[{"_1":2,"_99":-5,"_100":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75,87],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":72,"_74":72},"mediaId",6084751,"mediaKeyId","2907877-14e859ad2743b5907c1c0786a493573b","parentId",2907877,"title","Lawmakers, former officials urge structured transition of PEPFAR to country ownership to protect gains and U.S. interests","audioSeconds",2827,"startMs",1994000,"endMs",4821000,"viewUrl","/Search/View?dp=1&key=2907877-14e859ad2743b5907c1c0786a493573b&start=1994&end=4821","thumbnailUrl","https://assets.pipeline.soar.com/2907877-14e859ad2743b5907c1c0786a493573b/thumbnail_1994000.jpg","articleUrl","/articles/6084751/Lawmakers-former-officials-urge-structured-transition-of-PEPFAR-to-country-ownership-to-protect-gains-and-US-interests","mediaUrl","https://secure.pipeline.soar.com/6084751-5bdba943b7c030d4c813192cf9cdd348/orig.mp4?Expires=1773057797&Signature=bv3CfNJ2bLcpG6cFc7pXtEmlfrxxRTmwas0J0Lh71yJNLntZ82AjpzB-FGPzOq~Jb2IfL3zdMXtIpTVSpmmhJN90WdSO5XgAz3L80jn31qF0p-94fhJhQsLYFfFsxJkA7ckxqjPLtZMfEhsAZOLg1TCExlxHtKnS3r-RUX8YWYYwo1VDu-6-QBoXlBhrMklNya6LT7IXJJ3bf4e2QVRyBw364pvIoyk4MvI1fxpeh~r4zGyNF8M5w84ZFy1yxjg3p3doCwsU~abBdgQOGHY2~l1carkIydL9xV5Z2ameVK2Xb0cNNafUO6BfoO3ouGNNORf4DPZFL1IngBiY1CAKMQ__&Key-Pair-Id=KUT5TJCACFTXG","author","U.S. House Committee on Appropriations","date","2025-04-09T09:24:05.7Z","article","Ambassador Mark Dybul, former U.S. officials and members of the subcommittee told the panel that PEPFAR’s long‑term sustainability requires carefully planned transitions to domestic financing, private‑sector engagement and stronger country ownership.

Dybul and other witnesses said domestic financing already accounts for a rising share of HIV financing—one figure cited during the hearing put domestic sources at about 59 percent of HIV‑related spending in 2023—and that many countries could begin structured transitions now. Dybul said roughly three dozen countries with substantial PEPFAR and Global Fund allocations could “successfully transition within a few years,” provided the U.S. and partner governments negotiate formal compacts with annual, transparent benchmarks and reductions rather than abrupt cuts.

Witnesses and members emphasized that faith‑ and community‑based organizations would be particularly vulnerable to an unstructured withdrawal because many governments do not have mechanisms to fund them. Multiple witnesses urged integrating U.S. development finance and trade instruments—cited examples included the U.S. International Development Finance Corporation and the Millennium Challenge Corporation—to bring private investment and create markets that sustain health gains.

Several lawmakers framed the transition question in national security and diplomatic terms. Amb. Dybul and others argued that PEPFAR had created “soft power” benefits—one witness quoted a clinic director in Axum, Ethiopia saying, “PEPFAR means the American people care about us”—and warned that rapid U.S. retrenchment would open diplomatic and economic space that China, Russia and other competitors could fill. Members asked witnesses whether a properly executed transition would deny competitors a foothold; witnesses replied that a well‑managed handover to local governments and private partners would reduce that risk, while chaotic withdrawal would create openings for outside actors.

Members also asked about new technologies that could help achieve sustainability, including long‑acting injectable pre‑exposure prophylaxis and potential vaccines. Witnesses said those products could reduce new infections and lower long‑term treatment burdens, but stressed that they are supplements, not substitutes, for steady program operations and careful transition planning.

