from here and abroad rightly pointed out they “helped shape PEPFAR and have been central to its success, working together in a spirit of compassion and mercy, upholding the belief that all human life is sacred, and we are all God’s children worthy of healing care.”
PEPFAR does not — nor has it ever — funded abortions. Nevertheless, a handful of anti-abortion groups have waged an all-out assault against the initiative, whipping votes in Congress to attach unnecessary, restrictive and politically divisive language to its reauthorization. They’re attempting to slash the program’s renewal from five years to one — making it nearly impossible to strategically implement funding, plan for contingencies and adapt to changing conditions in target countries — and threatening to smear lawmakers who support a five-year renewal.
I unapologetically believe in a woman’s right to choose, but there are no federal PEPFAR funds being used for abortions. Period.
Make no mistake: I unapologetically believe in a woman’s right to choose, but there are no federal PEPFAR funds being used for abortions. Period. And I take umbrage with those who spread falsehoods about PEPFAR funding to serve their own political interests, especially at the expense of the innocent people, including children, we’re supporting with that funding.
President Bush himself — arguably one of the most conservative presidents elected in modern political history — has joined the public to push back on the lies being spread about PEPFAR. “There is no program more pro-life than one which has saved more than 25 million lives,” he wrote. “We are on the verge of ending the HIV/AIDS epidemic. To abandon our commitment now would forfeit two decades of unimaginable progress and raise further questions about the worth of America’s word.” It’s hard to escape the irony that, despite the widespread knowledge and understanding that abortion has no connection to PEPFAR, special interest groups claiming to care about the sanctity of life are the very ones poised to kill a historic program that has saved the lives of millions of people. As a father and grandfather with a deep connection to my faith, I challenge these so-called “pro-life groups” to travel to regions ravaged by the epidemic, look these people in the eye and tell them that politics and American culture wars take priority over their lives and the lives of their families. When PEPFAR was signed into law in 2003, an HIV or AIDS diagnosis was a death sentence for most people around the world. Twenty years later, through the generosity of the American people and one of the most successful foreign assistance programs ever developed, we have changed the course of human history. As we recognize World AIDS Day, we have a moral imperative to act decisively. As we recognize World AIDS Day, we have a moral imperative to act decisively. Now is the time for Republicans and Democrats in both chambers to demonstrate the commitment and courage that we’ve exhibited for two decades and ensure the program is reauthorized for the next five years in our shared mission to end AIDS by 2030. We have a real opportunity to end HIV/AIDS if we keep this program on track. Time is running out. We cannot, and should not, turn back. For millions of people around the world, whether we fund PEPFAR or not is a matter of life or death.
Sen. Ben Cardin
Sen. Ben Cardin, a Democrat who serves as the senior senator from Maryland, is the chair of the Senate's Foreign Relations Committee. 
