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Barbara Lee: PEPFAR is ‘more in peril’ than ever before

Congress has yet to reauthorize funding for Bush-era HIV/AIDS program

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U.S. Rep. Barbara Lee (D-Calif.) speaks about the future of PEPFAR at the Congressional Black Caucus Foundation's Annual Legislative Conference in D.C. on Sept. 22, 2023. (Washington Blade photo by Michael K. Lavers)

California Congresswoman Barbara Lee on Sept. 22 said the President’s Emergency Plan for AIDS Relief is “more in peril” now than at any point since its launch two decades ago.

“This program is reauthorized every five years, but it’s always on a bipartisan basis,” said Lee during a panel at the Congressional Black Caucus Foundation’s Annual Legislative Conference that took place at the Walter E. Washington Convention Center in D.C. “As we approach the benchmark of an AIDS-free generation by 2023, it is unfortunately more in peril now than ever before.”

Then-President George W. Bush in 2003 signed legislation that created PEPFAR.

Lee noted PEPFAR as of 2020 has provided nearly $100 billion in “cumulative funding for HIV and AIDS treatment, prevention and research.” She said PEPFAR is the largest global funding program for a single disease outside of COVID-19.

New PEPFAR strategy includes ‘targeted programming’ for marginalized groups

The panel took place amid the continued push for Congress to reauthorize PEPFAR for another five years. The federal government will shut down on Oct. 1 if Congress does not pass an appropriations bill.

Secretary of State Antony Blinken last December at a World AIDS Day event in D.C. acknowledged HIV/AIDS continues to disproportionately impact LGBTQ and intersex people and other marginalized groups. A new PEPFAR strategy the Biden-Harris administration announced that seeks to “fill those gaps” over the next five years includes the following points:

• Targeted programming to help reduce inequalities among LGBTQ and intersex people, women and girls and other marginalized groups

• Partnerships with local organizations to help reach “hard-to-reach” communities.

• Economic development and increased access to financial markets to allow countries to manufacture their own antiretroviral drugs, tests and personal protective gear to give them “the capacity to meet their own challenges so that they’re not dependent on anyone else.”

The Family Research Council Action in an email to supporters urged them to tell Congress to “stop Biden from hijacking PEPFAR to promote its radical social policies overseas.” Family Watch International has said PEPFAR “has been hijacked to advance a radical sexual agenda.”

“Please sign the petition to tell the U.S. Congress to ensure that no U.S. funds go to organizations that promote abortion, LGBT ideology, or ‘comprehensive sexuality education,'” said the group in an email to its supporters. 

A group of lawmakers and religious leaders from Kenya and other African countries in a letter they wrote to members of Congress in June said PEPFAR, in their view, no longer serves its original purposes of fighting HIV/AIDS because it champions homosexuality and abortion.

“We wrote that letter to the U.S. Congress not to stop PEPFAR funding to Kenya, but to demand the initiative to revert to its original mission without conditioning it to also supporting LGBTQ as human rights,” it reads.

Biden in 2021 signed a memo that committed the U.S. to promoting LGBTQ and intersex rights abroad as part of his administration’s overall foreign policy.

American officials earlier this year postponed a meeting on PEPFAR’s work in Uganda in order to assess the potential impact the country’s Anti-Homosexuality Act will have on it. The law, which Ugandan President Yoweri Museveni signed on May 29, contains a death penalty provision for “aggravated homosexuality.”

Biden in his U.N. General Assembly speech last week noted LGBTQ and intersex rights and highlighted PEPFAR. Family Watch International in its email to supporters included a link to the letter from the African lawmakers and religious leaders.  

The Southern Poverty Law Center has designated both the FRC and Family Watch International as anti-LGBTQ hate groups.

“[PEPFAR is] not about abortions,” said Lee.

