The mission of Issues in Perspective is to provide thoughtful, historical and biblically-centered perspectives on current ethical and cultural issues.

Former President George W. Bush recently wrote this defense of PEPFAR (President’s Emergency Plan for AIDS Relief):  “When I took office in 2001, the situation with HIV/AIDS on the African continent and elsewhere was dire. A group of advisers including Condi Rice, Josh Bolten and Mike Gerson encouraged me to act before an entire generation was lost.

I believe that every life has dignity and value. I also believe that of those to whom much is given, much is required. So we developed a plan with clear objectives and accountability, and we got to work.

In 2003, Congress authorized the President’s Emergency Plan for AIDS Relief, or PEPFAR, with huge bipartisan support. Twenty years later, the results are clear: PEPFAR has saved more than 25 million lives and prevented millions of HIV infections. Members of Congress and American citizens from both parties should be proud.

Instead of celebrating this success and extending these gains, some in Washington have called the future of this program—which accounts for less than one-tenth of 1 percent of our federal budget—into question.  We are on the verge of ending the HIV/AIDS epidemic. To abandon our commitment now would forfeit two decades of unimaginable progress and raise further questions about the worth of America’s word.  The reauthorization is stalled because of questions about whether PEPFAR’s implementation under the current administration is sufficiently pro-life. But there is no program more pro-life than one that has saved more than 25 million lives.”

Without reauthorization, parts of the program have expired. If Congress does not act soon, organizations that deliver lifesaving drug treatments and other forms of support to H.I.V. patients could have to curtail their work. And some specific measures could lose funding, including one that provides care for orphans and other vulnerable children. “PEPFAR has been a shining example of a bipartisan commitment to addressing a global health issue,” Sheryl Gay Stolberg, who covers health policy, explains. “If it doesn’t get reauthorized, it will be an example of how Washington is so broken that it’s even abandoning its moral leadership in the world.”

There is no partisan dispute on one point: The AIDS relief program is a major public health success. It has saved 25 million lives, equivalent to the population of Australia. In some countries, it has helped reduce the rate of H.I.V. infections by half or more. How? The program funds health care services in more than 50 countries. It has helped build clinics that distribute antiretroviral medications for H.I.V., which reduce the risk of developing AIDS and undercut the virus’s ability to spread. It has established testing centers to help catch the virus earlier. And it has encouraged other preventive measures, such as safer sex practices and circumcision.  The program is especially important in western and southern Africa. Many H.I.V. patients in these regions otherwise struggle to get treatment. Nothing in the program directly funds abortions.

Nicholas Kristof is certainly correct when he argues that, “So it’s a reflection of the madness that has infected the Republican Party that today some conservatives are repudiating perhaps the best thing they ever did and battling the reauthorization of this program.  Republicans should be extraordinarily proud of their boldness in crafting PEPFAR, which provides antiretroviral medicines to AIDS patients and operates in more than 50 countries.  The devastation of AIDS in the 1990s and 2000s, particularly in southern Africa, may be difficult for people today to understand . . .  Estimates circulated that AIDS would kill 100 million people over the next 20 years.  PEPFAR changed all that. It brought AIDS under control and gave countries their futures back.”

“This is America at its best,” Condoleezza Rice, President George W. Bush’s national security adviser and secretary of state, told Kristof.  “Let’s not throw away one of the really great moments when the United States took on this extraordinary challenge of people who were dying from this pandemic and intervened and started to save lives,” Rice said. “I just don’t understand why we wouldn’t want to continue to do that.”

In addition, Kristof argues that “PEPFAR is one reason polls show that Africa is one of the most pro-American parts of the globe. China is competing for hearts and minds there, and America’s struggle to reauthorize PEPFAR amounts to a gift to Xi Jinping.  Early this year, I chided Democrats for failing to acknowledge Bush’s heroism in creating PEPFAR. I wrote that column because we all have cognitive biases that nudge us toward self-congratulatory narratives in which our own side is virtuously battling idiots on the other side. PEPFAR reminds us of the complicated truth, which is that in 2003, Bush both began a catastrophic war that killed hundreds of thousands of people and also started a program that saved 25 million lives.”

The Bible is filled with the wonder of God’s grace, mercy and compassion on sinful humanity.  The Old Testament prophets taught that anyone who had experienced His mercy and compassion would feel it his duty to have compassion on others, especially the fatherless, the widow, the stranger, the poor and the afflicted.  [Deuteronomy especially stressed that Israel was to show compassion to all of these groups.]  Jesus both taught compassion and modeled compassion in His earthy ministry.  When Jesus was confronted with human need, the Gospels often state that He was “moved with compassion.”  What He felt inwardly led Him to action—healing the sick, giving sight to the blind, hearing to the deaf, etc.

Compassion meshes with grace and mercy to explain how God deals with sinful humanity—and because we as Christians have experienced these blessings we should be people of compassion, grace and mercy.  It is astonishing to me that some members of Congress in the Republican Party are unwilling to extend this proven and tested example of compassion—PEPFAR.  Their hardness of heart and their seared conscience are shameful and disgusting.  May God have mercy on these people who are our leaders and cause them to exhibit the compassion that the Son of God has on lost humanity.

See George W. Bush in the Washington Post 13 September 2023); “The Morning” of the New York Times (2 October 2023); and Nicholas Kristof, “Will Republicans Abandon This Medical Triumph?” in the New York Times (21 September 2023).