On April 8, the
House Committee on Appropriations' Subcommittee on National Security, Department of State, and Related Programs hosted a hearing assessing the President’s Emergency Plan for AIDS Relief (PEPFAR). The hearing showcased the bipartisan support for PEPFAR – essential since the program’s launch in 2003 – as members from both parties, including Chairman Mario Diaz-Balart and Ranking Member Lois Frankel, applauded the 26 million lives it has saved. The hearing also showcased continued challenges that the program faces as the administration’s position on foreign assistance evolves.
The first U.S. Global AIDS Coordinator, Ambassador Mark Dybul, participated in the hearing and testified on the need to foster a structured, tailored transition for PEPFAR countries to assume ownership of the program. Members from across the aisle agreed that while a multi-year transition that enables country-led sustainability is necessary, an abrupt stop to PEPFAR programming would be counterproductive to over two decades of work, jeopardize American interests and investments, and risk millions of lives.
The George W. Bush Institute’s
PEFPAR Beyond 2030 series
recommends a tiered approach to PEPFAR transition. Countries are in different phases of ending HIV as a public health threat by 2030. While some are on the path to self-sustainability, others are falling behind. It is possible, even necessary, to begin to transition PEPFAR programming to country ownership, which would require less funding as the program nears 2030. But an abrupt halt in funding in two years or less could prevent PEPFAR from achieving its goals.
It is crucial to think carefully and at the country-specific level about this transition to ensure that our strategic goals are achieved. Our rivals like China and Russia are waiting in the wings to influence, overtake, and denigrate decades-long U.S. efforts. We must continue to support PEPFAR and ensure we get the job done – America's geopolitical influence and precious lives are at risk.
