McCaul, chair of the House Foreign Affairs Committee that oversees the President’s Emergency Plan for AIDS Relief, had been cautiously optimistic for months that he could broker a deal to re-up a program that is credited with saving 25 million lives and long enjoyed bipartisan support.

He has not been successful in reconciling the differences between his fellow Republicans, who claim that the Biden administration is using PEPFAR to support abortion providers abroad, and House Democrats, who are against re-establishing the Trump administration’s rules that prevent foreign aid from going to organizations that offer or advise on abortions. Attempts to find a solution that would prolong the program for longer than one year but less than five, while emphasizing the current prohibition on federal funds being used for abortions, have failed.

Negotiations have also hit a snag in the Senate. Senator Ben Cardin

The chief negotiator in the higher branch, (D-Md.), stated that he does not intend to propose a new bill for reauthorization in the current year.

In an interview, he stated, “Negotiations are still ongoing. We were prepared to progress much earlier, but we were unable to obtain the required backing from the Republican party.”

Currently, the most optimistic outcome for renewing the yearly budget of $7 billion for this program relies on a government spending procedure that is facing challenges and disagreements and is expected to extend into January and February without any assurance of success. PEPFAR could continue to operate without being officially reauthorized in the event of a prolonged government shutdown. However, its supporters argue that without a lasting commitment from the U.S., organizations combatting HIV and AIDS globally will face difficulties in hiring staff and initiating long-term initiatives.

The 2024 election further complicates the possibility of reaching a compromise.

Rep. Chris Smith

The primary adversary in the House, (R-N.J.), proposes to allocate one year of funding for the program with fresh anti-abortion limitations through the State Department’s budget. He informed POLITICO that he views the extended reauthorization proposals suggested by McCaul, Cardin, and other members as efforts to limit the actions of a future conservative president, and refers to it as an “impossible path” going forward.

Smith stated that he and his colleagues in the House will not back down. He believes that any sort of compromise on this matter is phony and a total surrender.

Earlier this autumn, McCaul had a meeting with former President George W. Bush to discuss the future of PEPFAR. He was hopeful that his colleagues would eventually agree.

However, he has now conceded that Smith and his supporters are determined to achieve a level of success equivalent to Mexico City, despite the lifting of Trump-era limitations by President Joe Biden. Furthermore, he stated that many members of the Freedom Caucus would oppose providing assistance to Africa.

According to Tom McClusky, the head of government relations at Catholic Vote, he and fellow opponents of abortion are collaborating with Smith and other staunch lawmakers in Congress to resist the extension of PEPFAR without limitations. He also stated that attempts to find a middle ground have been unsuccessful and have led to a standstill.

“I am attempting to determine a course of action, but I am unable to identify one,” he stated. “With both program participants and the Biden administration advocating for what they call ‘reproductive freedom,’ I cannot understand how we can simply stand by and agree with this.”

Smith, McClusky, and their supporters maintain that PEPFAR is not in danger, as funding has persisted and other government initiatives have operated without renewal for extended periods.

However, members of the Democratic Party in Congress and advocates of the initiative contend that a five-year extension is essential in providing the necessary stability for organizations actively involved in delivering services, allowing them to hire personnel and develop long-term strategies. A brief renewal or lack of renewal may give the impression to other nations that the United States is losing its dedication to eradicating HIV and AIDS.

“Any failure would convey the completely incorrect message to the rest of the global community,” stated Representative.Ami Bera
Last week, during a roundtable discussion on Capitol Hill to commemorate World AIDS Day, Representative (D-Cal.) urged lawmakers and advocates to take action. He emphasized the need for moral courage in making the right decisions.

During the event, Dr. John Nkengasong, who serves as the U.S. global AIDS coordinator and leads PEPFAR, reported receiving numerous calls from concerned officials in countries that receive support from the program, expressing their fears about its potential non-renewal.

“The gains we have made so far are fragile,” Nkengasong said. “But hope dies last. We continue to remain hopeful that we will get a clean, five-year reauthorization that will enable us to bring this fight to an end.”

2019 Labor-HHS-Education appropriations bill

In September, the GOP-controlled House of Representatives passed a temporary one-year budget for PEPFAR that includes additional limitations on abortion as part of the 2019 spending bill for Labor, Health and Human Services, and Education.

Bill allocating funds for State, Foreign Operations, and Related Programs.

The bill is not expected to be passed in its current state due to the Democrats’ opposition to the restrictions and other provisions supported by Republicans. This applies to the 2024 fiscal year.

Cardin expressed his desire for a five-year reauthorization in 2024 and emphasized the importance of avoiding annual litigation on the matter. He also highlighted the need for a multi-year authorization to align with the commitments of international partners.

Both Democrats and Smith and his supporters show no indication of being willing to compromise, resulting in a standstill that could make it difficult for a PEPFAR reauthorization bill to be included in a larger spending package in the beginning of next year, if one is even formed.

Conflicts within the GOP and among political parties, including disagreements over abortion policies, have caused delays in passing multiple spending bills and brought the government close to shutdown on two separate occasions in the past three months.

Congress passed two short-term funding patches that expire in January and February. That eliminated the possibility of the typical end-of-year omnibus bill that many on both sides of the PEPFAR fight saw as the best vehicle for its reauthorization and kicked the fight into an election year when compromise — particularly on a contentious issue like abortion — will be more challenging.

“I am glad that the [continuing resolution] doesn’t extend until Christmas,” said McClusky regarding the efforts to hinder the approval of a clean reauthorization. “It’s more challenging to impede progress when everyone is eager to go home.”