Faith-based health organizations defend at-risk AIDS initiative from Republicans

Like all organizations controlled by the US Conference of Catholic Bishops, Catholic Relief Services opposes abortion in any form.

As the website of this 80-year-old humanitarian organization clearly states, CRS is “dedicated to preserving the sacredness and dignity of human life from conception to natural death.”

But CRS and dozens of other faith-based aid organizations, many of whom oppose abortion, now find themselves defending a US program that has dramatically reduced the worldwide spread of AIDS from attack by erstwhile allies, a smattering of Republicans who claim that under President Joe Biden the program is advancing abortion rights.

Led by Rep. Chris Smith of New Jersey, these Republicans have thwarted the five-year reauthorization of PEPFAR, or the President’s Emergency Plan for AIDS Relief. (The 45-day spending deal Congress agreed to late last week extended existing funding levels for PEPFAR but reauthorization is still in question.) Since the program was created by President George W. Bush in 2003, Congress has always reauthorized PEPFAR with solid bipartisan support.

“Regrettably, PEPFAR has been reimagined — hijacked — by the Biden Administration to empower pro-abortion international non-governmental organizations, deviating from its life-affirming work,” Smith said in a release.

The claim that PEPFAR empowers abortion came as a shock to many faith-based groups that partner with health care nonprofits overseas to combat AIDS.

“That is not something that we’ve seen or experienced in our work with PEPFAR,” said Meghan Topp Goodwin, a senior policy and legislative specialist for Catholic Relief Services, which receives PEPFAR dollars.

PEPFAR has been considered the gold standard among US global health initiatives and is credited with saving the lives of 25 million people by providing antiretroviral drugs to AIDS patients in more than 50 countries. The program has funded clinics, provided testing centers and encouraged preventive measures—all of which have measurably reduced the spread of AIDS.

Faith-based organizations, critical to PEPFAR’s functioning, are confounded that a program with such a proven track record of success could now be at risk.

“It literally makes no sense,” said Doug Fountain, executive director of Christian Connections for International Health, a global network of more than 100 faith-based organizations that provide or advocate for health and humanitarian aid abroad. “There’s no way that abortion is going to play a part in foreign, domestic or foreign assistance. It’s just not even feasible.”

A number of laws prohibit the use of US taxpayer dollars to promote or procure abortions overseas. There’s the Helms Amendment, signed into law almost 50 years ago, that prohibits foreign assistance from paying for the performance of abortion. There’s also the 1981 Siljander Amendment that prohibits the use of funds to lobby for or against abortion in foreign operations.

The assault on PEPFAR began in May with a report by the conservative Heritage Foundation warning that the Biden administration was using the program to promote a “radical social agenda”—including abortion. The Heritage Foundation report questioned US support for treating HIV, the virus that causes AIDS, calling it “a lifestyle disease.”

“For conservatives committed to personal responsibility,” the report said, HIV/AIDS “should not enjoy greater priority than deadlier and more unavoidable diseases receive in the allocation of public funds.”

The Family Research Council and Susan B. Anthony Pro-Life America have also criticized the program, claiming that some of the health organizations that receive grant money to provide AIDS treatment through PEPFAR also provide abortion services and that PEPFAR therefore is indirectly funding abortion procedures.

PEPFAR supporters say that line of argument, sometimes known as the “fungibility” argument, can get messy quickly. Some might argue that faith-based organizations shouldn’t receive funds either because they may indirectly fund religious services or prayer, a violation of the establishment clause of the US Constitution, which prohibits funds for explicitly religious activities.

“The problem is that this line of logic cuts both ways, and can backfire on faith-based organizations,” said Fountain. “I am concerned that some people who are watching all of this are ready to argue that we should defund faith-based work for the exact same reasons.”

Last week, the US House of Representatives passed a bill to reauthorize PEPFAR for one year instead of five. It’s unlikely to pass in the Democratic-led Senate, which wants a full five-year reauthorization.

Faith-based organizations fear a one-year reauthorization risks dragging PEPFAR into a polarizing political process that will permanently stifle the program.

“It would politicize the program in a way that’s extremely detrimental and it just doesn’t really accomplish anything but kick the can down the road,” said Catherine Connor, vice president of public policy and advocacy for the Elizabeth Glaser Pediatric AIDS Foundation, an organization that implements PEPFAR in Africa.

The Elizabeth Glaser Pediatric AIDS Foundation receives most of its funding from PEPFAR. It uses that funding in countries across Africa to run programs to prevent mother-to-child transmission of HIV and to ensure that children infected with HIV get the treatment they need.

Connor said that 15 years ago, some 2,000 African children were born infected with HIV daily; without treatment most would die by age 2. Now that number has dropped to a few hundred a day.

PEPFAR also requires that 10 percent of the money spent go toward orphans with AIDS. That provision has been instrumental to World Vision, the heavyweight Christian relief organization.

The plight of orphaned children got then-World Vision chief executive Rich Stearns involved in advocating for the creation of the AIDS program after he met two orphaned boys trying to care for themselves on a trip to Uganda in 1998. AIDS, Stearns realized, was creating a generation of orphaned children who needed access to food and education.

While PEPFAR’s funding is secure for another year, that particular set-aside for orphaned children will expire in 2024 without reauthorization.

“World Vision really fought for that provision because we were seeing that it isn’t just about testing, it isn’t just about treatment,” said Lisa Bos, senior director of government relations for World Vision. “Those things are important, but there were these other impacts on children.”

Many faith-based organizations have been involved with PEPFAR for 20 years and are deeply invested in the fight to bring HIV under control, which they suggest is tantalizingly close.

“There is a very plausible scenario where HIV could be under global control by 2030,” said Fountain. “If we double down, we can actually do that and take this off the table. If PEPFAR funding becomes a casualty of a political process where it’s just now another budget item that gets argued over year in and year out, it could rob our momentum and I’m concerned about that.” —Religion News Service

Yonat Shimron

Yonat Shimron is a national reporter and senior editor at Religion News Service.

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