Friday, December 1st, marks the 35th World AIDS Day. Over the last four decades and more, we have lost far, far too many millions to HIV and AIDS. But "The end of AIDS is possible, it is within our grasp," says Winnie Byanyima, Executive Director of UNAIDS. To that end, we take inspiration from legendary labor organizer Mother Jones, who called on workers to remember the dead and fight like hell for the living.
On World AIDS Day this year, we are fighting for a clean reauthorization by the U.S. Congress of PEPFAR, the most successful global health program in U.S. history. PEPFAR — the U.S. President's Emergency Plan for AIDS Relief — has saved 25 million lives to date. Moreover, PEPFAR has provided 20 million people with life-saving HIV medications and made it possible for 5.5 million babies to be born HIV-free to mothers living with the virus. In Tanzania — one of more than fifty countries where PEPFAR works — HIV-related deaths have dropped 76%, while new infections have dropped 58% over the twenty years since PEPFAR was launched.
One would reasonably presume that clean reauthorization of PEPFAR — that is, with no policy changes and no amendments — would be a no-brainer because the program is clearly working. After all, there is an overwhelming bipartisan consensus on the importance of, and the continued need for, PEPFAR. This support comes not only from progressive champions such as Rep. Barbara Lee (D-CA) but from Senators on both sides of the aisle. Former President George W. Bush has forcefully defended PEPFAR, which is surely his administration's most lasting positive legacy. Many faith-based organizations strongly back PEPFAR reauthorization — including both conservative Catholic and evangelical leaders who call PEPFAR "a pro-life miracle." The support reflects a broad bipartisan understanding that clean, five-year reauthorization is already the compromise position, and the life-saving way forward.
But these times are far from reasonable, and a handful of outliers and extremists who disregard PEPFAR's two decades of successful lifesaving efforts are seeking to make reauthorization an issue for domestic political gain. Anti-abortion extremists have found a champion in Rep. Chris Smith (R-NJ), who chairs the House Subcommittee on Global Health, Global Human Rights, and International Organizations. Smith has held up PEPFAR reauthorization, insisting on adding various anti-abortion amendments to the legislation and pushed for only a one-year reauthorization.
In echoing the dishonest talking points of the Heritage Foundation, the Family Research Council, and Susan B. Anthony Pro-Life America, Smith's strategy appears to be banking on a Republican victory in 2024 as a prelude to a radical right-wing overhaul of PEPFAR and U.S. global health strategy overall. In particular, Smith is following the Heritage Foundation's truly terrifying Project 2025 far-right playbook to fundamentally reshape the U.S. government.
From the Kaiser Family Foundation's meticulous research to Catholic priests working in Africa, voices far and wide have debunked the extremists' claims that PEPFAR is promoting abortion. The continued need for PEPFAR is clear: globally, there were 1.3 million new HIV diagnoses in 2022, while an estimated 5.4 million people living with HIV globally still do not know their HIV status, according to UNAIDS. Moreover, these new diagnoses are not evenly distributed, as stigmatized and criminalized populations, including LGBTQI+ communities, bear a massively disproportionate burden of HIV.
Pure and simple, to combat these trends, we need PEPFAR, and PEPFAR needs the stability of a clean, five-year authorization now.
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