Anti-AIDS program in GOP crosshairs over abortion funding

Republicans are fuming at the State Department after learning that recipients of funding from the legacy program to curb HIV/AIDS across Africa, PEPFAR, performed abortions in violation of U.S. law.

U.S. officials told members of Congress that a review of PEPFAR-funded service providers in Mozambique had revealed that four nurses had performed 21 abortions since January 2021, Reuters reported this week.

While abortion is legal in that country, service providers across Africa that get funding through the President's Emergency Plan for AIDS Relief (PEPFAR) are barred under U.S. law from providing abortion services.

The State Department presented its findings to the Senate Foreign Relations Committee and House Foreign Affairs Committee this week, prompting outrage from Republicans.

The PEPFAR program, established under Republican President George W. Bush, is credited with saving more than 25 million lives over the course of two decades and was routinely funded for periods of five-years.

But in March 2024, lawmakers reauthorized PEPFAR for only one year, hindering service-provider operations from planning for long-term priorities. PEPFAR authorization expires on March 25.

The discovery that some of the funding went to services that provided abortions is likely to add extra hurdles to the program’s long-term reauthorization, especially under the trifecta of Republican control of the White House, Senate and House.

Rep. Chris Smith (R-N.J.), chair of the House Foreign Affairs Subcommittee on Africa and Global Health Security and Diplomacy Bureau, called the revelation “just the tip of the iceberg” and vowed investigations into PEPFAR’s programs.

In 2024, Smith led the effort to delay PEPFAR reauthorization over what he said was opposition to Biden administration efforts to integrate the program with sexual and reproductive health and rights services. Smith called for investigations into the Centers for Disease Control and Prevention’s (CDC) role in administering funding to service providers under PEPFAR.

“The CDC’s actions are a direct violation of both the letter and spirit of the law. It is unacceptable for our government to use PEPFAR’s taxpayer dollars to promote or provide abortion, especially in a program meant to save lives from HIV/AIDS” Smith said.

The Republican chairs of the Senate Foreign Relations, House Foreign Affairs and Senate Health, Education, Labor, and Pensions committees also called for investigations.

“I will not support one dollar of American money going towards abortion anywhere in the world, and I will do all I can to ensure this never happens again,” said Sen. James Risch (R-Idaho), chair of the Senate Foreign Relations Committee.

Rep. Gregory Meeks (D-N.Y.) pushed back, saying that increased partisanship is threatening a landmark health program that has saved millions of lives in Africa.

“We don't reauthorize PEPFAR, the lives of hundreds of thousands of children will die,” he said during a panel discussion at the U.S. Institute of Peace on Tuesday.

“So not to reauthorize PEPFAR and to disregard a continent that is important, domestically to us, for the future, for the minerals, etc that we need — is dangerous to us. Because then somebody's going to step up to do it and guess who that's going to be? China.”

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