Abortion politics are threatening a successful global AIDS program.
For decades, the U.S. has bankrolled global efforts to fight the spread of AIDS, saving tens of millions of lives. Congress has extended the program on a bipartisan basis since President George W. Bush created it in 2003.
At least, until now. Congress is gridlocked on a bill that would reauthorize the program, known as PEPFAR. Lawmakers passed a spending deal on Saturday to avert a government shutdown for 45 days, but that legislation did not reauthorize the AIDS program.
Without reauthorization, parts of the program expired over the weekend. If Congress does not act soon, organizations that deliver lifesaving drug treatments and other forms of support to H.I.V. patients could have to curtail their work. And some specific measures could lose funding, including one that provides care for orphans and other vulnerable children.
“PEPFAR has been a shining example of a bipartisan commitment to addressing a global health issue,” my colleague Sheryl Gay Stolberg, who covers health policy, told me. “If it doesn’t get reauthorized, it will be an example of how Washington is so broken that it’s even abandoning its moral leadership in the world.”
Why is this happening? Abortion politics are largely to blame. Some of the health organizations that fight AIDS also provide abortion services, and Republicans do not want to subsidize those groups. Even if the money does not directly fund abortions, these critics worry that PEPFAR strengthens the groups that provide them. House Republicans passed a bill last week extending the program only for a year and with more anti-abortion restrictions.
Supporters, including some Republicans, want a five-year extension without any new anti-abortion language. Many worry that cutting off groups that also provide abortions would damage anti-AIDS efforts. In recent weeks, Bush — himself an opponent of abortion rights — lobbied for the program’s renewal.
There is no partisan dispute on one point: The AIDS relief program is a major public health success. It has saved 25 million lives, equivalent to the population of Australia. In some countries, it has helped reduce the rate of H.I.V. infections by half or more.
How? The program funds health care services in more than 50 countries. It has helped build clinics that distribute antiretroviral medications for H.I.V., which reduce the risk of developing AIDS and undercut the virus’s ability to spread. It has established testing centers to help catch the virus earlier. And it has encouraged other preventive measures, such as safer sex practices and circumcision.
The program is especially important in western and southern Africa. Many H.I.V. patients in these regions otherwise struggle to get treatment.
Nothing in the program directly funds abortions.
Critics’ argument is, in short, that money is fungible. Program partners may not use federal funds directly on abortions, but they may use the money to set aside other dollars that can then go to abortions. The critics want the program to stop supporting any group that provides abortion services.
But PEPFAR operates in many countries that lack basic health care infrastructure, so it cannot be all that picky in choosing partners. In some regions of the world, strict anti-abortion language could force the program to pull out because it would no longer be able to find a partner that meets its standards. More people would die from AIDS as a result.
PEPFAR remains funded for now. But Congress has not passed a longer-term extension of the program, which requires a separate bill.
If Congress does not reauthorize the program, it could send a chilling message. For the first time in decades, the global fight against AIDS would no longer seem like a bipartisan priority. The program’s partners may start to wonder whether they can rely on the funding and if they should work with the U.S. on a now-politicized issue. “It would be a huge departure from the past,” said Jennifer Kates of KFF, a health policy organization.
For an AIDS fight that has saved so many people over the decades, those problems could over time translate to millions of preventable deaths.
Related: Women in poor places where H.I.V. is still very common often struggle to get preventive medicine, The Economist writes.
THE LATEST NEWS
A trial begins today in a New York lawsuit accusing Donald Trump of fraudulently inflating his wealth. The Trump campaign is using the case as an opportunity to rally supporters.
Gov. Gavin Newsom chose Laphonza Butler, president of the political organization Emily’s List, to fill California’s Senate vacancy after the death of Dianne Feinstein.
Representative Matt Gaetz, the hard-right Republican from Florida, said he would try to remove Kevin McCarthy as House speaker for working with Democrats to avert a government shutdown.
McCarthy said Gaetz’s efforts would fail, telling CBS: “I’ll survive. You know this is personal with Matt.”
War in Ukraine
A Russia-leaning party finished first in Slovakia’s parliamentary elections, a sign of flagging support for Ukraine in the West.
