How renewing a Bush era program for Africa will help us fend off Russia and China, boost national security

In medical school, I recall learning about HIV/AIDS. Understanding the science behind HIV/AIDS helped build my appreciation of the horrors it can unleash on our fellow humans when they become infected and adequate treatment is unavailable. 

The personal stories shared from those who have suffered around the world only confirmed how devastating HIV/AIDS can be to humanity. But our lectures on the subject ended on a high note – an overview of the President’s Emergency Plan for AIDS Relief, or PEPFAR.

PEPFAR, a bipartisan initiative that began in 2003 under the George W. Bush administration, is one of America’s greatest global health achievements and a key diplomacy program that not only is a moral imperative but enhances our national interests and makes us a stronger and safer nation. 

As World AIDS Day approaches on Dec. 1, we must ensure the program remains intact.

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The HIV/AIDS epidemic began in 1981. Initially considered a “death sentence,” HIV/AIDS also carried significant stigma with it, though many people didn’t even know they became infected until they were very sick. 

While certain initiatives in the United States and globally began to try to tackle this massive worldwide issue, none created widespread, lasting success. But that all changed in 2003 with PEPFAR. 

Since its inception, PEPFAR has helped save 25 million lives, while also ensuring an additional 5.5 million babies are born without HIV. PEPFAR recipient countries also boast a 20% lower mortality rate than would have been expected without the program. 

HIV/AIDS was once the leading cause of death in sub-Saharan Africa and the fourth biggest killer globally, but that fact is – at least for now and if we continue to fund PEPFAR adequately – a line in history books.

No matter where you look, the facts are clear. PEPFAR works. 

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As Americans, we should be proud that when we came together for the common good in a time of dire need worldwide, a program unlike any other was born and continues to make a positive difference to this day. As former President Bush recently wrote, “every life has dignity and value” and “no program [is] more pro-life than one that has saved more than 25 million lives.” PEPFAR remains a prime example of America leading not only from strength, but from principle and with empathy. 

But while the moral obligation and global health progress made are often cited by those in favor of PEPFAR reauthorization, what is commonly less focused on is how the program impacts our national security, prosperity and interest at home.

Today, China and Russia remain two of America’s biggest adversaries. Their shared desire to gain power across the globe is evident, and, over the past decade, the two countries have expanded trade and strengthened defense ties. 

They have also journeyed into Africa, focusing on the continent as a priority in their anti-U.S. influence campaigns. They have thrown substantial assets at Africa, including financial resources, in hopes of shifting Africa’s perception of the United States. But PEPFAR stands in their way.

In contrast with loans made by China and Russia meant to simply buy influence without any transparency or accountability, PEPFAR requires transparent data collection to hold all parties accountable. By doing so, real progress has been made, and our friends in Africa have responded favorably. 

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In fact, public opinion of the United States and U.S. leadership in countries where PEPFAR operates is higher than the global average. PEPFAR-supported countries are also more politically and economically stable, helping to prevent the rise of anti-American extremism and chaos. 

These PEPFAR outcomes help us foster stronger relationships and strategic partnerships to help tackle global challenges and protect our borders.

To whom much is given, much is required. With the generosity of the American people and strong bipartisan support for 20 years, PEPFAR has become an undeniable success. 

It remains a great source of national pride and a prime example of U.S. leadership at its finest as the largest commitment by a nation to address a single disease in history. It positively impacts both the world at large and us here at home. 

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America has always been a shining city upon a hill that the world turns to in its darkest day, and we cannot falter now. Across four U.S. presidents and 10 U.S. Congresses, PEPFAR has remained, yet it has not been fully reauthorized for its full five years since President Donald J. Trump signed the PEPFAR Extension Act of 2018. 

With an investment of only one-tenth of 1% of the U.S. federal budget, PEPFAR can continue uninterrupted and the goal of ridding the world of HIV/AIDS epidemic by 2030 can be achieved. Congress must reauthorize PEPFAR for five more years now.

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