The world’s most powerful HIV initiative is “in jeopardy”, Dr Tedros Adhanom Ghebreyesus has warned, as he made a rare intervention in American politics to urge the US Congress to renew funding for Pepfar.
Writing in the Telegraph on World Aids Day, the head of the World Health Organization called on lawmakers to commit to five more years of funding for the multi-billion programme, to “send a clear signal” that America remains committed to ending Aids.
Since it was launched by President George Bush 20 years ago, Pepfar (the President’s Emergency Plan for AIDS Relief) has pumped more than $100 billion into the fight against HIV and Aids across 50 countries – saving some 25 million lives and enabling 20 million people to start antiretroviral treatments in the process.
“Pepfar’s track record of saving lives and stopping infections are something that people and politicians of all political colours can be proud of,” Dr Tedros said, calling it “one of the most ambitious health programmes ever attempted”.
Traditionally, the fund has received support from both sides of the political aisle in America, and the process of reauthorising its funding every five years has been uncontentious.
But this year that precedent was broken, with Pepfar ensnared in domestic political debates.
At the end of September, Congress missed a deadline to approve $6.8 billion of funding amid opposition from a group of conservative Republicans who claimed President Joe Biden has “hijacked” the programme “to promote abortion on demand”.
Pepfar, the Biden administration and global health experts say there is no evidence to support this claim – especially as the initiative is subject to the 1973 Helms amendment, which restricts US aid from funding abortion abroad.
Yet amid the stalemate, the fund’s future is in doubt. While it has the resources needed to operate until September 2024, there are concerns that the delays could hit future plans, limit the purchase of critical supplies – including drugs and condoms – and damage trust with partners across the globe.
There are also fears about proposals from some Republicans to change the reauthorisation process so that it happens annually, rather than every five years. Critics say this would hinder the stability and effectiveness of the fund.
On Friday, Dr Tedros said leadership from the US “remains as critical as ever” in the fight against HIV and Aids – which still killed 630,000 people in 2022.
“When President Bush started Pepfar, the goal of an AIDS-free generation seemed completely implausible. Now it’s very real and feasible,” said Dr Tedros.
“By reauthorising Pepfar lawmakers would send a clear signal to the world that the United States remains committed to ending AIDS and to securing a healthy and safe world for all.
“Bridging the political divide changed the course of the AIDS global epidemic; keeping that bipartisan approach is our best bet toward one day being able to consign the disease to the history books,” he said.
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