Last week I participated in a press conference on Capitol Hill with Congressman Mike Pence, Chuck Colson Of Prison Fellowship, best-selling author and pastor Rick Warren, and a host of others who are concerned about the future of the President’s Emergency Plan for AIDS Relief (PEPFAR).Why the conference? The group which assembled wants to ensure that the good work that this program began will continue. A renewal bill entitled “The US Global HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008” is scheduled to be marked up by the House Committee on Foreign Affairs next week. Many fear that partisan politics will mar the good work done in the original bill.
In this year’s State of the Union address, the president announced his intention to take the program to another level. He stated, “...America is leading the fight against disease. With your help, we are working to cut by half the number of malaria-related deaths in 15 African nations. And our Emergency Plan for AIDS relief is treating 1.4 million people. We can bring healing and hope to many more. So I ask you to maintain the principles that have changed behavior and made this program a success. And I call on you to double our initial commitment to fighting HIV/AIDS by approving an additional $30 billion over the next 5 years.”
Our press conference was simply an attempt to help the public understand that this landmark policy should be expanded from a positive, 5-year prototype just as the president suggested. The average American does not know the following history.
In his State of the Union address in 2003, President George Bush originally announced the PEPFAR program. It is the largest aid commitment ever made by any nation for an international health initiative to fight a single disease --- HIV/AIDS. At the time of the original announcement, only 50,000 people were receiving treatment for HIV/AIDS in sub-Saharan Africa. The original commitment was $15 billion over a 5 year period. The results have been phenomenal. As the president stated in his address, the program helped provide antiretroviral treatment for over 1.4 million men women and children through September 30, 2007. Over 86,000 children, age 14 and under, are receiving this life saving treatment. In addition 62% of the individuals on direct PEPFAR support are women and children.
The program has been built on an A-B-C approach to the prevention of HIV/AIDS. Three keys to preventing the spread of this dreaded disease are Abstinence programs, Be faithful programs, and using Condoms. Together, these three reduce the number of partners and prevent risky behaviors. A report to Congress stated that the Abstinence and Be faithful programs have reached more than 40 million people including nearly 11 million primary-age children. At the same time, studies suggest that those programs that have begun to shift to condom-only paradigms are less effective at curbing the HIV infection rate. This has been observed in both Uganda and Botswana.
The benefit of the abstinence aspect of the PEPFAR program thus far is that it has helped create a change in personal behavior and social/ sexual norms among young people. The amazing results of PEPFAR’s first few years is the beginning of changing the way an entire generation views life, family, and health.
In spite of these facts, pro-abortion, anti-family ideology has gripped current policy makers. The newly proposed bill plans to undo rules that prevent money from going to abortions, while continuing to fund other aspects of family planning. Policy makers would also like to do away with a pledge that recipients of PEPFAR monies will not support the legalization of prostitution or sex trafficking. But this not a prudish limitation; the groups funded may still provide condoms or condom information to prostitutes. The pledge was conceived of to "ensure that pimps and brothel owners don't become U.S. government partners," according to, Rep. Chris Smith, R-N.J. architect of the pledge and policy.
Rep. Mike Pence, R-Ind., described the problem very succinctly. He said that these new adjustments to the AIDS program "would transform the program into a mega-funding pool for organizations with an abortion promotion agenda."
In response, some Democratic legislators purport that studies show some groups will not make the pledge because of concerns about alienating the women they are targeting. In addition, other groups see legalized and/or controlled prostitution as a way to slow the spread of HIV infection. In my mind, these are illogical assertions based on ideology instead of facts.
The most confusing aspect of this debate is that there are people in the faith community who are in favor of changing the current PEPFAR formula. Advocates of the “new” program cite 360 grassroots, faith-based partners in 36 countries. The American Jewish World Service has created a coalition with groups like the National Council of Jewish Women and the Union for Reform Judaism who strongly support the bill.
In summation, it is important to remember that the new bill undermines the abstinence aspect of the program without real scientific evidence to support the proposed change. Second, the new bill would also erase the power of the faithfulness programs originally established. Third, the blending of “family planning” and “reproductive health” programs with HIV/AIDS programs could be disastrous in terms of mission drift and lack of focus. Finally, the new bill could create large amounts of funding for international abortion providers.
So what should we do about it? I recommend that you pass this article on to a friend and let our congressmen know that we support PEPFAR the way it was originally written. Despite the excitement of presidential politics in a major election year, we need to make sure we mind the knitting of legislative policy in this transition period. The ball is in our court!