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Marco Rubio exempts PEPFAR's HIV relief from international aid freeze

Zimbabwe health clinic testing and treatment HIV Tuberculosis diabetes
JEKESAI NJIKIZANA/AFP via Getty Images

Microscopist Mazvita Chataurwa prepares slides to conduct tests on patient's sputum samples in an on-site laboratory, at Rutsanana Polyclinic in Glen Norah township, Harare June 24, 2019. - The health clinic is a one stop testing and treatment centre for HIV, Tuberculosis and diabetes in Zimbabwe. It's one of 10 pilot clinics offering free treatment against the diseases and also free diagnosis. In a country where public health services have practically collapsed, containing the spread of TB has been a persistent struggle. The annual number of TB infections in Zimbabwe remains among the highest in the world.

The new Secretary of State Marco Rubio's waiver ensures PEPFAR's vital HIV/AIDS relief continues despite Trump's aid freeze, but the exclusion of gender identity programs raises concerns.


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New Secretary of State Marco Rubio on Tuesday issued a waiver ensuring that the President’s Emergency Program for AIDS Relief, or PEPFAR, which helps fight HIV and AIDS internationally, is exempt from Pres. Donald Trump’s 90-day freeze on most foreign aid spending, the Washington Post reports. The memo, a copy of which was obtained by the Post, was sent to service NGOs and other organizations impacted by the freeze.

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“For purposes of this waiver, life-saving humanitarian assistance applies to core life-saving medicine, medical services, food, shelter, and subsistence assistance, as well as supplies and reasonable administrative costs as necessary to deliver such assistance,” the memo reads.

The news was welcomed by the international HIV/AIDS advocacy group UNAIDS.

“UNAIDS welcomes this waiver from the US government which ensures that millions of people living with HIV can continue to receive life-saving HIV medication during the assessment of US foreign development assistance,” Winnie Byanyima, UNAIDS executive director, said in a statement. “This urgent decision recognizes PEPFAR’s critical role in the AIDS response and restores hope to people living with HIV.”

The memo directs that “existing life-saving humanitarian assistance programs should continue or resume work if they have stopped,” but cautions the resumption is temporary and subject to conditions.

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While the news of PEPFAR’s exemption was welcome news to some in the LGBTQ+ and NGO community, a further reading of the memo shows such hope for a supportive and affirmational State Department under Rubio is premature. In addition to abortions and family planning conferences, the waiver specifically notes that “gender or DEl ideology programs, transgender surgeries, or other non-life saving assistance” are not exempt from Trump’s 90-day pause on federal foreign aid spending freeze.

As originally written, Trump’s order to freeze most foreign aid spending would have devastated PEPFAR.

PEPFAR is overseen by the State Department. The program started in 2003 under Republican President George W. Bush. Rubio had supported the program while he was a U.S. senator.

The program received $7.5 billion annually under the former Biden/Harris administration. PEPFAR is the main source of HIV-fighting drugs to 54 developing countries, mostly in Africa, according to amfAR, the Foundation for AIDS Research.

Daily, PEPFAR supports more than 222,000 people on antiretroviral treatment and provides services for 17,695 orphans and vulnerable children affected by HIV, amfAR reports. PEPFAR also provides care for 3,618 women experiencing gender-based violence.

The program has saved an estimated 26 million lives to date.

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