Editor’s note:
New Jersey Republican Chris Smith says he’s working to continue funding for a global health program that has saved millions of lives from drastic cuts proposed by the Trump administration. Opposition to the cuts is attracting bipartisan support.
In its latest budget request, the administration aims to slash 38 percent, or $2.9 billion, from the U.S. President’s Emergency Plan for AIDS Relief, (or PEPFAR), a move that would also dismantle the agency that has administered the program for decades.
Additionally, the administration has asked Congress to cancel $8.3 billion in funding already appropriated for foreign aid, including $400 million for the AIDS/HIV relief program.
The House is scheduled to vote on the
$9.4 billion rescission
this week, though proposed cuts to the AIDS relief program have drawn public concern from some congressional Republicans and broad condemnation from Democrats.
Since its creation, PEPFAR has grown into the largest program from a single government focused on a single disease. It is credited with saving more than 26 million lives, primarily in sub-Saharan Africa, by funding prevention and medical treatment for patients with HIV or AIDS and for people who have not contracted HIV, such as vulnerable children.
The U.S. has spent more than $120 billion on PEPFAR since President George W. Bush announced the effort to almost universal surprise during his State of the Union address in 2003.
Initially, Bush requested $15 billion to combat HIV/AIDS in 15 countries, including 12 in Africa. Since then, PEPFAR has helped blunt the spread of HIV in more than 50 countries, according to the health group IAS.
Asked about looming cuts to PEPFAR after House votes Thursday, Smith told NJ Spotlight News he’s “working on it behind the scenes” but declined to say more.
Smith has historically been an advocate for the program. In 2018, he was the lead sponsor in Congress to reauthorize PEPFAR.
“PEPFAR’s success has been made possible by the 20-year strong bipartisan support — across U.S. congresses and presidential administrations — and the incredible compassion and generosity of the American people,” Smith
said in 2023
, marking two decades of the program.
PEPFAR “is widely viewed as the most successful U.S. foreign aid program since the Marshall Plan,” Smith said, referring to the effort America and its Western allies led to rebuild Europe after World War II.
During the Biden administration, Republican support for the program dimmed after U.S. officials told members of Congress nurses paid with PEPFAR money had performed abortions in Mozambique, where abortion is legal. Smith also opposed using funds for abortions.
Last year, Smith led an effort to delay PEPFAR’s reauthorization — something Congress must do to formally approve government policies and programs — following the Mozambique development, which he called “the tip of the iceberg.”
Approval for the program lapsed this spring.
Since the early 1980s, when he arrived in Congress, Smith has been one of the most vocal anti-abortion advocates on Capitol Hill. For years he’s been a fixture at the annual March for Life demonstrations in Washington and introduced bills to codify what is called the “Hyde Amendment” — a ban on tax dollars to pay for abortions — into federal law.
Smith has been a “one-man” hurdle to reapproving the program, New York Rep. Gregory Meeks, the top-ranking Democrat on the House Foreign Relations Committee, said Thursday.
“Since we’ve started talking about the renewal, he’s virtually been a one-man stand on this,” Meeks said in an interview with NJ Spotlight News. “Quite frankly, I’ve tried to go around him.”
“Even though many of my Republican colleagues believe in it, they don’t want to go around him,” Meeks said of Smith. “But we’ve got to keep trying. We’ve got to do all that we can to save these lives.”
A Smith spokesman, Jeff Sagnip, did not respond to questions from NJ Spotlight News about Smith’s current work on PEPFAR and the future of the program.
Smith is not alone in his criticism of PEPFAR funding that has gone to abortion procedures.
In January, Sen. Jim Risch, an Idaho Republican who chairs the Senate Foreign Relations Committee, said it was “disgusting” that money meant to combat HIV and AIDS had been used for the Mozambique abortions.
“This violation means that the future of the PEPFAR program is certainly in jeopardy,” Risch said.
At an appropriations hearing last week, White House budget chief Russ Vought, who has
pushed
for deep cuts to social services, said the administration doesn’t want much funding for HIV prevention through PEPFAR.
“It is something that our budget will be very trim on,” Vought said. “At some point, the continent of Africa needs to absorb more of the burden of providing this healthcare.”
Foreign aid accounts for about 1.2% of the federal budget,
according to the Pew Research Center
, and it was a “bigger share of federal spending at the height of the Cold War.”
Cuts to PEPFAR are a death sentence for many, said Rep. Glenn Ivey of Maryland, a Democrat. “We really can’t sugarcoat this. More people are going to die.”
