Congress’ reauthorization of PEPFAR, the Bush-era HIV prevention program, is encountering scrutiny from conservatives who have noted that both President Biden’s agenda and recipients of PEPFAR funding have shown an interest in promoting abortion overseas.
Congressional Pro-Life Caucus Co-Chair Chris Smith (R-N.J.) raised those concerns in a letter he sent last week, telling colleagues that the administration is “hijack[ing]” the foreign aid program.
“President Biden has hijacked PEPFAR, the $6 billion a year foreign aid program designed to mitigate HIV/AIDs in many targeted—mostly African—countries in order to promote abortion on demand,” Smith said in the letter, which was obtained by Fox News Digital. “Bad actor nongovernment organizations (NGOs) that promote abortion have received at least $1.34 billion from PEPFAR funds—the lack of transparency by the Administration means it could be more—since FY 2021 and are now poised to carry out Biden’s new strategy directives.”
Prior to Smith’s letter, the conservative Heritage Foundation released a report in May that raised concerns about the left-leaning tilt of PEPFAR and its recipients. A long list of conservative organization heads also wrote congressional committees, asking them to ensure taxpayer money wouldn’t be used to “promote abortions and push a radical gender ideology abroad.”
More recently, a group of 139 African Parliamentarians sent Congress a letter expressing “our concerns and suspicions that this funding is supporting so-called family planning and reproductive health principles and practices, including abortion, that violate our core beliefs concerning life, family, and religion.”
Smith, who co-sponsored PEPFAR’s reauthorization in 2017, accused the administration of “radically chang[ng] the trajectory” of the program, Fox News Digital reported. His letter points to documents on PEPFAR that indicate an interest in “reproductive” rights or health – often code for liberalized abortion access.
For example, the State Department’s 2023 Country and Regional Operational Plan for PEPFAR states: “PEPFAR should work particularly with multilateral, foundation, and private sector donors to partner in the provision of economic and educational opportunities, and with government partners, to incorporate evidence-based interventions into local structures such as schools and with organizations advocating for structural, systemic, and institutional reforms in law and policy regarding sexual, reproductive, and economic rights of women.”
A September 2022 document titled “Reimagining PEPFAR’s Strategic Direction” says that “[w]here possible, PEPFAR will integrate HIV programming into strengthened public health systems to manage tuberculosis, high burden non-communicable diseases, sexual reproductive health, rights and services, as well as other local health priorities that impact PLHIV [people living with HIV/AIDS] – to protect HIV/AIDS gains and strengthen health and economic outcomes.”
Smith’s letter also highlights pro-abortion advocacy from Population Services International (PSI), Pathfinder International, and VillageReach, which collectively received more than $100 million in PEPFAR funding over the last two years. He listed several examples of how international organizations were allegedly engaging in the type of integration the 2022 document discussed.
More specifically, he pointed to PSI and Pathfinder statements showing an interest in promoting abortion. He also honed in on a manual VillageReach and Planned Parenthood produced with PEPFAR funding.
The controversy has raised questions about whether organizations might be using U.S. funding in a way that violates the Helms Amendment’s prohibition on promoting abortion overseas. Helms is still in place but House Democrats previously tried to exclude Helms from its budget process in 2021. And as Live Action News previously reported, the Biden administration’s FY22 budget proposal excluded Helms and other protections on taxpayer funding.
Fox News reported that a White House spokesperson denied abortion ties and blamed the controversy on a “false narrative”:
A White House spokesperson told Fox News Digital PEPFAR funding “does not support” abortion provisions in accordance with “longstanding legal restrictions on the use of foreign assistance funding for abortions.”
The official explained that the “false narrative” on abortion was a “disinformation campaign” spread by groups that oppose the reauthorization of PEPFAR, which has enjoyed bipartisan support for 20 years.
Smith, meanwhile, accused the Biden administration of “misdirection” and worried that Helms didn’t adequately prevent abortion promotion.
DevEx reported that both PSI and VillageReach denied violating U.S. law.
“We adhere strictly to all applicable regulations to ensure compliance and to provide essential reproductive healthcare services while respecting local laws,” PSI reportedly said. “PSI’s safe abortion work remains separate from US government funding due to long-standing US laws and regulations,” it added.
VillageReach reportedly described Smith’s letter as providing an “inaccurate portrayal of the program.” It added that the services it delivered “complied with U.S. law and Malawi law.”
Smith’s letter didn’t link to the manual but appeared to be referring to a training manual that can be found on healthpolicyplus.com and contains a 17-page section on “unsafe abortion and young people.” In it, facilitators are told to host exercises in which participants consider different scenarios involving abortion. One of the exercises asks participants to choose one of six patients to receive an abortion. The manual also lists “factors that could help reduce unsafe abortion in young people,” including “availability and accessibility of safe abortion services.”
Part of Smith’s suspicions also stemmed from a government-funded hotline that provided information on “sexual and reproductive health.” VillageReach’s website contains an evaluation of that hotline with information on “referrals/linkages to care.” It reads: “How effective was the CCPF hotline in connecting the general population to needed health care services? Did the hotline provide timely and appropriate referrals to health facilities for clients presenting with specific health symptoms/danger signs or clients requiring certain preventive/family planning services?”