HIV/AIDS activists protest inside house speaker kevin mccarthy (r-calif.)’s office in d.c. on sept. 11, 2023. (washington blade video by michael k. lavers)

U.S. Agency for International Development Administrator Samantha Power during the panel referenced Bush’s recent op-ed in the Washington Post that urged lawmakers to reauthorize PEPFAR.

“The way he put it is no program is more pro-life [than] one that has saved more than 25 million lives,” said Power.

Power referenced the “manufactured controversy that is making it difficult to get this reauthorization.” U.S. Global AIDS Coordinator Dr. John Knengasong said a failure to reauthorize PEPFAR would weaken “our own foreign policy and diplomacy.”

“Once again the United States will be missing in action,” stressed Lee.

Assistant Health and Human Services Secretary for Legislation Melanie Egorin and Kenny Kamson, a Nigerian HIV/AIDS activist, also spoke on the panel that MSNBC host Jonathan Capehart moderated. 

From left: U.S. Global AIDS Coordinator Dr. John Nkengasong and U.S. Agency for International Development Administrator Samantha Power discuss the future of PEPFAR at the Congressional Black Caucus Foundation’s Annual Legislative Conference in D.C. on Sept. 22, 2023. (Washington Blade photo by Michael K. Lavers)
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Federal Government

UPenn erases Lia Thomas’s records as part of settlement with White House

University agreed to ban trans women from women’s sports teams

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U.S. Education Secretary Linda McMahon (Screen capture: C-SPAN)

In a settlement with the Trump-Vance administration announced on Tuesday, the University of Pennsylvania will ban transgender athletes from competing and erase swimming records set by transgender former student Lia Thomas.

The U.S. Department of Education’s Office for Civil Rights found the university in violation of Title IX, the federal rights law barring sex based discrimination in educational institutions, by “permitting males to compete in women’s intercollegiate athletics and to occupy women-only intimate facilities.”

The statement issued by University of Pennsylvania President J. Larry Jameson highlighted how the law’s interpretation was changed substantially under President Donald Trump’s second term.

“The Department of Education OCR investigated the participation of one transgender athlete on the women’s swimming team three years ago, during the 2021-2022 swim season,” he wrote. “At that time, Penn was in compliance with NCAA eligibility rules and Title IX as then interpreted.”

Jameson continued, “Penn has always followed — and continues to follow — Title IX and the applicable policy of the NCAA regarding transgender athletes. NCAA eligibility rules changed in February 2025 with Executive Orders 14168 and 14201 and Penn will continue to adhere to these new rules.”

Writing that “we acknowledge that some student-athletes were disadvantaged by these rules” in place while Thomas was allowed to compete, the university president added, “We recognize this and will apologize to those who experienced a competitive disadvantage or experienced anxiety because of the policies in effect at the time.”

“Today’s resolution agreement with UPenn is yet another example of the Trump effect in action,” Education Secretary Linda McMahon said in a statement. “Thanks to the leadership of President Trump, UPenn has agreed both to apologize for its past Title IX violations and to ensure that women’s sports are protected at the university for future generations of female athletes.”

Under former President Joe Biden, the department’s Office of Civil Rights sought to protect against anti-LGBTQ discrimination in education, bringing investigations and enforcement actions in cases where school officials might, for example, require trans students to use restrooms and facilities consistent with their birth sex or fail to respond to peer harassment over their gender identity.

Much of the legal reasoning behind the Biden-Harris administration’s positions extended from the 2020 U.S. Supreme Court case Bostock v. Clayton County, which found that sex-based discrimination includes that which is based on sexual orientation or gender identity under Title VII rules covering employment practices.

The Trump-Vance administration last week put the state of California on notice that its trans athlete policies were, or once were, in violation of Title IX, which comes amid the ongoing battle with Maine over the same issue.

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Federal Government

White House finds Calif. violated Title IX by allowing trans athletes in school sports

Education Department threatens ‘imminent enforcement action’

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California Gov. Gavin Newsom (D) (Washington Blade photo by Michael Key)

The Trump-Vance administration announced on Wednesday that California’s Interscholastic Federation and Department of Education violated federal Title IX rules for allowing transgender girls to compete in school sports.

