The waiver includes PEPFAR, a program that has saved 26 million lives
This article originally appeared on The Dallas Morning News’ website.
The President’s Emergency Plan for AIDS Relief, or PEPFAR, helps people around the world stay healthy while also keeping America safe and prosperous and countering the influence of adversaries like China and Russia. The Trump administration and Secretary of State Marco Rubio did the right thing Tuesday in granting PEPFAR a waiver from a freeze in its funding as part of a larger review of foreign assistance spending.
Like all other federal programs, PEPFAR should be subject to review. But it’s vital that the administration keep it exempt from the pause in funding so that it can continue to ensure that those on treatment receive uninterrupted care. In fact, it’s a matter of life and death.
PEPFAR has become one of the most successful foreign assistance programs in U.S. history since it was launched by President George W. Bush in 2003 with strong bipartisan support. It has saved 26 million lives, including more than 7.8 million babies born HIV-free, over the past two decades. During President Donald Trump’s first term, the program had impressive success and has enjoyed support from administrations of three other presidents from both parties.
A successful, multiyear transition toward full country ownership of the effort has begun, but the mission isn’t complete. That means that now isn’t the time to halt funding.
Disease and violence know no borders, as we learned both from COVID-19 and the time before PEPFAR, when the HIV/AIDS epidemic was wiping out large segments of society, most notably in Africa, and creating significant instability in many countries.
People were dying, babies were being born with this uncurable disease, and entire communities faced extinction because antiretroviral treatment was unavailable to people living with HIV in low- and middle-income countries.
In addition to saving lives, PEPFAR enhances America’s strategic influence in Africa and engenders goodwill toward the United States. It has helped stabilize the continent as it teetered on the brink. Geopolitically, strong relations with African nations — those hit hardest by HIV/have — help the United States. Africa is resource-rich and home to the world’s youngest and fastest-growing population. Almost 2.5 billion people will reside in Africa by 2050, most under 30.
Russia and China have taken note and are eager to capitalize on any weakness in U.S.-African relations, which are strong largely because of PEPFAR. Any pause in PEPFAR funding would create an opening for them to exploit, offering inferior alternative medicines and undermining the lifesaving work we have done there.
For individuals with HIV, any interruption in treatment risks the emergence of strains of the virus that are resistant to low-cost drugs. If they spread, this could reverse decades of progress and make HIV control even more costly. And, as we learned during COVID-19, such effects aren’t limited to one region of the world.
Alternatively, those who consistently uphold their treatment regimen can reduce the virus in their blood to undetectable levels, making it nontransferable. For a pregnant woman living with HIV, a consistent routine ensures that she lives a healthy life and that her baby is born HIV-free.
Americans should feel proud that they have helped save so many precious lives at a relatively small cost and with a great return on investment. PEPFAR and the HIV/AIDS response have provided global economic benefits of over $1 trillion.
PEPFAR has also changed the way the United States uses foreign aid. The program’s data-driven model ensures that taxpayer dollars are directed toward people who need it most, and it established partnerships with local governments, civil society, and the private sector to advance and eventually hand off sustainable programming.
The accountability measures built into PEPFAR have also allowed it to detect and address issues in the rare cases when things go wrong or the program doesn’t live up to its own standards.
For example, a PEPFAR partner reported late last year that PEPFAR funds in Mozambique were improperly used to perform abortions. This violation of U.S. law is a disturbing departure from the spirit and purpose of the program and must be fully investigated. Doing so will afford the Trump administration the opportunity to ensure PEPFAR stays true to its original goals of addressing the HIV/AIDS challenge by saving lives.
After all, lives are at stake, and so are vital U.S. national security interests. Maintaining funding for PEPFAR will also enhance the view of the current administration among Africans as generous and supportive.
PEPFAR is an extraordinary accomplishment, changing the course of history for a continent. It’s bringing lifesaving results through accountable measures and should be exempt from the pause in funding, for the good of the United States and the world. Because, as Bush reminded us at the outset of the program, all life is precious — and there’s no program more pro-life than one that has saved 26 million lives.
