Last month, Congress and the Trump Administration agreed to drop the proposed cut to PEPFAR’s fiscal year 2025 funding from the recissions package that ultimately was passed and signed into law. This show of bipartisan support protects funding for the vital work of the President’s Emergency Plan for AIDS Relief, a program credited for saving more than 26 million lives. With vigorous implementation over the next few years, PEPFAR can achieve its goal to end HIV/AIDS as a public health threat by 2030.
Last month, the House Appropriations Committee held a markup of the fiscal year 2026 National Security, Department of State, and Related Programs bill. Under the proposal, the PEPFAR budget and U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis, and Malaria in FY2026 would amount to approximately $6.2 billion – a minimal decline from $6.5 billion in the current fiscal year. The bill would also require Secretary Marco Rubio to submit a strategy on a gradual and responsible transition of PEPFAR programming to country ownership. Avoiding interruptions in program implementation remains critical, even a matter of life and death.
The mission to defeat the global threat of HIV/AIDS should be rooted in saving human lives and advancing U.S. national interests. We should remain committed to ensuring that nations hardest hit by the global AIDS crisis receive the support they need to keep people safe and healthy, while preventing adversaries like Russia and China from advancing inferior programs.
Figure of the Week
1.4 million
That was the number of children living with HIV in 2024 according to the latest data from UNAIDS on the HIV/AIDS pandemic. Advancements in treatment for pregnant and breastfeeding women have protected children from developing HIV. As a result, the number of new HIV infections among children from 2010 to 2024 declined by 62%.
Although progress in reducing new HIV infections is greatest among children, advancement has stalled in recent years. Among children up to 14 years old, the 95-95-95 targets in 2024 were lower than the global average. Only 63% of children knew their status (compared to 87% of all people living with HIV), 87% were on treatment (compared to 89%), and 86% had undetectable levels of HIV in their blood (compared to 94%).
To end HIV/AIDS as a public health threat by 2030, PEPFAR and its partners must not take their eye off the ball. They must work alongside influential civil society partners to ensure that pregnant and breastfeeding women as well as young children maintain strict treatment regimens.
Ally Updates
Southern Methodist University is collecting interviews for an oral history project documenting the history of PEPFAR. The project involves interviews with U.S.-based policymakers and advocates instrumental in PEPFAR’s creation. Future phases will consist of interviews with PEPFAR partners and beneficiaries in South Africa and will eventually expand into greater Africa and Southeast Asia.
SMU’s Brian Franklin recently interviewed Franklin Graham, evangelist, missionary, and president of Samaritan’s Purse, for the project. Rev. Graham shared his history of faith-based initiatives to support HIV/AIDS relief: “[My goal] was to try to draw awareness to the evangelical world or to the Christian world of the importance of helping people that were infected with HIV, to try to help them.”
Bush Institute Insights
On July 18, I provided an update on the decision by Congress and the administration. Congressional approval to maintain PEPFAR funding demonstrates the United States’ ongoing commitment to saving millions of lives from HIV/AIDS. This action highlights the bipartisan support PEPFAR has consistently received, which is a crucial signal to our allies. Moving forward, PEPFAR must focus not only on making vital investments in HIV/AIDS but also on building self-sustainable networks so that countries can sustain the progress achieved over the past 22 years. By strengthening data-driven programs, partnering with civil society, and leveraging innovative public-private collaborations, PEPFAR has the tools needed for continued success.
In the News
- In a recent post on his personal website and an op-ed in the Wall Street Journal, Bill Gates explains why his passion for global health begins and ends with investing in human lives: “People in global health argue about a lot of things, but here’s one thing everyone agrees on: Health aid saves lives.” Gates recognizes how critical global health investment is to saving vulnerable populations, especially children, and that, unfortunately, cuts to global health funding only increase the amount of “preventable deaths” reported each year.
- In an op-ed published by The Hill, Chelsea Sobolik, director of government relations for global Christian humanitarian organization World Relief, commends Congress for preserving PEPFAR from budgetary restrictions. Even in the face of fiscal constraints, she writes, it is important that the federal government prioritize life-saving initiatives well within its capabilities. Sobolik particularly praises Senate Republicans for keeping PEPFAR alive, given its immense impact over the past two decades: “It is one of the most successful, life-affirming humanitarian programs in history, and it has bipartisan roots that reflect a shared moral responsibility to protect life.”
- The World Health Organization (WHO) has added the groundbreaking drug lenacapavir to its HIV prevention recommendation list amidst uncertainty about the future of PEPFAR. WHO reports that the drug is underutilized around the world, a problem that could only get worse if the current U.S. administration follows through on its plans to cut global humanitarian assistance funding. This could hinder lenacapavir from being used to curb AIDS-related deaths across the world, as the drug is nearly 100% effective in preventing HIV infection.
- The International AIDS Society (IAS) published a statement during its 2025 conference praising the United States Congress for bipartisan support in sparing PEPFAR funding from budget cuts. “PEPFAR has been one of the greatest success stories in global health, transforming the HIV response,” IAS President Beatriz Grinsztejn stated. International AIDS Society leadership views PEPFAR as a lifeline for African communities as administrators strategize implementation of stronger domestic investments and reduce dependence on global donors.
