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President's Emergency Plan for AIDS Relief
The United States President's Emergency Plan For AIDS Relief (PEPFAR) is the global health funding by the United States to address the global HIV/AIDS epidemic and help save the lives of those suffering from the disease. As of 2023, PEPFAR has saved over 25 million lives, primarily in sub-Saharan Africa.
Launched by U.S. President George W. Bush in 2003, as of August 2024, PEPFAR has provided cumulative funding of $120 billion for HIV/AIDS treatment, prevention, and research since its inception, making it the largest commitment by any nation focused on a single disease in history. PEPFAR is implemented by a combination of U.S. government agencies in over 50 countries and overseen by the Global AIDS Coordinator at the United States Department of State.
The PEPFAR program has in recent years been criticized by members of the Republican Party who have sought to block its re-authorization. Republicans alleged that the program promoted abortion.
In 2025, the second administration of President Donald Trump put USAID on a 90-day freeze which involved putting PEPFAR on halt and taking its computer systems offline. Later, on January 28, 2025, the Trump administration granted a waiver for essential medicines and medical services which included HIV medicines.
However, it was later estimated that only about 50% of PEPFAR programs restarted in February. In July, The Lancet published a study about impacts of the funding freeze, but the full impacts were still unknown as of September[update].
PEPFAR began with President George W. Bush and First Lady Laura Bush, and their interests in AIDS prevention, Africa, and what Bush termed "compassionate conservatism." According to his memoir Decision Points the two of them developed a serious interest in improving the fate of the people of Africa after reading Alex Haley’s Roots and visiting The Gambia in 1990. In 1998, while pondering a run for the U.S. presidency, he discussed Africa with Condoleezza Rice, his future secretary of state. Rice said that, if elected, working more closely with countries on that continent should be a significant part of his foreign policy. She also told him that HIV/AIDS was a central problem in Africa but that the United States was spending only $500 million per year on global AIDS, with the money spread across six federal agencies, without a clear strategy for curbing the epidemic.
In April 2003, the United States House of Representatives passed what would become PEPFAR by a 375-41 majority, although with an amendment that one-third of the prevention money had to go to sexual abstinence programs. 20 percent of the overall money would go to prevention, 15% to palliative care, 10% to orphans, and 55% to treatment.
In May 2003, both the House and Senate passed passed and President Bush signed the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (“Global AIDS Act”). This specified a series of broad and specific goals, and alternated between specifying measurable goals and time periods in some areas and delegating authority to the President for identifying goals in other areas. This legislation also established the State Department Office of the Global AIDS Coordinator to oversee all international AIDS funding and programming.
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President's Emergency Plan for AIDS Relief
The United States President's Emergency Plan For AIDS Relief (PEPFAR) is the global health funding by the United States to address the global HIV/AIDS epidemic and help save the lives of those suffering from the disease. As of 2023, PEPFAR has saved over 25 million lives, primarily in sub-Saharan Africa.
Launched by U.S. President George W. Bush in 2003, as of August 2024, PEPFAR has provided cumulative funding of $120 billion for HIV/AIDS treatment, prevention, and research since its inception, making it the largest commitment by any nation focused on a single disease in history. PEPFAR is implemented by a combination of U.S. government agencies in over 50 countries and overseen by the Global AIDS Coordinator at the United States Department of State.
The PEPFAR program has in recent years been criticized by members of the Republican Party who have sought to block its re-authorization. Republicans alleged that the program promoted abortion.
In 2025, the second administration of President Donald Trump put USAID on a 90-day freeze which involved putting PEPFAR on halt and taking its computer systems offline. Later, on January 28, 2025, the Trump administration granted a waiver for essential medicines and medical services which included HIV medicines.
However, it was later estimated that only about 50% of PEPFAR programs restarted in February. In July, The Lancet published a study about impacts of the funding freeze, but the full impacts were still unknown as of September[update].
PEPFAR began with President George W. Bush and First Lady Laura Bush, and their interests in AIDS prevention, Africa, and what Bush termed "compassionate conservatism." According to his memoir Decision Points the two of them developed a serious interest in improving the fate of the people of Africa after reading Alex Haley’s Roots and visiting The Gambia in 1990. In 1998, while pondering a run for the U.S. presidency, he discussed Africa with Condoleezza Rice, his future secretary of state. Rice said that, if elected, working more closely with countries on that continent should be a significant part of his foreign policy. She also told him that HIV/AIDS was a central problem in Africa but that the United States was spending only $500 million per year on global AIDS, with the money spread across six federal agencies, without a clear strategy for curbing the epidemic.
In April 2003, the United States House of Representatives passed what would become PEPFAR by a 375-41 majority, although with an amendment that one-third of the prevention money had to go to sexual abstinence programs. 20 percent of the overall money would go to prevention, 15% to palliative care, 10% to orphans, and 55% to treatment.
In May 2003, both the House and Senate passed passed and President Bush signed the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (“Global AIDS Act”). This specified a series of broad and specific goals, and alternated between specifying measurable goals and time periods in some areas and delegating authority to the President for identifying goals in other areas. This legislation also established the State Department Office of the Global AIDS Coordinator to oversee all international AIDS funding and programming.
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