The institute founded by President George W. Bush on Wednesday issued an urgent call to Congress to restore the global AIDS program known as PEPFAR, a centerpiece of Mr. Bush’s foreign policy legacy that fell victim to the abortion policy on Capitol Hill.
PEPFAR — the President’s Emergency Plan for AIDS Relief — has saved an estimated 25 million lives since Mr. Bush founded 20 years ago. The $6.9 billion program, which must be reauthorized by Congress every five years, has long had bipartisan support and is often cited as a powerful example of American moral leadership in the world.
But an uncertain future awaits her. The law authorizing the program expired on Sept. 30 after some House Republicans claimed, without evidence, that the Biden administration was using it to promote abortion abroad. Those Republicans want to attach abortion restrictions to PEPFAR that would doom its reauthorization in the Democratic-controlled Senate.
The Bush Institute, which is nonpartisan, has so far been reluctant to enter the debate.
But in a bipartisan letter signed by more than 30 retired ambassadors, think tanks and foreign policy organizations — including the Carter Center, founded by former President Jimmy Carter — the institute pleaded with Congress to reauthorize the program. It claims that in addition to saving lives, PEPFAR counters the growing influence of Russia and China and enhances America’s reputation as a global leader.
“PEPFAR is a model of United States leadership and a source of great national pride,”
the letter said. “It is one of the most successful international development programs since World War II. Abruptly abandoning it now would send a grim message, suggesting that we are no longer able to set aside our politics for the betterment of democracy and the world.”
At least for now, PEPFAR continues to operate. But advocates fear that, without basic approval, the program could be subject to budget cuts or even elimination in the future. And they say the program is weaker without the bipartisan impimature of Congress.
“The classic conservative talking point is that we don’t want to fund programs that aren’t authorized,” said Keifer Buckingham, director of advocacy at the Open Society Foundations and a longtime supporter of PEPFAR. “It’s also fair to say that in global health and global health policy, optics matter,” she added.
Mr. Bush himself did not sign the institute’s letter; people close to him said he tries to use his voice sensibly. The leading individual signatory is dr. Deborah L. Birx, a senior fellow at the Bush Institute who led PEPFAR under Presidents Barack Obama and Donald J. Trump, and also served as Mr. Trump’s coronavirus response coordinator.
But Mr. Bush has made no secret of his desire to reauthorize the program. over the summer, he discussed her future with Representative Michael McCaul, Republican of Texas and chairman of the House Foreign Affairs Committee, for lunch at the Bush family estate in Maine. In mid-September he announced op-ed in The Washington Post calling on Congress to bail him out.
At the time, PEPFAR supporters on Capitol Hill thought they were making progress toward breaking the gridlock. Representative Barbara Lee, a Democrat from California who is a leading proponent of the program, said in an interview at the time that she was working with freshman Republican Rep. John James of Michigan on bipartisan reauthorization legislation.
But the effort was put on hold last month in the face of a government shutdown threat, and remains stalled as the House is in a state of dysfunction and Republicans can’t pick a speaker.