In the fall of 2023, former secretary of state Condoleezza Rice appeared on MSNBC’s Morning Joe as part of a push to persuade Congress to reauthorize the President’s Emergency Plan for AIDS Relief (PEPFAR). Launched by President George W. Bush in 2003, the successful humanitarian program had already saved more than 25 million lives in Africa and other parts of the world through critical HIV prevention and treatment programs. But, caught up in partisan budget negotiations and the broader abortion debate, it was suddenly in Congress’s crosshairs. Rice expressed regret that the future of the nonpartisan program, which had brought together such disparate figures as Jesse Helms and Bono, was at risk. “I am a Presbyterian minister’s daughter,” Rice said. “When there are hurting people in the world, your Christian conviction is that you have to do what you can to help.”
Congress eventually preserved the program. A short-term reauthorization was slipped into an omnibus funding bill in March 2024, notably without any of the anti-abortion provisions many legislators had wanted. But Republican wariness wasn’t quelled. Even before Donald Trump won reelection and issued a ninety-day freeze of foreign-aid programs during his first days in office, Idaho senator James Risch, chairman of the Senate Foreign Relations Committee and a practicing Catholic, had put a hold on about $1 billion in funds over concerns that PEPFAR dollars were going toward abortions abroad. Rep. Chris Smith, a Catholic who is chair of the House Foreign Affairs Subcommittee on Africa, continues to call for language prohibiting administrators from funding groups that advocate for access to abortion services. “I think we need a top-to-bottom review of PEPFAR,” he said. “I think it needs to be seriously evaluated.” And while Secretary of State Marco Rubio, another Catholic, has publicly stated that he wants to continue PEPFAR, he also believes the success of the program means it should be scaled down.
But any serious evaluation of PEPFAR must consider both its record of success and the continuing need for its life-saving services. An estimated 5.1 percent of people in Uganda have HIV, according to the United Nations. Since 2010, PEPFAR and other U.S. aid initiatives have helped decrease new HIV infections in Uganda from eighty-three thousand to thirty-eight thousand. During that same period, AIDS-related deaths in Uganda have decreased from fifty-three thousand to nineteen thousand. This progress is remarkable, but incomplete. Trump’s ninety-day freeze has greatly hindered PEPFAR’s ability to deliver aid to millions of people affected by HIV and severely disrupted drug supply chains in Uganda and across Africa. Further interruptions will result in thousands of deaths and undo decades of progress against HIV and AIDS.
Despite the Catholic Republicans lined up against it, many of the same religious voices who originally supported PEPFAR are once again speaking up in its defense. The U.S. Conference of Catholic Bishops and Catholic Relief Services, its international charitable arm, have urged Catholics to contact their elected officials. Other leaders from a range of faith traditions continue to call on the Trump a ministration to keep this essential international humanitarian-aid program in place—much like that daughter of a Presbyterian minister did two years ago.
As Rice reminded us, the United States is at its best when it acts with compassion. Letting this historically successful nonpartisan program get picked apart by partisan legislators and a power-hungry executive would represent a rejection of the humanitarian values that inspired its creation. We would be turning our backs on the people most in need.
