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What would you do with a phenomenally successful anti-disease program that has saved an estimated 25 million lives – adults and children – in poor countries during the past two decades? For a growing number of Republicans in the U.S. House of Representatives, the answer is “shut it down until we like it” – even though a Republican president created the program.

PEPFAR, which stands for President’s Emergency Plan for AIDS Relief, is the program in question. Former President George W. Bush implemented it. PEPFAR has primarily been administered in Africa due to the manner in which HIV/AIDS has devastated that continent. Incidentally, the 43rd U.S. president is popular in several parts of Africa, in large part due to the fact that he supported sending billions of dollars in aid to the multiple nations on the continent. (When I traveled to Ghana recently, the hotel at which I stayed was located just off George W. Bush Highway.)

As has been widely reported, PEPFAR is the largest economic aid program that addresses a single disease in the history of the world. Usually approved in $5 billion increments, PEPFAR has enjoyed strong bipartisan support over the years, having been administered under four U.S. presidents and approved by 10 consecutive congresses.

PEPFAR is one of a shrinking number of initiatives on which Democrats and Republicans generally agree, but that might be changing. Indeed, PEPFAR could be in jeopardy in the not-too-distant future. Why? Republicans have increasingly expressed their desire to prevent PEPFAR from working with organizations that provide abortions, advocate abortion rights, provide referrals, or even offer information about abortion services – even if they do so without money that the U.S. provides. Of course, U.S. law already prohibits PEPFAR funds from being used for abortions. Still, that’s not a high enough bar for some of its critics.  

Tragically, the fraught domestic issue of abortion rights is threatening an international program that arguably has saved more lives than any other health initiative in world history. Though it is rarely spoken of in such terms today, HIV/AIDS remains a pandemic and continues to wreak havoc in many poor countries. Changing the parameters under which PEPFAR operates could substantially decrease its effectiveness because there are relatively few on-the-ground organizations in Africa with which it can work.  

I am a pro-life Christian. Thus, I very much understand the deep conviction that compels people to oppose abortion. I am also a loyal American who is increasingly concerned about the fragility of democracy in a pluralistic nation that appears to be ripping apart at the seams. In short, even though I agree with the aphorism that “if we don’t legislate morality, we’ll legislate little else”, I am nonetheless mindful that my definition of morality differs from others. In my view, governmental imposition of specific moral beliefs should happen exceedingly rarely and only after a very broad consensus is reached.

If we allow our religious beliefs (or the lack thereof) to become the primary factor in determining how we govern, we will set precedents that we almost certainly will regret later (e.g., when those with whom we strongly disagree religiously assume the mantle of power). Democracy is an experiment that must strike a delicate balance between curtailing the unfettered will of the majority versus allowing the tyranny of an overly zealous minority to dismantle generally accepted norms. Obviously, majority rule should prevail most of the time, but that does not mean that the inherent and “unalienable” rights of the minority should be trampled underfoot.

I am cautiously optimistic that PEPFAR will be allowed to continue its unprecedented work to foster the prevention of the spread of HIV/AIDS and to bring healing and hope to those who are ravaged by it. We cannot allow the arrogance of moral authoritarianism to abrogate the right of desperate people to live healthier and more productive lives. God is watching.

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