Senate Republicans voted to preserve funding for HIV/AIDS relief on Tuesday night, abandoning a controversial $400 million proposed cut to PEPFAR woven into President Donald Trump’s $9 billion spending reductions package. The vote moves Trump’s campaign against government spending closer to fruition, but a final vote in the Senate, and likely the House of Representatives, is expected Thursday.
Sparing PEPFAR (The President’s Emergency Plan for AIDS Relief) came after several Republican senators, including Sen. Susan Collins (R-Me.), heavily objected to gutting the historic HIV/AIDS initiative. The spending measure still includes cuts to unused funds from USAID and public broadcasting, however new language added by the Senate reportedly protects global health program funding related to maternal health, malaria, and tuberculosis.
Russell Vought, director of the Office of Management and Budget, told reporters Tuesday that Trump was on board with the PEPFAR exemption. A senior Trump administration confirmed this detail with Fortune.
“There is a substitute amendment that does not include the PEPFAR rescission and we’re fine with that,” Vought said, adding the vast majority of alleged savings remained. “Big chunks of this proposal are not falling out.”
Vought and a small constituency of Republicans previously argued for cutting PEPFAR funds citing abortion-related concerns. It is against U.S. law for foreign aid to be used to fund abortions. In June, Vought told a Senate committee that PEPFAR had spent $9.3 million “to advise Russian doctors on how to perform abortions and gender analysis.” Senior PEPFAR officials from previous administrations and other implicated parties refuted these allegations to the New York Times. Rachael Cauley, the communications director for the OMB, maintained Vought’s claims and alleged that the Times’ reporting was “false” in a statement to Fortune and said that her office was awaiting a correction.
While OMB’s Russia PEPFAR abortion claims remain contested, in January, a review of service providers in Mozambique, where abortion is legal, found that four nurses performed a total of 21 abortions since January 2021. U.S. officials immediately notified Congress upon discovering this violation and said that it was the first instance in PEPFAR’s two-decade history that program-funded providers were found to have provided an abortion.
Regardless of the program’s recent controversy, the move to save PEPFAR funding may prove useful in coopting GOP support from powerful lawmakers like Collins, who chairs the Senate Appropriations Committee and is an outspoken critic of Trump’s proposed cuts. She and GOP Sen. Lisa Murkowski of Alaska and Sen. Mitch McConnell of Kentucky have continued to vote against the broader spending legislation, despite a looming Friday deadline for Congress.
Despite Collins’ objections, she told reporters she was pleased with the success of her PEPFAR advocacy. “This is something I’ve worked hard to protect from the beginning.”
The HIV/AIDS relief program was launched in 2003 by then-President George W. Bush, and is considered one of the nation’s foremost global healthcare initiatives, namely in Africa. The U.S. has invested more than $110 billion in response to HIV/AIDS, and PEPFAR is credited with saving 26 million lives, preventing millions of HIV infections, and helping control the HIV/AIDS epidemic in more than 50 countries.
The program has long benefited from bipartisan support, having been reauthorized by Congress four times. However, the Trump administration’s near-shuttering of USAID, the main government agency responsible for implementing PEPFAR programming, has stunted the health initiative’s impacts. Similarly, reductions at the Centers for Disease Control, PEPFAR’s secondary implementing agency, stand to further reduce its efficacy.
Still, a senior administration official maintained to Fortune that Trump and the government at large remain committed to fighting HIV/AIDS, pointing to the release of $1.3 billion in funding for the Global Fund to fight AIDS by Secretary of State Marco Rubio.
“We’re already working with countries and other partners to ensure that they shoulder a greater share of the burden where they can. We continue to make targeted investments in mother to child prevention, and other key areas of focus,” they said.