Foreign ministers from E.U. member countries are gathering in Kyiv for a surprise meeting.
Russia may be preparing to test an experimental nuclear-powered cruise missile, according to a Times investigation.
“The fire has reached us”: The Times pieced together the desperate final hours of Syrian asylum seekers who died in a wildfire in a Greek forest.
Turkey conducted airstrikes against a Kurdish rebel organization that took responsibility for a suicide bomb attack in Ankara.
A fire broke out at a nightclub complex in southeastern Spain, killing at least 13.
The Catholic Church
Catholic bishops will discuss priestly celibacy and the blessing of gay couples at an assembly at the Vatican known as the synod.
Pope Francis has invited lay people, including women, to attend and vote during the meeting for the first time. Read about the gathering.
A prominent Texas bishop who is critical of Pope Francis said the meeting threatens the “basic truths” of Catholic doctrine.
Other Big Stories
The Supreme Court returns today for a new term. Justices are expected to revisit issues like gun rights, race and free speech.
Sam Bankman-Fried, the founder of FTX, will stand trial this week for fraud. Many in the crypto industry want to see him held accountable.
The authorities in New York are searching for a 9-year-old girl who disappeared while riding a bike with friends at a state park.
Three police officers in Baton Rouge, La., are accused of trying to cover up their use of stun guns during a strip search in a department restroom.
A grizzly bear killed two people in Banff National Park in Canada, officials said.
The Nobel Prize in Physiology or Medicine was awarded to Katalin Kariko and Drew Weissman, for their discoveries that led to the development of Covid vaccines.
Republicans want to change how we talk about their extreme abortion policies, moving away from terms like “pro-life.” We threaten women’s lives if we let them, Jessica Valenti argues.
Here are columns by David French on Christian nationalism and Nicholas Kristof on unions.
Gail Collins and Bret Stephens discuss Kevin McCarthy and the Republican debate.
Rite of the snake charmers: In the small Italian village of Cocullo, draping snakes over a statue kicks off a centuries-old ritual.
Just say vagina: Upstart feminine care brands are ditching the euphemistic marketing of their predecessors.
Windy City: Spend 36 hours in Chicago.
Metropolitan Diary: Cutting a sandwich line in Manhattan.
Lives Lived: Evelyn Fox Keller was a theoretical physicist, mathematical biologist and feminist theorist who explored the way gender pervades and distorts scientific inquiry. She died at 87.
Sunday night football: The Chiefs defeated the Jets, 23-20, even though the New York side had its best performance of the season. (And yes, Taylor Swift was there.)
Around the N.F.L.: A week after a historic offensive performance, the Miami Dolphins fell back to earth with a loss to the Buffalo Bills. And the Philadelphia Eagles beat the Washington Commanders in overtime to remain undefeated. Here are takeaways from the weekend.
Gymnastics: Simone Biles became the first woman to land a Yurchenko double pike vault at an international competition. The sport is renaming the move after her.
W.N.B.A.: The New York Liberty advanced to the league finals after eliminating the Connecticut Sun in an 87-84 win.
Curse breaker: Tim Wakefield was a pitcher for the Red Sox who, in 2004, played a critical role in the team winning its first World Series championship in 86 years. He died at 57.
ARTS AND IDEAS
Dogs on film: A puppy waddling through space. A dog digitally placed on a train, passing alpine mountains. Much of the content on DogTV, a television and subscription service, is meant to cater to bored and anxious dogs who are left home alone, but owners, it appears, are watching too. One dog owner, Jay, described his wife coming home to find him watching the channel. “She’ll be like, ‘What are you doing?’,” he said. “And I’m like, ‘Well, you got to see this — they’re going through the fields, and the ducks are following him.’”
More on culture
“Peaks and valleys”: Read our critic’s review of U2’s concert at the Sphere, a new performance venue in Las Vegas.
THE MORNING RECOMMENDS …
Sprinkle sesame seeds to add crunch to this salmon dish.
Catch “Ferris Bueller’s Day Off” before it leaves Netflix.
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Take our news quiz.
Here is today’s Spelling Bee. Yesterday’s pangram was encampment.
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