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Poll: Bipartisan majority backs U.S. role in global AIDS response amid debate on reauthorizing PEPFAR

Michael Odhiambo, an HIV treatment adherence counselor, examines an HIV-positive patient at the IOM treatment center in Nairobi, Kenya, Nov. 29, 2018. (OSV News photo/Baz Ratner, Reuters)

WASHINGTON (OSV News) — Amid ongoing debate in Congress over the reauthorization of PEPFAR, a majority of voters support the United States continuing its commitment to the global AIDS response, according to a new poll by the Bipartisan Policy Center in collaboration with Morning Consult.

PEPFAR, the U.S. President’s Emergency Plan for AIDS Relief, authorized by Congress and President George W. Bush in 2003, is the U.S. government’s global effort to combat HIV/AIDS. The program is the largest global health program devoted to a single disease and is credited with saving 25 million lives, scaling back the epidemic’s spread.

PEPFAR also is seen as an example of successful bipartisanship, having been reauthorized with broad bipartisan support in 2008, 2013, and 2018. But PEPFAR’s future remains in question as Congress has not yet done so in 2023.

The program, in part, distributes antiretrovirals in countries where as many as one-third of adults were impacted. PEPFAR’s funding has totaled more than $110 billion to date. Congress missed its deadline to reauthorize the program before the end of the fiscal year, but some have urged them to do so by the end of the calendar year.

The poll found that a bipartisan majority of voters (82%) said it is important for the U.S. “to lead efforts in global health and support the United States continuing its commitment to the global AIDS response.” This included 87% of Democrats, 78% of independents and 79% of Republicans.

Most voters surveyed (52%) initially said they were not familiar with PEPFAR, but after hearing more about the program, a majority responded affirmatively that it has increased goodwill toward the U.S.

Two in three voters (66%) support the U.S. continuing its commitment to the global AIDS response. More than half replied they would like to see Democrats and Republicans work together on the U.S.’ contribution to the global efforts against AIDS.

Debate over the potential reauthorization of PEPFAR this year prompted some pro-life advocates to raise concerns about what they said was the potential for some program funding going to abortion, while others said safeguards are in place to prevent such spending. The Biden administration has denied using PEPFAR for such a purpose.

A July 14 letter from Catholic Relief Services and the U.S. Conference of Catholic Bishops to congressional lawmakers argued in favor of PEPFAR’s reauthorization while outlining important principles they said should guide Congress as it considers the matter.

“We write to affirm PEPFAR’s extraordinary life-saving work to date, and to express our strong, ongoing support for its goals and hope for its robust continuation,” said the letter, signed by Bishop David J. Malloy of Rockford, Illinois, then-chairman of the USCCB’s Committee on International Justice and Peace, and Bishop Michael F. Burbidge of Arlington, Virginia, chairman of its Committee on Pro-Life Activities, as well as Sean Callahan, CRS president and CEO.

The letter stated that the “life-saving work of PEPFAR should never be entangled with the promotion of abortion, a grave evil and the opposite of life-saving care.”

Deborah Birx, a senior fellow at the George W. Bush Institute and an expert in fields including infectious disease and global health, told OSV News in October, “I hope (the faith) community understands how important they are in global health care and delivery, but it’s more than that.”

“They’re connected to their communities as an organization of trust,” said Birx, who was previously coordinator of the United States Government Activities to Combat HIV/AIDS, a U.S. special representative for global health diplomacy, and the White House coronavirus response coordinator in the Trump administration.

“And when you want to combat pandemics, that’s what you have to have, because if you don’t have trust, you can’t deliver health care,” she said.

In a statement Dec. 1 marking the 35th World AIDS Day, John Nkengasong, ambassador-at-large, U.S. global AIDS coordinator and senior bureau official for Global Health Security and Diplomacy, praised the “bold decision by President Bush, coupled with 20 years of bipartisan support from Congress and the generosity of the American people,” for the success of PEPFAR, saying it “changed the course of the HIV/AIDS pandemic.”

“Despite our remarkable progress in transforming the course of the HIV/AIDS pandemic from the early days of death and despair to the hope and opportunity we have today, we still have a lot of work to do — as a global community — to end HIV/AIDS as a public health threat and to ensure the response is sustained,” he said.

Nkengasong said PEPFAR “remains driven by evidence and data and committed to our partnerships with PEPFAR-supported countries,” emphasizing the Biden administration believes Congress’ reauthorization of PEPFAR will help the world “end HIV/AIDS as a public health threat by 2030.”

Kate Scanlon is a national reporter for OSV News covering Washington. Follow her on X (formerly Twitter) @kgscanlon.

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