The State Department launched a new bureau Tuesday aimed at making the battle against global outbreaks a lasting priority of U.S. foreign policy, even as one of its key elements – a widely acclaimed HIV program – has become caught up in the political battle over abortion.
The bureau is to include the 20-year-old initiative known as the President's Emergency Program for AIDS Relief, or PEPFAR. The program is relatively unknown to Americans but has succeeded beyond most early expectations in addressing the AIDS crisis and is credited with saving up to 25 million lives worldwide.
The bureau will be led by a public health official integral to PEPFAR, John Nkengasong. Born in Cameroon, Nkengasong was a founder of U.S. Center for Disease Control and Prevention operations in Africa. He helped set up some of the sub-Saharan's first sophisticated labs for work with HIV and AIDS.
President George W. Bush started PEPFAR in Africa in 2003. The program retains bipartisan support. But anti-abortion groups and some House Republicans, including Rep. Chris Smith of New Jersey, are pushing to attach abortion-related limits on U.S. health support overseas to the reauthorizing legislation They are also seeking yearly votes on PEPFAR's continuance.
While the Democratic-controlled Senate is expected to try to squash any such GOP conditions on the HIV program, the skirmish signals the PEPFAR program is now likely a captive of U.S. abortion politics going forward.
Secretary of State Antony Blinken, in a ceremony for the new Bureau of Global Health Security and Diplomacy, made only a passing reference to the abortion fight threatening PEPFAR's normally assured support from lawmakers, saying he hoped Congress approved the program for another five years, without amendments.
The $100 billion in U.S. support for the PEPFAR program over 20 years is credited with lasting improvements in health care systems globally.
Nkengasong helped establish one of the first local government-run HIV drug programs, in Ivory Coast at a time that HIV and AIDS medications were too scarce and too costly for most people in the sub-Saharan
The lessons learned from the U.S. HIV program "are applied daily" in dealing with other threats, he said Tuesday.
The success of the PEPFAR program as it grew across Africa and around the world over decades made it "the single greatest health achievement in history," said Samantha Power, head of the U.S. Agency for International Development.
Power cited the economic and human toll of the COVID-19 pandemic, and pointed to estimates that the warming climate and other changing conditions make for a 40% increase in the chances that another pandemic on the same scale as COVID will happen in our lifetimes.
Creation of the new bureau is meant to raise health security as a global priority, build up the capacity of U.S. diplomats and local health systems globally to better curb outbreaks, and get the most out of U.S. assistance to health systems globally, Blinken said.