Across the hearing witnesses agreed on two priorities: avoid abrupt cuts that would reverse health gains, and develop country‑by‑country transition plans with clear timelines, realistic benchmarks and private‑sector participation. Several members urged the administration and implementing agencies to provide such transition compacts to the committee as part of FY2026 appropriations oversight.","mediaType","Video","parentTitle","Hearing – Assessing the President’s Emergency Plan for AIDS Relief (PEPFAR)","oneSentenceSummary","Witnesses and members said PEPFAR should move toward country led programs with clear benchmarks and private‑sector involvement while guarding against chaotic withdrawals that could harm public health and U.S. diplomatic interests; China’s increasing presence in Africa was cited as a security risk if transitions fail.","taxTitle","Appropriations: House Committee, Standing Committees - House & Senate, Congressional Hearings Compilation, Legislative, Federal","taxId",1832,"location","","headline","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":72,"_73":72,"_74":72},6084756,"Committee probes Helms Amendment violation after Mozambique incident; witnesses call for training and audits",3020,894000,3914000,"/Search/View?dp=1&key=2907877-14e859ad2743b5907c1c0786a493573b&start=894&end=3914","https://assets.pipeline.soar.com/2907877-14e859ad2743b5907c1c0786a493573b/thumbnail_894000.jpg","/articles/6084756/Committee-probes-Helms-Amendment-violation-after-Mozambique-incident-witnesses-call-for-training-and-audits","https://secure.pipeline.soar.com/6084756-460f52c6ae85e977677abd9a685c1610/orig.mp4?Expires=1773057797&Signature=ijl~P8NhlXtvparG736ANLZByzibrMM6GdmJIZD5EwGRCWuvXaRUmoP5KO5Q3RSDLWyfHEa5rb75nkSYNXCxlARpMO5La33cyGbH5Avpk9LGgEcRjxR0ahWG3H0azvgo~PPOYzXsWi4gqsEgJviZbyCkAEgu6-kPjql3yATvUtLJ45Xb7gwDS9VoVnoJAJ3CAjE00cBzD-05v1jKJ-QkSXsyZDgL2vEvaS-zjSnypkl6aY36C0~5di2CzvgfRbcIJMC5RMviSuzWhnN2ZasrIvadlHqYXRL3oh9~q8g-VWt~y~wlKnPxO3U950cBTMU6MLTbMnTHAaCqqltM28HgNw__&Key-Pair-Id=KUT5TJCACFTXG","During the hearing, lawmakers and witnesses addressed an incident in Mozambique in which PEPFAR‑funded salaries covered nurses who performed abortions, a potential violation of the Helms Amendment.

Ranking Member Frankel and other members described the episode as a breach of U.S. law. Witnesses said the incident involved nurse salaries that were paid by PEPFAR funds; the nurses performed abortion care and, according to testimony, those salaries were later recovered by U.S. authorities (approximately $4,000 was described in the hearing). Committee members emphasized that any violation of the Helms Amendment is unacceptable and undermines public trust in U.S. assistance.

Ambassador Mark Dybul and other implementing witnesses recommended a set of specific safeguards: mandatory training for every individual and organization receiving U.S. funding on Helms Amendment restrictions and U.S. policies, signed attestations confirming understanding of those rules, routine and randomized program reviews in the field, and clear accountability and penalties when violations occur. Dybul said such measures are standard oversight tools and that effective implementation requires resources and personnel to carry out regular compliance reviews.

Lawmakers asked for details about how U.S. funds can end up supporting prohibited activities when they are intended for health services. Witnesses explained that many PEPFAR investments support broader health‑system roles (for example, paying nurses who provide multiple services), and without clear training and supervision recipients may not understand specific U.S. legal restrictions.

