The President’s Emergency Plan for AIDS Relief reauthorized by Congress

Learn more about Hannah Johnson.
Hannah Johnson
Program Manager, Global Policy
George W. Bush Institute

Last week, Congress reauthorized the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) for one year. The reauthorization affirms our country’s commitment to a program that has saved more than 25 million lives and prevented 5.5 million babies from acquiring HIV. PEPFAR’s lifesaving work will continue in sub-Saharan Africa and beyond, and we are one step closer to ending the HIV/AIDS epidemic.  

Since its inception in 2003, PEPFAR has received continuous bipartisan support through two Republican and two Democratic administrations, eleven Congresses, and now four reauthorizations. Historically, Congress has reauthorized the program for five-year periods, and Congressional oversight remains important. A one-year reauthorization is welcome news but will pose longer-term challenges for the program, making it more difficult to plan beyond an annual funding cycle.  

However, in a time of intense partisanship, a one-year PEPFAR reauthorization is a testament to the vital importance of the program. Lives will continue to be saved around the world because of the compassion and generosity of the American people. 

As one of the most successful foreign aid programs since the Marshall Plan, PEPFAR has instilled democratic values in the countries it operates in, emphasized the importance of civil society engagement, and allowed countries to combat other pandemics like COVID-19 and Ebola.  

PEPFAR also stands in stark contrast to Chinese lending structures and health programming that lack accountability, transparency, and long-term sustainability. Instead, over half of PEPFAR’s country-level funding goes to local organizations and is informed by granular, disaggregated data. 

Since 2009, the program has operated on a budget that has gone virtually unchanged. Conflict, natural disasters, and pandemics like Ebola and COVID-19 would typically require increased funding. However, PEPFAR’s innovative use of strategic partnerships and investment in health systems has ensured that the program continues to succeed – despite flat funding for over a decade.  

UNAIDS estimates that approximately 39 million people were living with HIV and 630,000 people died from AIDS-related illnesses globally in 2022. Young people face high risks of contracting HIV, and it’s the leading cause of death among women of reproductive age. These populations are the backbone of society and integral to sustainable development and combatting extremism. Failure to continue the momentum gained over the last twenty years by providing targeted programming toward youth, adolescent girls, and young women poses significant threats to health, economic growth, and opportunity across the globe. 

It’s clear that PEPFAR’s tremendous progress toward eliminating HIV/AIDS can’t stop now. The program’s one-year reauthorization is an important step toward continuing PEPFAR’s lifesaving work around the world, and we must continue to build on this progress next year and beyond.