Don’t hold U.S. AIDS relief program hostage to false abortion claims

AIDS was the reason I moved to the West African country of Ivory Coast in 1993, at the height of its HIV epidemic. In my 35-year career as a public health doctor and epidemiologist, I have witnessed a remarkable arc from a time when AIDS was a death sentence to the present, when people living with HIV can expect a normal life span, and the number of new HIV infections and deaths in most African countries has declined dramatically. This trajectory was made possible in large part by the President’s Emergency Plan for AIDS Relief, spearheaded by former President George W. Bush in 2003.

The hardest aspect of my family’s six-year sojourn in Ivory Coast was witnessing the agonizing demise of patients and colleagues dying of AIDS. I recall all too well walking the hallways of hospitals in Abidjan that were lined with skeletal figures on stretchers, waiting to die. Yet within a few years, PEPFAR transformed such tragic scenes replaying in many African countries. When we moved to Tanzania in 2005, AIDS was no longer a death sentence thanks to the lifesaving HIV medications provided by PEPFAR and other initiatives like the Global Fund.

In the two decades since it was launched, PEPFAR has saved 25 million lives that would otherwise have been lost to AIDS, and it has generated goodwill toward the U.S. around the world. Until this year, the program was reauthorized every five years whether Republicans or Democrats held a majority in Congress.

U.S. Rep. Christopher Smith, R-N.J., and his colleagues are holding up reauthorization of PEPFAR because of allegations that the program’s funds may indirectly support abortions. Smith was a longtime advocate of PEPFAR, and he has traveled through African countries and met AIDS survivors who are alive thanks to the program. Yet such encounters were quickly forgotten, and toeing the line of think tanks like the Heritage Foundation took precedence over the lives of AIDS survivors in other countries.

The charges that PEPFAR dollars are supporting abortions in recipient countries, as claimed in a Heritage Foundation report, are completely false. Organizations receiving PEPFAR funds are required to guarantee that none of the funds will be used to promote or provide abortion services. When I directed the Centers for Disease Control and Prevention’s PEPFAR work in Tanzania, we carefully reviewed budgets and conducted site visits to ensure that all PEPFAR grant recipients adhered to these restrictions. My work on HIV/AIDS continues in my current job at the University of Washington, where I oversee PEPFAR projects in Mozambique and Zimbabwe; and we continue to abide closely to the restrictions around the funding of abortion activities.

We were fortunate to be living in Tanzania when President George W. Bush visited several PEPFAR sites there. The reception he got from throngs of people lining the roads and public spaces where he traveled was evidence of the goodwill that PEPFAR engendered toward the U.S.

While living in Africa, we also saw many development projects that were funded by China, mostly on the construction of roads and buildings. But China doesn’t fund public health programs at the scale that the U.S. does, and construction projects don’t save people’s lives. Millions of people have survived AIDS thanks to U.S.-funded health projects.

Now is not the time to endanger the hard work and goodwill fostered by thousands of public health workers and their counterparts in other countries. People’s lives are at stake, and PEPFAR should be reauthorized and funded in its entirety and not picked apart on account of partisan political games.