Every H.I.V.-positive pregnancy is a crisis pregnancy. As a mother feels her baby growing and moving within her womb, she hopes the child will inherit the best of her and her partner. It is an aching tragedy when a mother’s body becomes a threat to her baby instead of its refuge.
The President’s Emergency Plan for AIDS Relief, a multibillion-dollar global health initiative started under President George W. Bush, has brought hope to H.I.V.-positive mothers across Africa, and put the end of AIDS within reach. Through H.I.V./AIDS prevention and treatment, PEPFAR has saved 25 million lives and, by preventing mother-to-child transmission of the virus, allowed nearly eight million babies to be born free of the disease. But President Trump’s 90-day freeze of foreign aid programs and sudden stop-work orders have halted this work.
For decades, PEPFAR has enjoyed broad bipartisan support, including from many pro-life politicians and doctors who value its effort to safeguard mothers and babies. Many of these same politicians — most notably Secretary of State Marco Rubio — are now in a position to help restore its lifesaving aid. As pro-life writers, doctors and activists, we ask Mr. Rubio and other pro-life officials and lawmakers to fully restore PEPFAR and protect babies, both born and unborn.
Every minute counts: In South Africa alone, a shutdown of PEPFAR aid is expected to result in the birth of 230 H.I.V.-positive babies per day.
Waivers signed in recent weeks by the Trump administration were supposed to keep some lifesaving aid going, but they haven’t been enough to fully restart operations. That’s 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. On Friday, a federal judge ordered the temporary reinstatement of hundreds of these workers, but these programs require more stability than appeals, injunctions, and stays can provide.
As a result, clinics are closing their doors and rationing what little medication they have left. One of us, Dr. Loftus, works at a mission hospital in Kenya that since the Jan. 24 stop-work order has seen no funds for its more than 3,160 H.I.V. patients and the 42 workers serving them.
Even if the waivers were working as intended, they offer only a partial exemption, focused on immediate treatment. But PEPFAR clinics don’t just hand out drugs — they counsel families, treat other acute and chronic diseases that patients develop, run support groups for youth and work to prevent H.I.V. infection. This work builds the connections and trust needed to dispense treatment.
Before PEPFAR was created in 2003, half of children in Africa infected with H.I.V. at birth died before their second birthday. Instead of growing chubby and pulling up to stand for the first time, these children became thin and weak, at risk of dying from complications of infections as minor as the common cold.
We think PEPFAR 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. 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.
Every day, PEPFAR helps about 430 pregnant women get an H.I.V. diagnosis early enough to reduce their viral load and prevent transmission to their babies. If PEPFAR’s work remains interrupted for the full 90-day foreign aid pause, an estimated 136,000 babies will be infected with H.I.V. at birth who otherwise would not be.
Supporting PEPFAR means putting babies’ lives above partisan politics. The program has drawn scrutiny to make sure it complies with the law and never promotes or performs abortion. In this first term, President Trump brought PEPFAR under the Mexico City Policy, which extends that prohibition to any work that partners do, even on their own time and with their own funding.
PEPFAR providers are audited for compliance with this policy; in the single documented case of a violation, in which four nurses in Mozambique were found performing abortions, quick action was taken and funds were frozen. Churches across Africa have been some of the first and most faithful partners in this work.
Over PEPFAR’s existence, the program has driven down the price for saving a life. The monthly cost of distributing antiretrovirals has dropped precipitously, and the program has handed off many of its responsibilities to partner countries. For just 0.1 percent of America’s total federal budget, PEPFAR lays the groundwork to eliminate AIDS as a public health crisis.
It’s a thrilling time to be alive, when it is newly legal to protect life in the womb at home and when we can extend protection to babies born abroad. PEPFAR is the kind of world-reshaping project that only America can achieve. In the next 50 years, we should see the end of any baby contracting H.I.V. from his or her mother. Don’t throw away this incredible victory.
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