US AIDS relief program gets one-year extension in spending bill

The flagship U.S. program to combat HIV and AIDS abroad got a one-year reprieve in the spending bill, putting a temporary pause on what was an atypical partisan fight over the initiative.

The one-year extension for PEPFAR, the President’s Emergency Plan for AIDS Relief, keeps funding flat through March 2025, but it won’t impose any anti-abortion restrictions sought by conservatives. 

PEPFAR is credited with saving 25 million lives since it was launched by then-President George W. Bush in 2003, and it typically has enjoyed bipartisan support. It’s been widely regarded as one of the most successful global health programs in U.S. history. This is the first time the program has been reauthorized for fewer than five years. 

Bush has been lobbying to save the program, and he warned in an opinion piece in the Washington Post last fall that the U.S. risked backpedaling on “two decades of unimaginable progress and raise further questions about the worth of America’s word.” 

But outside conservative groups and GOP lawmakers last year began targeting the program over concerns about sending money to groups that perform abortions. Even though U.S. law prohibits the use of U.S. foreign assistance, including PEPFAR funding, for abortion, Republicans held up the renewal for months, allowing several key provisions of the program to expire last fall. 

They wanted to reinstate the so-called Mexico City policy enacted by former President Trump, which blocked U.S. federal funding for non-governmental organizations that performed abortions or provided abortion counseling or referrals.  

Punting the PEPFAR fight until next year keeps it out of election year politics, but the abortion issues are not likely to go away. It also extends the program into another potential Trump administration, which would likely move quickly to reinstate the previous restrictions. 

Advocacy groups said they were happy to see the program renewed, even if it was only for a year. 

“I think it’s sending that it’s sending a really important signal to our partner countries that the U.S. is still committed to this fight,” said Katie Coester, Associate Director of Public Policy and Advocacy at the Elizabeth Glaser Pediatric AIDS Foundation. 

“We appreciate that leaders in Congress got together and got the short extension of the expiring provisions, we’re really pleased with that, but still feel … it sort of falls short of meeting the moment,” Coester said.