Several prominent pro-lifers are calling on U.S. Secretary of State Marco Rubio to restore funding to a foreign-aid program meant to prevent mothers in Africa from transmitting AIDS to their babies.

The program, called the President’s Emergency Plan for AIDS Relief, or PEPFAR, is among those that have been hindered in the wake of the Trump administration’s funding freeze for foreign aid, according to supporters, who told the Register that Rubio should turn the spigot back on because it’s helping save lives.

“Some clinics that distribute antiretrovirals have already closed their doors. It’s difficult for a mom to know what to expect — especially when she needs to be able to count on her doctor for her whole pregnancy,” said Leah Libresco Sargeant, an author and pro-life Catholic who co-authored a column published by The New York Times on Monday calling for the Trump administration and members of Congress “to fully restore PEPFAR and protect babies, both born and unborn.”

 In the op-ed, Sargeant and her co-authors argue that the Africa AIDS program “should be a special priority of the pro-life movement.”

 “Its treatments empower mothers to protect their unborn children and provide hope that the births of these children will be moments of joy, not despair,” the op-ed says. “It’s the same kind of hope we’ve tried to give mothers when we’ve stood outside abortion clinics to offer alternatives, or counseled women through high-risk pregnancies.”

The AIDS program in Africa was founded in 2003 during the administration of President George W. Bush, who envisioned it as “a medical version of the Marshall Plan,” according to his 2010 memoir Decision Points. The U.S. government has spent about $120 billion on the program since its beginning, including $6.5 billion in fiscal year 2024 (which ended Sept. 30, 2024), according to KFF, a nonprofit organization headquartered in San Francisco that tracks health policy.

The program pays for clinics and medication for people exposed to the virus that causes AIDS in many of the countries of sub-Saharan Africa. It also promotes prevention using the so-called “ABC” method, which Bush in his memoir says stands for “Abstinence, Be faithful, or else use a Condom.”

Republicans who control Congress and the White House are suspicious of foreign aid, fueled by a sense that much of it has promoted left-wing social agendas instead of U.S. national interests.

A major target for Republicans’ ire is the U.S. Agency for International Development (USAID), an independent federal agency that administered the AIDS program and which President Donald Trump has said was run by what he called “radical left lunatics” before his administration radically decreased its workforce and put it under the secretary of state’s jurisdiction.

The U.S. House Foreign Affairs Committee is planning to hold a hearing on foreign aid at 8:30 a.m. Thursday, Feb. 13, titled “The USAID Betrayal.”

‘Foreign Aid Done Right’

But supporters of the Africa AIDS program say it’s a boon both to Africa and to the United States.

“This is actually an example of foreign aid done right, for the most part,” said Kathryn Jean Lopez, senior fellow with National Review Institute and a pro-life Catholic, told the Register.

Lopez, one of four authors of The New York Times column, acknowledged that “no program is perfect.” During the Biden administration, some pro-lifers criticized the AIDS program in Africa for, in their view, promoting abortion.

That concern was shared by the National Right to Life Committee, which in September 2023 was among several pro-life organizations that criticized the way Biden officials were running the program through USAID.

Carol Tobias, president of the National Right to Life Committee, told the Register she supports the AIDS program, but that the Biden administration used it to spend large sums on abortion and that Trump administration officials ought to make sure that stops.

“The PEPFAR program has shown that it saves lives, but it was greatly corrupted by the Biden administration,” Tobias, who is not one of the authors of the pro-PEPFAR New York Times column, told the Register by text.

“We are hopeful that the Trump administration will quickly resolve the problems in the program and provide lifesaving care once again, while maintaining the prohibition on abortion funding,” she said.

Pushback Against Program Pause

On Jan. 20, the day he took office, President Trump issued an executive order pausing U.S. foreign aid for 90 days to allow time for assessing line items to see if they are effective and consistent with U.S. foreign policy, but also allowing the secretary of state to “waive the pause … for specific programs.”

To receive foreign-aid funds during the freeze, a program needs a waiver approved by the secretary of state. Rubio has said that he has issued dozens of waivers, including a waiver on Jan. 28 for programs that offer “lifesaving humanitarian assistance.”

But supporters of the Africa AIDS program say it still hasn’t received the money it needs to operate.

Republican U.S. Sen. Bill Cassidy of Louisiana called PEPFAR “pro-life, pro-America and the most popular U.S. program in Africa,” in a social-media post Feb. 3.

“There’s even a waiver acknowledging this, yet I’m told that drugs are still being withheld at clinics in Africa. This must be reversed immediately!!” Cassidy wrote.

On Feb. 4, a reporter from The Washington Post during a press conference asked Rubio about “accounts of the U.S. exemptions on President Trump’s aid freeze not working,” specifically mentioning the AIDS program in Africa as an example.

“Are these waiver problems something you’re seeing and looking to address?” the reporter asked.

In his answer Rubio didn’t address the AIDS program directly, but he said he has authorized funding to continue for humanitarian programs.

“But I issued a blanket waiver, that said, ‘If this is lifesaving programs’ — okay? — if it’s providing food or medicine or anything that is saving lives, and is immediate and urgent, you’re not included in the freeze,” Rubio said.

“I don’t know how much more clear we can be than that. And I would say, if some organization is receiving funds from the United States and does not know how to apply [for] a waiver, then I have real questions about the competence of that organization. Or, I wonder if they are deliberately sabotaging it for purposes of making a political point,” Rubio added.

The four pro-life authors of The New York Times op-ed supporting the AIDS program say the State Department’s waivers “haven’t been enough to fully restart operations … because bank and email accounts have been locked, invoices are not being paid, and there’s no way to fund ongoing work.”

“Organizations on the ground need formal clearance to operate, but, in many cases, the U.S.A.I.D. workers who provide that clearance were placed on leave,” the op-ed states.

Sargeant told the Register the State Department “is not keeping up with the scale of need” when it comes to waivers and that Rubio should step in and approve the AIDS program.

“PEPFAR should be exempted from stop works and freezes preemptively, without needing to be individually waived,” Sargeant said by email. “I’d like to see the same steps taken for food delivery to starving communities, too.”

A spokesman for the State Department did not respond to a request by the Register for comment by publication.

Lopez told the Register that there are aspects of the Trump administration’s actions with respect to foreign aid that she finds troubling.

“I personally think for Catholics looking at this wrecking ball that has gone to USAID, it’s kind of an examination-of-conscience moment, where we think, ‘Okay, what are our duties to our neighbors that are half a world away?’” Lopez said.

Even so, Lopez told the Register she is hopeful that Rubio will restore funding to the AIDS program in Africa, suggesting that PEPFAR may be temporary collateral damage in the Trump administration’s larger war on what administration officials consider waste and abuse in foreign aid.

“I think they just want to clean up the place, and good things are in the midst of bad things,” Lopez said. “But I have no reason to believe that anybody in the administration has it out for PEPFAR.”