As Congress Considers Reauthorization of PEPFAR, KFF Examines the Role of Abortion

As Congress considers reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR) for a fourth time, KFF explores the debate over abortion policy that has stalled the legislation and the potential implications if Congress does not reauthorize the program. PEPFAR spans more than 50 countries and has been reported to have saved 25 million lives since President George W. Bush created it in 2003. Funding for the program in FY 2023 was $6.9 billion, including funding for the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

Despite a long history of broad and bipartisan support—and in the wake of the U.S. Supreme Court’s overturning of the constitutional right to abortion—the U.S. government’s signature global health effort in the fight against HIV has been drawn into a broader political debate about abortion, even though U.S. law prohibits the use of U.S. foreign assistance, including PEPFAR funding, for abortion.

In this new analysis, KFF provides an overview of the current debate and answers key questions about the role of the abortion debate in PEPFAR’s reauthorization, including:

• What concerns about abortion have been raised?
• What has been the response by PEPFAR and the U.S. government?
• What U.S. government laws and policies regarding abortion apply to PEPFAR?
• What are the implications if PEPFAR is not authorized?

Read “PEPFAR Reauthorization and Abortion” for more information and access “PEPFAR Reauthorization 2023: Key Issues”, which discusses top issues related to PEPFAR’s authorization and funding. You can also find a variety of resources about the program in our PEPFAR Policy Resource Hub.