This World AIDS Day is different from years past. On a day in which we should be celebrating 25 million lives saved by our investments in curing HIV/AIDS, recommitting to an AIDS-free generation, and increasing resources for communities on the frontlines of this disease, we are stuck in a stalemate. The future of people living with this disease is in jeopardy. The President’s Emergency Plan for AIDS Relief, otherwise known as PEPFAR, is also celebrating its 20th anniversary, but this year became the first in its two decades of existence that the most successful bipartisan global health program in American history has not been reauthorized — and time is running out.
During last year’s World AIDS Day celebrations, I had the privilege of attending several events to commemorate the occasion. I was fortunate enough to see President George W. Bush — a man whose policy I rarely agreed with over the years — most notably including our largest disagreement over engaging in the wars in Iraq and Afghanistan. Despite our policy differences however, I partnered with President Bush with the shared goal of tackling the HIV/AIDS crisis.
But by the time I spoke with President Bush about this issue, I had already been working on it for years. Upon the retirement of the late, beloved Rep. Ron Dellums (D-Calif.), who was a champion of global health initiatives and so many other issues of equity and justice on the global scale, I won his congressional seat. In 1999, I introduced legislation to create an “AIDS Marshall Plan for Africa” with his input and in 2001, I brought this issue up to President Bush in the Oval Office. He asked about the beaded red ribbon I wore to the White House that day. I explained to him what was taking place in Africa and the disproportionate impact this deadly disease was having in the Black community in the United States. He asked me if I could have it, and I pinned it on his lapel.
That was a key moment in launching the effort to create PEPFAR. Along with the Congressional Black Caucus, I worked with President Bush and others in Congress — both Republicans and Democrats — to craft a global HIV/AIDS legislative package. He pledged the investment at his State of the Union Address, and in May 2003, we passed Public Law 108-25, the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act. That legislation established what we now know as PEPFAR, the President’s Emergency Plan for AIDS Relief. Since then, because of bipartisan, bicameral efforts in Congress, PEPFAR has provided billions to address the HIV and AIDS pandemic.
As ranking member of the Appropriations Subcommittee on State and Foreign Operations, our primary funding mechanism for all non-defense international spending and as a principal architect of PEPFAR, I feel a deep obligation to protect this program. PEPFAR has successfully remained above the messiness of partisan politics. It has consistently and unequivocally been characterized as a life-saving program not worthy of the bickering that accompanies so much of our political discourse today. Our obligation is not only to millions of AIDS patients across the globe, but to the activists, advocates and lawmakers on both sides of the aisle who have worked tirelessly to establish this program and ensure its bipartisan reauthorization every five years for the past two decades.
Bipartisanship is a lost art in today’s Washington. It’s no secret that this fall has been ripe with dysfunction. A weeks-long Speaker race, two near catastrophic GOP government shutdowns, and Republican in-fighting — both rhetorical and physical — have made things contentious. Right now, Capitol Hill is not a place you would go looking for bipartisan harmony. But we have a chance to change course.
In the 20 years of PEPFAR, we’ve seen incredible progress towards our goal of an AIDS free generation. And as a result, globally, AIDS-related deaths have been cut by almost two-thirds and new HIV infections have been reduced by more than half since their respective peaks. But as we saw in the COVID-19 pandemic, there were major setbacks. Success is not inevitable; more work still needs to be done.
But It was years of hard work on both sides of the aisle, from lawmakers, activists and advocates alike that got us to where we are today. And it will take more hard work to keep the program going. I’ll never forget being at the bill signing by President Bush, which was preceded by tough negotiations between Democrats and Republicans. Notably there was a Republican president, Democrats were in the minority in both chambers, and the bill passed by a vote of 205 Democrats and 230 Republicans.
Republicans like President George Bush and Sen. Bill Frist (Tenn.) were noble partners in this effort and deserve staunch praise for their work to make this progress, as well as the staff who continue to work tirelessly behind the scenes. It also included warriors like the late, great Rep. Donald Payne (D-N.J.), Sen. John Kerry (D-Mass.), Speaker Nancy Pelosi (D-Calif.), and artists like U2’s Bono. Most important were the combined voices of activists in the United States and African countries determined to make the concerns of their communities heard in the halls of Congress.
It's now time for us to reignite the bipartisanship that has been linked to the PEPFAR program for so long. In a Congress wrought with dysfunction, let this be the guiding light for collaboration across the aisle. We cannot allow misinformation — the primary dividing factor in this issue and so many others — to win. With millions of lives saved, let this World AIDS Day be the one marked by more than a social media post. This World AIDS Day should be the day that reminds us of the potential of this program, this Congress, and our fight against HIV/AIDS.
Barbara Lee represents the 12th District in California. She is ranking member of the Appropriations Subcommittee on State and Foreign Operations.
