213 - Undoing Good in the World: Republicans Sabotage Soft Power

PEPFAR Threatened

America’s Soft Power is its strength.  Foreign students flock to our universities because they are among the world’s best and because of our reputation as a caring, mostly freedom-loving, nation. Our respect for the rule of law, our reputation for judicial independence, the integrity of our currency and money and banking system, and our (relative) absence of corruption are all well celebrated and greatly lauded overseas. Now, however, slanted Republicans in the House of Representatives are attacking one of the most successful examples of moral leadership advanced in this century by our government. Abortion politics has intruded once again to threaten our legitimacy and sterling good works beyond our shores, and to undercut our soft power.

We are engaged in a monumental competition with China and Russia for the hearts and minds in Africa, as elsewhere across the globe.  But Africa has fifty-five countries, more than other continents. We need their support as we help Ukraine battle Putin and assist Israel in halting Hamas. We also require resources like lithium and cobalt from Africa and oppose control over such minerals being ceded to China. Stability in Africa is another crucial objective of U. S. policy, but Russia is helping to destabilize nations in the Sahel, like Mali, Niger, and the Central African Republic, cuts dangerous deals with South Africa, and generally disturbs what were advances in Africa fostered previously by American policy endeavors.

PEPFAR – the President’s Emergency Plan for AIDS Relief -- and the Peace Corps are among our most respected soft power contributions to African development. Now a posse of mostly ignorant Republican Representatives are holding up the reauthorization of PEPFAR to gain political attention from antiabortionists.  Just like Senator Tommy Tuberville, a former football coach, has held up the appointment of more than sixty ambassadors and more than 300 military promotions, using his Senatorial “privileges” and undermining national security, so his counterparts in the House are trying to make the enormous attributes of PEPFAR into dangers, all for narrow political publicity in the culture wars.  Africa should not be held captive to wildly misplaced Republican political attention seeking, all of which assists Russian and Chinese designs on public support across the globe.

            Of all the legislative acts emphasizing our abundant store of soft power, none in today’s troubled world is as significant as PEPFAR. Proposed and enacted during the otherwise vastly compromised and aggressive presidency of George W. Bush, it is likely to have saved the lives of 25 million people, mostly in Africa, since 2003. It is a $7 billion program that has cost $100 billion over twenty years and been routinely reauthorized in a bipartisan manner by Congress every five years since it was started as an experimental innovation during the depths of deadly HIV-AIDS pandemic. Now the post-Roe abortion-obsessed Republicans are refusing to reauthorize PEPFAR – Bush’s only bright legacy – because they falsely claim (who knows why?) that the Biden administration is using PEPFAR to promote abortion in Africa. PEPFAR officially lapsed on Sept. 30, at the end of fiscal year, although a few parts of the program are still using unexpended funds.

            The Republican assertion is patently erroneous.   But Republican abortion-baiters in the House want to attach heavy no abortion language to the reauthorization bill, infuriating the Senate, and our government. PEPFAR deals in HIV-AIDS and other maladies prevalent throughout Africa. Abortion is obviously none of the above, but Republicans are nevertheless trying to make political capital in their constituencies by raising the hobgoblin of abortion in a legislative zone that Halloween has never encompassed.

            Until Sept. 30, PEPFAR assisted 65 million Africans with HIV treatment and testing services. It was offering life-saving antiretroviral medicines to 20 million men, women, and children in more than fifty countries. Furthermore, PEPFAR is actively attempting to remove health care inequalities confronted by adolescent girls and young women, all the time battling HIV/AIDS as a security threat and a cause of school dropouts.

            Additionally, PEPFAR has long tried to help HIV/AIDS sufferers to cope with the full range of collateral damage that accompanies HIV/AIDS. Tuberculosis, an old disease that is particularly prevalent in southern Africa in a virulent form – multidrug resistant TB – very often consumes those with HIV/AIDS and makes treating their HIV/AIDS much more difficult. 

TB remains one of the world’s deadliest infectious diseases and is the leading cause of death for people living with HIV, responsible for an estimated 187,000 fatalities in 2021—approximately one-third of all HIV-related deaths

PEPFAR is now seeking (if it is reauthorized and funded) to prevent over 500,000 TB-related deaths among people with HIV.  It wants to use new scientific tools to improve diagnosis methods among the HIV populations, especially in TB-prone places like South Africa, Nigeria, Kenya, Tanzania, and Mozambique.

            Another worthy PEPFAR initiative may erroneously have attracted conspiracy theorists and Republicans looking for a peg on which to hang their predilection for abortion friendly political arousing. PEPFAR wants to launch a Safe Births, Healthy Babies program to eliminate the mother to child transmission of HIV in those countries in Africa where mothers with HIV infect their babies. Until now, PEPFAR has helped 5.5 million babies be born HIV-free.  It has used various preventive methods, plus a strong educational and instructional component. Nevertheless, about 130,000 babies were newly infected by their mothers in 2022.  The official PEPFAR announcement of this approach says that “The new initiative will primarily focus on scaling up community-level and facility level interventions, aiming to attract and retain pregnant women in HIV care.”  There is no mention of abortion; nor can anyone easily insinuate that PEPFAR is going to encourage abortions. But, then, few hard-right Republicans seek the facts.

Nations once overrun by HIV/AIDS like Botswana have reached the previously unthinkable milestone of less than 500 new HIV cases per 100,000 live births, thanks to PEPFAR.  Such a success story demonstrates that with focused effort, an AIDS-free land can be achieved. The Safe Births, Healthy Babies initiative promises to do just that and will advance the global effort to end HIV/AIDS as a public health threat by 2030  -- providing the Republicans stop interfering with a superb soft power accomplishment.

            Meddling with good initiatives is but another example of Trump-era inspired political chicanery. Just possibly, President Bush’s pleas for reauthorization, the Biden administration’s insistence on such a result, and a newly sponsored bill to do so will finally make It to the floor of the House, even a House led by a speaker is an anti-abortion hard-liner. But we have no guarantees.

            PEPFAR has no abortion advocacy hidden in its legislative skirts. But all manner of formerly easy Congressional actions are distorted by the Trumpian era in which they are living and from which we suffer. So I end today’s Newsletter with a preposterous statement uttered by that orange-colored potential convict and quoted in the Economist this week: “Trump compared the prosecutions he is facing [in New York and Atlanta] with the persecution of Nelson Mandela.”  Trump, echoing Mandela at the Rivonia trial in 1962, said that he was “willing to go to jail.”  Amen.