Senate Republicans are hesitant about cutting the widely supported global HIV/AIDS program, PEPFAR, as they approach a July 18 deadline to vote on President Trump’s initial funding request.
Last month, during a call to Congress, Trump proposed eliminating the $900 million budget allocated for the President’s Emergency Plan for AIDS Relief (PEPFAR). The House has already approved this funding withdrawal, leaving the Senate to make a final decision.
Launched under President George W. Bush, this historically bipartisan HIV program has faced scrutiny from Republicans in recent years. Nevertheless, there are still dedicated supporters on both sides.
Leading the charge against cutting PEPFAR is Senator Susan Collins (R-Maine), who chairs the Senate Approval Committee.
“I’m strongly opposed to withdrawing funds from PEPFAR, which has reportedly saved around 26 million lives and prevented nearly 8 million infants from contracting AIDS from infected mothers. The success rate of this program is immense,” Collins stated. “I can’t see any reason to end it.”
Other Republican lawmakers also express robust support for PEPFAR. Senator Mike Rounds (R-S.D.) remarked, “Most Republicans are in favor of certain foreign aid elements, which have shown almost comparable success to those we currently support.”
The Approval Committee has the power to approve, reject, or amend Trump’s proposal. With just a week left for voting, legislators are working out the finer details of the funding package.
Senator Sherry Moore Capito (R-W.Va.) noted, “There’s ongoing discussion about gathering more detailed data. PEPFAR is very popular, and we know it has a significant impact on many lives.”
Senator John Kennedy (R-La.) mentioned that his colleagues are asking important questions regarding the potential cuts, adding that Trump’s budget director, Las Vaut, will return to the Senate next week to provide further explanations.
“Many of us have discussed necessary budget cuts but seem hesitant to go back to the drawing board. It’s a moment of truth,” Kennedy remarked. “It’s kind of like wanting to go to heaven — everyone does, but few are prepared to make the journey, and it feels relentless if we don’t pass this budget proposal.”
PEPFAR has been reauthorized by Congress four times in history, but a significant delay occurred during the last reauthorization when Representative Chris Smith (R-N.J.) attached anti-abortion stipulations affecting program partnerships.
Those restrictions expired in March but were later renewed for a year.
Abortion remains a contentious topic among some Republicans concerning PEPFAR’s ongoing support. Senator Lindsey Graham (R-S.C.), a long-time advocate of PEPFAR, mentioned that he would back the rescue package after learning some funds might be redirected to abortion services.
Earlier this year, it was reported that service providers funded by PEPFAR in Mozambique performed at least 21 abortions since January 2021, allegedly in violation of U.S. law.
Supporters of PEPFAR argue the program is remarkably efficient, saying that its budget constitutes less than 0.1% of U.S. spending. Over its 22-year run, PEPFAR has received more than $120 billion, with $6.5 billion earmarked for 2025.
Beyond saving lives, PEPFAR is viewed as a pivotal element of U.S. foreign policy and soft power globally.
Gilea Lethobosian, a former PEPFAR Chief and Duke Global Health Institute Fellow, stated, “We’ve encountered numerous health challenges. Cutting PEPFAR undermines America’s global influence, essentially ceding ground to countries that don’t share our values. This is why it’s shortsighted and could weaken our security and standing abroad.”
David J. Kramer, executive director of the George W. Bush Institute, cautioned that if PEPFAR funding is reduced, foreign adversaries are poised to fill the gap.
“China and Russia are eager to capitalize if the U.S. fails to uphold its commitments,” Kramer noted in a letter to the Senate Budget Committee. “While PEPFAR focuses on saving lives, China’s lending and health initiatives often lack accountability and long-term viability, while Russia amplifies instability and violence, compromising infrastructure along the way.”
Some maintain that PEPFAR was always intended to be a temporary program that would eventually transition responsibilities to recipient countries. It’s already operational in over 50 countries.
“The administration claims it intends for PEPFAR to shift towards state-led initiatives, implying a need to move funds to encourage countries to spearhead their own HIV programs. But funding cuts of $400 million seem contradictory to that goal.”
