This bill would extend the President’s Emergency Plan for AIDS Relief (PEPFAR) program’s end date from 2018 to 2023. PEPFAR, first proposed by President George W. Bush in 2003, is the U.S. government’s global effort to combat HIV. It’s the largest global program devoted to a single disease. It was originally authorized as a five-year, $15 billion initiative to combat global HIV/AIDS, tuberculosis (TB), and malaria primarily for 15 hard hit “focus countries,” and fund multilateral contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund), and UNAIDS.
What is House Bill H.R. 6651?
Cost of House Bill H.R. 6651
In-Depth: Rep. Christopher H. Smith (R-NJ) introduced this bill to fund PEPFAR beyond its 2018 expiration. Rep. Barbara Lee (D-CA), a cosponsor of this bill, calls PEPFAR a successful bipartisan collaboration on U.S. leadership in global public health:
“For the last 15 years, PEPFAR has been a testament to the bipartisan cooperation on U.S. leadership in global public health. Thanks to PEPFAR, millions of lives have been saved through HIV/AIDS treatment, care, and education. But our work is far from over – we are at a tipping point and Congress must recommit to this fight. Many still do not have the resources and care they need, and stigma stands in the way of eradicating this disease for good. At this pivotal time, Congress must do the important work to protect and fund programs like PEPFAR and the Global Fund. As an early champion of these initiatives, I am so proud of our work across the aisle, ensuring that PEPFAR can continue to save lives for decades to come.”
Charles Lyons, president and CEO of the Elizabeth Glaser Pediatric AIDS Foundation, which supports this bill, calls this bill’s support for PEPFAR essential to the program’s continuation:
“Over the past 15 years, PEPFAR has driven stunning progress in the global fight against AIDS, including enabling more than 2.2 million babies to be born HIV-free to HIV-positive mothers. As a long-term PEPFAR implementer, we see the program’s remarkable success up close, but we are also very aware how much work remains. Sustained support and leadership on the part of the U.S. is instrumental, and EGPAF welcomes this step toward renewing commitments to ending the epidemic.”
Loyce Pace, President and Executive Director of Global Health Council (GHC), adds that PEPFAR is a prime example of investing in global health:
“We know that investments in global health work, and PEPFAR is a prime example of that. Over the past 15 years, PEPFAR has had an impact on the lives of those living with HIV/AIDS, as well as building health systems to address malaria, TB, and maternal and child health. By renewing our commitment to this groundbreaking initiative, we emphasize its value and pave the way for even more global health progress worldwide.”
The Center for American Progress’ Scott H. Evertz argues that PEPFAR, while admirable in its intentions, is a critically flawed program:
“PEPFAR has meant nothing less than another chance at life for millions of people around the world. And it provided a positive image of the United States at a time of controversial foreign policy entanglements. Yet the reality is that the Bush administration’s PEPFAR legacy is far more complicated and problematic. The program has proved deficient in many respects, most notably in prevention and reaching out to populations most in need of services. Some of these limitations are rooted in the statute or implementing regulations; others have played out on the ground through different interpretations of U.S. government policies; but most are due to a framework that placed ideology above science.”
Health GAP’s executive director, Asia Russell, adds that PEPFAR is “the kind of global AIDS response policymakers craft when they have one hand tied behind their backs,” and argues that the current PEPFAR plan fails to highlight the “dangerous impact” of expanding the Global Gag Rule, which blocks U.S. funds to any organization involved in abortion advice and care overseas. Ms. Russell adds that a truly ambitious HIV/AIDS strategy would be more global than PEPFAR’s current direction:
“An ambitious strategy wouldn't limit efforts toward epidemic control in just 13 of PEPFAR's more than 50 countries, but would aggressively map out a plan for ending AIDS as an epidemic in all countries, including those with the highest burden and greatest need such as Mozambique, South Sudan, the Democratic Republic of Congo and other parts of West Africa… PEPFAR leadership should sound the alarm about the risks of committing too few resources to the global AIDS response and the dangers of using scarce resources for anything other than evidence-based strategies."
The Trump administration has been hostile to PEPFAR, suggesting that it views it as a “massive, international entitlement program.”
This bill passed the House Foreign Affairs Committee on a unanimous vote with the support of 12 cosponsors, including six Republicans and six Democrats. It has the support of the United States Conference of Catholic Bishops (USCCB), Catholic Relief Services (CRS), Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Friends of the Global Fight Against AIDS, Tuberculosis and Malaria (Friends), World Vision, Global Health Council, and the ONE Campaign.
Of Note: Since its original authorization, PEPFAR has been reauthorized twice, in 2008 and 2013. To date, PEPFAR funding has totaled over $70 billion. PEPFAR is widely credited with changing the trajectory of the global HIV/AIDs epidemic. Since its inception, PEPFAR has supported HIV treatments for over 13.3 million people globally, putting an AIDS-free generation in reach. Thanks to PEPFAR, 2.2 million babies have been born HIV-free to mothers receiving antiretroviral drugs.
- Cosponsor Rep. Barbara Lee (D-CA) Press Release
- CBO Cost Estimate
- Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) Press Release (In Favor)
- United States Conference of Catholic Bishops (USCCB) Press Release (In Favor)
- United States Conference of Catholic Bishops Press Release (In Favor)
- World Vision Press Release (in Favor)
- Global Health Council Press Release (In Favor)
- Joint Letter From Various Health Organizations (In Favor)
- Kaiser Family Foundation (Context)
- Council on Foreign Relations (Context)
- The Atlantic (Context)
- Vox (Context)
Summary by Lorelei Yang(Photo Credit: iStockphoto.com / spukkato)
PEPFAR Extension Act of 2018
To extend certain authorities relating to United Sates efforts to combat HIV/AIDS, tuberculosis, and malaria globally, and for other purposes.
- Not enactedThe President has not signed this bill
- The senate has not voted
- The house has not voted
Committee on Foreign AffairsIntroducedAugust 3rd, 2018
- house Committees