Primer: Left-Wing Subversion Through the President’s Emergency Plan for AIDS Relief (PEPFAR) Program
Background:
The President’s Emergency Plan for AIDS Relief (PEPFAR) was launched in 2003 by President George W. Bush as a government-wide initiative to combat HIV/AIDS in foreign countries.1 PEPFAR supports a wide range of HIV/AIDS prevention, treatment, and care activities and is the most expensive foreign assistance program in history by any nation.2 Since 2003, PEPFAR has spent over $100 billion3 and operates in more than 50 countries worldwide.4
Source: U.S. State Department5
PEPFAR is managed by the U.S. Department of State’s Office of the Global AIDS Coordinator (OGAC).6 Its programs are implemented by multiple federal agencies, including the U.S. Agency for International Development (USAID), the U.S. Department of Health and Human Services, the U.S. Department of Defense, the Peace Corps, the U.S. Department of Labor, the U.S. Department of Commerce, and the U.S. Department of the Treasury.7 Most of its assistance is funneled through non-governmental organizations (NGOs) and international institutions.8
Source: National Institute of Health9
Most of these NGOs are comprised of individuals who support the left’s radical agenda. For example, employees at Chemonics, the largest PEPFAR contractor, gave 97 percent to Democrats during campaign cycles, while other non-profits involved gave 99.8 percent to Democrats.10 Chemonics has supported “increasing resources for sexual and reproductive services” and served as a 2022 sponsor for the International Family Planning Conference in Thailand, which asserted support for finding a way to “give women control over their bodies and choices.”11 These are known to be euphemisms for abortion related services, for which the U.S. government is prohibited from providing funding. Family Health International 360, another PEPFAR partner, supports left-wing causes, such as support for LGBTQIA+ people in Africa.12 The same is also true of ICAP at Columbia University, a PEPFAR partner, which launched a study on how COVID-19 impacted New York City’s LGBTQIA+ community.13
Recission of Woke Activities:
President Trump’s Office of Management and Budget recently transmitted a $9.4 billion rescissions package to Capitol Hill.14 This package includes cuts to the Corporation for Public Broadcasting, including NPR and PBS, as well as woke and weaponized foreign aid.15 Part of the package consists of modest cuts of $400 million16 to PEPFAR, which, as noted above, is a $100 billion program with average annual funding of $5 billion to foreign nations.17 A modest reduction would preserve any funds allocated to actual life-saving treatments or prevention programs. Instead, the rescission can be targeted at woke and weaponized spending, such as radical LGBTQIA+ support activities.
Indeed, PEPFAR is plagued with woke initiatives that are at odds not only with American values but often also those of the host countries, too. It appears that PEPFAR has become one of the key promotion centers of the left’s radical views on sexuality and gender. For example, according to the Office of Management and Budget, millions of dollars of PEPFAR funds have been utilized for LGBTQIA+ programs, condoms, and vasectomies:
- $833,000 was provided for “transgender people, sex workers and their clients and sexual networks” in Nepal.18
- $5.1 million was provided for “resilience of lesbian, gay, bisexual, transgender, intersex, and queer global movements.”19
- $3 million was provided for circumcision, vasectomies, and condoms in Zambia.20
The Biden Administration made PEPFAR’s support for LGBTQIA+ individuals a key priority. In 2022, a State Department press release stated, “by the end of Fiscal Year 2023, PEPFAR plans to support more than 250,000 gay men and other men who have sex with men and more than 16,000 transgender people on HIV treatment.”21 Instead of discouraging high-risk behaviors that could lead to HIV infection, the Biden Administration subsidized and encouraged those behaviors to continue in countries that PEPFAR serves. Also, PEPFAR requires an anti-prostitution pledge for participants, but it still provides funding initiatives to support so-called sex workers.22 For example, a PEPFAR-funded study had an express goal of helping USAID and Ghana’s government “understand the vulnerabilities and needs of adolescents and adults engaging in sex work.”23 While this study does not overtly violate the anti-prostitution pledge, it is worth Congress and the Trump Administration investigating whether PEPFAR has enhanced its support of sex work in foreign countries.
Furthermore, despite being barred from providing abortion services under U.S. foreign assistance rules, PEPFAR-funded service providers in Mozambique performed a total of 21 abortions since January 2021.24 This did not happen by accident; the Biden Administration ensured that support for abortion services was a standard operating procedure. Early in 2021, the Biden Administration issued an order “to support women and girls’ sexual and reproductive health and rights in the United States, as well as globally.”25 In 2023, Congressman Chris Smith (R-NJ) sounded the alarm when PEPFAR was up for reauthorization in Congress by stating that two groups with a track record of pushing abortion — Population Services International (PSI) and Village Reach, received $96.5 million and $10.1 million, respectively, over the last few years from PEPFAR under President Biden.26 As demonstrated above, many other PEPFAR partners appear to support abortion related services. Family planning programs under PEPFAR, like most other foreign assistance programs, are designed to normalize and push access to abortion and promote the LGBTQIA+ agenda as part of “family planning” and under the euphemism of “reproductive health.”27 USAID, which has helped administer PEPFAR programs, has openly admitted that family planning programs have reduced family sizes and, by inference, the global population.28 Weaponizing aid by forcing abortion acceptance in countries that reject it and funneling radical social policies into foreign countries under the guise of humanitarianism undermines local traditions and does not advance American interests. Moreover, it is likely to breed resentment, as it erodes national identities and fuels backlash that makes the world less stable and America less respected.
