PEPFAR is an acronym that stands for the President's Emergency Plan for AIDS Relief. It is the largest foreign aid program targeted at a specific disease, and it is widely considered to be one of the most successful US foreign aid programs ever.

George W Bush who started the program in 2003. It continued and expanded under President Obama and even thrived during the Trump years. But today its fate is uncertain. Funding for PEPFAR is provided by congress every five years, and typically this is a highly bi-partisan and wholly uncontroversial affair. It was due to be re-authorized this year -- but with the end of the fiscal year rapidly approaching, this legislation has not gone through.

At issue is domestic politics around abortion. Anti-abortion groups in the United States have falsely accused PEPFAR under the biden administration of somehow indirectly or secretly supporting abortion. This idea has infected Republican politics -- several Republican members of congress who once supported PEPFAR are now preventing a vote on its re-authorization, threatening to undermine what one of these very members of congress once called "The most successful foreign aid program since the Marshall plan."

On the line to discuss PEPFAR's history of success and its uncertain future is Gayle Smith, CEO of the One Campaign and former head of the US Agency for International Development.