Members asked the administration and implementing agencies to provide documentation on how the error occurred, to describe corrective actions already taken, and to identify steps to prevent future violations. Several lawmakers said those materials should inform the subcommittee’s oversight and appropriation decisions.","Members and witnesses described a small, isolated incident in Mozambique where nurses paid with PEPFAR funds performed abortions; witnesses said the payment was repaid, recommended mandatory Helms Amendment training and regular field audits to prevent recurrence.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":92,"_47":93,"_49":94,"_51":95,"_53":96,"_55":56,"_57":58,"_59":97,"_61":62,"_63":64,"_65":98,"_67":68,"_69":70,"_71":72,"_73":72,"_74":72},6084761,"Lawmakers, aid groups warn PEPFAR stop‑work orders and waiver process have disrupted treatments and services",345,3100000,3445000,"/Search/View?dp=1&key=2907877-14e859ad2743b5907c1c0786a493573b&start=3100&end=3445","https://assets.pipeline.soar.com/2907877-14e859ad2743b5907c1c0786a493573b/thumbnail_3100000.jpg","/articles/6084761/Lawmakers-aid-groups-warn-PEPFAR-stopwork-orders-and-waiver-process-have-disrupted-treatments-and-services","https://secure.pipeline.soar.com/6084761-ea7c07d83a650f900f10447ace6aa8bd/orig.mp4?Expires=1773057797&Signature=Ad1PNcJ8VA5jgjV7Ub0E~qgGLSbETKDX0qiskTWgyQfQ4~Dq72HFeTZFBLghl4pNej1bUSp2DZ~sw7nNu~soI131JqIaeBGPKzVZlEC~24jpbhI7ylWlYV9h0qh1qH8zZQMQdMgmXL838WObEZ5mL5cm~eJ0cpSwGD5eYtLmtIM97PYPcslSdqJU-WwuqxncGSRsyfauv2JsypoGb~T7lHWEKKHj3bsAXDHBr5~O6Xj7ZIRff-4XiJqv~D4toXf6Ad7f4gZ32qOu2HHZ~u34nBekniQrZeyymp0aqDXTkigmIkpWeYDE71eAU~C91n2x~kKuM~4hxLuDxq-Npzd29g__&Key-Pair-Id=KUT5TJCACFTXG","Chairman (name not specified), Ranking Member Kathy Frankel, Ambassador Mark Dybul and Catherine Connor told the House Appropriations Subcommittee on National Security, Department of State and Related Programs that recent administrative actions halted or delayed PEPFAR-funded activities, creating gaps in testing, treatment and community support.

Committee members and witnesses said the administration’s initial stop‑work orders for foreign assistance and the subsequent waiver process were handled in ways that made it hard for implementing partners to restart services quickly. Catherine Connor, vice president for public policy and advocacy at the Elizabeth Glaser Pediatric AIDS Foundation, said the waivers that permitted “life‑saving” activities were not applied automatically and required project‑level reviews before work could resume. “There was a process that had to go through once the waivers were announced,” Connor said, describing revisions to work plans and budgets and additional permissions needed to restart programs.

The subcommittee heard several concrete examples of disruption. Witnesses said some programs that initially received waivers were later terminated; at least two national programs supporting roughly 200,000 people on HIV treatment in Eswatini and Lesotho have been affected, according to Connor. Implementers reported shortfalls in pediatric antiretroviral (ARV) stock levels, diminished laboratory and sample transport capacity, and cuts to orphans and vulnerable children (OVC) services that provide food, caregiver support and other household‑level assistance. Connor described a case in which an OVC provider that had supported a gravely ill 5‑year‑old was terminated and could no longer help the family.

Ambassador Mark Dybul, a long‑time PEPFAR official and Georgetown University faculty member, and other witnesses emphasized the interconnected nature of services: removing testing, counseling or sample transport can impede access to ARVs even where drug supplies remain. “If you take HIV testing away…we can’t even start the process,” one witness said, noting that a single broken link in the care continuum can cause broader service failures.

Lawmakers pressed witnesses about the scale and urgency of the problem. Members cited programwide figures presented in the hearing—PEPFAR has supported more than 20 million people on antiretroviral therapy and has been credited with saving roughly 26 million lives since 2003—and asked how many people might be affected if disruptions continue. Witnesses warned of increased mortality, rising transmission and greater risk of drug resistance if supply or service interruptions persist, especially for children who, they said, experience treatment interruptions more rapidly than adults.

Members and witnesses repeatedly urged clearer, faster procedures for implementing waivers and restoring services, including in‑field reviews of capacity and explicit guidance about which activities qualify as lifesaving. They also asked for timely information about which projects remain funded, which were terminated or shrunk, and what implementing partners and national governments can do to fill gaps.

Committee members said oversight by Congress and transparent reporting from implementing agencies will be needed while appropriators craft fiscal‑year 2026 funding decisions.

As the subcommittee continues work on the FY2026 appropriations bill, several members asked for follow‑up briefings and clearer documentation from the administration on which activities are paused, which have resumed and the timeline for restoring full service continuity.","Witnesses and members of the House Appropriations subcommittee said a recent stop‑work order, delayed waiver implementations and some contract terminations have interrupted HIV testing, antiretroviral delivery and community services in multiple countries including Eswatini and Lesotho.","actionData","errors"]

Article not found

Lawmakers, former officials urge structured transition of PEPFAR to country ownership to protect gains and U.S. interests

Committee probes Helms Amendment violation after Mozambique incident; witnesses call for training and audits

Lawmakers, aid groups warn PEPFAR stop‑work orders and waiver process have disrupted treatments and services