Troubling reports of women living with HIV having been sterilized without their informed consent in Africa are another reason to be skeptical of the ethics of the PEPFAR program.29 Reports indicated that these women were sterilized in facilities funded in part by international donors, including some allegedly receiving PEPFAR funding.30 It is important to note that one of the chief architects of PEPFAR was Dr. Anthony Fauci, the former director of the National Institute of Allergy and Infectious Diseases, who was responsible for much of the failed response to the COVID-19 pandemic, along with the weaponization of the federal government against the American people.31 Fauci has supported unethical gain-of-function experiments32 in the past, and it would not be surprising if forced sterilizations were overlooked or even supported under his direction.
Conclusion:
PEPFAR has been co-opted by the left to promote radical ideologies and to facilitate the murder of unborn children. As Congress conducts its FY2026 appropriations process, it should consider ending funding for PEPFAR and shifting responsibilities to host countries. Congress should immediately approve President Trump’s rescission request, eliminating woke and weaponized PEPFAR funding. For too long, American taxpayers have borne the cost of wasteful spending that undermines their values.
Endnotes
1. (May 13, 2025). “The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR),” KFF. https://www.kff.org/global-health-policy/fact-sheet/the-u-s-presidents-emergency-plan-for-aids-relief-pepfar/
2. (June 4, 2025). “PEPFAR About Us,” U.S. Department of State. https://www.state.gov/about-us-pepfar
3. Ibid.
4. https://2017-2021.state.gov/where-we-work-pepfar/#:~:text=The%20U.S.%20President’s%20Emergency%20Plan,Regional%20Operational%20Plan%20(ROP).
5. Ibid.
6. (June 4, 2025). “PEPFAR About Us,” U.S. Department of State. https://www.state.gov/about-us-pepfar
7. Ibid.
8. (May 2025). “PEPFAR Organization and Implementation,” National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK207009/
9. Ibid.
10. Meisburger (5/24/23). “Reform PEPFAR, the 25-year ’emergency’ foreign aid program,” The Hill. https://thehill.com/opinion/4015763-reform-pepfar-the-25-year-emergency-foreign-aid-program/
11. https://icfp2022.org/sponsor/chemonics/
12. (November 2022). “Success Story: Offering mental health services for LGBTQI+ people in Algeria, Morocco, and Tunisia,” FHI 360.
https://www.fhi360.org/wp-content/uploads/2024/02/resource-epic-mental-health-success-story.pdf
13. (June 23, 2021). “ICAP Launches Study to Assess Impact of COVID-19 Among New York City’s LGBTQ+ Community,” ICAP.
https://icap.columbia.edu/news-events/icap-launches-study-to-assess-impact-of-covid-19-among-new-york-citys-lgbtq-community/
14. https://www.whitehouse.gov/wp-content/uploads/2025/03/Proposed-Rescissions-of-Budgetary-Resources.pdf
15. Ibid.
16. Ibid.
17. (May 13, 2025). “The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR),” KFF.
https://www.kff.org/global-health-policy/fact-sheet/the-u-s-presidents-emergency-plan-for-aids-relief-pepfar/
18. https://x.com/WHOMB/status/1929991241199939866
19. Ibid.
20. Ibid.
21. PEPFAR Release (June 22,2022). “PEPFAR Stands with LGBTQI+ Individuals; Planned Programming for COP22 surpasses $235 million; New Partnership with UNDP to Counter Punitive and Discriminatory Laws,” U.S. State Department.
https://2021-2025.state.gov/pepfar-stands-with-lgbtqi-individuals-planned-programming-for-cop22-surpasses-235-million-new-partnership-with-undp-to-counter-punitive-and-discriminatory-laws/
22. Beard (September 5, 2018). “What’s up with PEPFAR’s Anti-Prostitution Pledge?,” Public Health Post. https://publichealthpost.org/health-equity/whats-up-with-pepfars-anti-prostitution-pledge/
23. Ibid.
24. Lewis and Zengerle (January 16, 2025). “Anti-AIDS program in peril after US finds nurses in Mozambique provided abortions,” Reuters.
https://www.reuters.com/world/us/anti-aids-program-peril-after-us-finds-nurses-mozambique-provided-abortions-2025-01-16/
25. (January 28, 2021), “Memorandum on Protecting Women’s Health at Home and Abroad,” The White House,, https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/28/memorandum-on-protecting-womens-health-at-home-and-abroad/
26. Miller (June 10, 2023). “Biden administration ‘hijacking’ George Bush AIDS program to push abortion in Africa: GOP congressman,” Fox News.
https://www.foxnews.com/politics/biden-administration-hijacking-george-bush-aids-program-to-push-abortion-in-africa-gop-rep
27. https://americarenewing.com/wp-content/uploads/2024/03/Budget-Center-for-Renewing-America-FY23.pdf
28. Ibid.
29. Wangira (December 4, 2023). “HIV and Forced Sterilizations: How Four Kenyan Women found justice,” The BBC. https://www.bbc.com/news/world-africa-67553104
30. https://www.state.gov/wp-content/uploads/2020/08/PLGHA-2019-Review-Final-8.17.2020-508.pdf
31. Hearing Wrap Up (June 4, 2024). “Dr. Fauci Held Publicly Accountable by Select Subcommittee,” House Committee on Oversight and Accountability.
32. Ibid.
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