In a press release, the U.S. Department of Education’s Office of Civil Rights threatened “imminent enforcement action” including “referral to the U.S. Department of Justice” and the withholding of federal education funding for the state if the parties do not “agree to change these unlawful practices within 10 days.”

The agency specified that to come into compliance; California must enforce a ban excluding transgender student athletes and reclaim any titles, records, and awards they had won.

Federal investigations of the California Interscholastic Federation and the state’s Department of Education were begun in February and April, respectively. The Justice Department sued Maine in April for allowing trans athletes to compete and refusing a similar proposal to certify compliance within 10 days.

Broadly, the Trump-Vance administration’s position is that girls who are made to compete against trans opponents or alongside trans teammates are unfairly disadvantaged, robbed of opportunities like athletics scholarships, and faced with increased risk of injury — constituting actionable claims of unlawful sex discrimination under Title IX.

This marks a major departure from how the previous administration enforced the law. For example, the Department of Education issued new Title IX guidelines in April 2024 that instructed schools and educational institutions covered by the statute to not enforce categorical bans against trans athletes, instead allowing for limited restrictions on eligibility if necessary to ensure fairness or safety at the high school or college level.

Sports aside, under former President Joe Biden the department’s Office of Civil Rights sought to protect against anti-LGBTQ discrimination in education, bringing investigations and enforcement actions in cases where school officials might, for example, require trans students to use restrooms and facilities consistent with their birth sex or fail to respond to peer harassment over their gender identity.

Much of the legal reasoning behind the Biden-Harris administration’s positions extended from the 2020 U.S. Supreme Court case Bostock v. Clayton County, which found that sex-based discrimination includes that which is based on sexual orientation or gender identity under Title VII rules covering employment practices.

A number of high profile Democrats, including California Gov. Gavin Newsom, have recently questioned or challenged the party’s position on transgender athletes, as noted in a statement by Education Secretary Linda McMahon included in Wednesday’s announcement.

“Although Gov. Gavin Newsom admitted months ago it was ‘deeply unfair’ to allow men to compete in women’s sports, both the California Department of Education and the California Interscholastic Federation continued as recently as a few weeks ago to allow men to steal female athletes’ well-deserved accolades and to subject them to the indignity of unfair and unsafe competitions.”

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Trump’s dismantling of US foreign aid derails HIV prevention effort in Africa

FDA approved breakthrough preventative drug lenacapavir earlier this month

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President Donald Trump (Washington Blade photo by Michael Key)

On June 18, the Food and Drug Administration approved a long-acting injectable for the prevention of HIV that could have a transformational impact on decades-long efforts to end the epidemic in the U.S. and abroad.

Offering robust protection with just two doses per year, lenacapavir has the potential to dramatically improve uptake and adherence compared to daily oral PrEP regimens like Truvada or Descovy, particularly for high risk populations living in places with poor health infrastructure or where stigma about HIV discourages frequent testing and clinic visits.

According to the New York Times, however, the rollout of lenacapavir for HIV prevention overseas has been stymied by the gutting of agencies, staff, programs, and funding dedicated to foreign aid and public health during President Donald Trump’s second term.

Among other moves, the administration has frozen or withdrawn nearly all U.S. foreign development assistance, dismantled the U.S. Agency for International Development and reduced the size of its workforce by more than 95 percent, and shuttered key public health units housed under the U.S. Department of Health and Human Services, the National Institutes of Health, the Centers for Disease Control and Prevention, and the FDA.

As a result, the Times reports, HIV programs across the African continent have been “scrambling to procure drugs that the United States once supplied, replace lost nurses and lab technicians, and restart shuttered programs to prevent new infections.”

Experts fear HIV infection rates are climbing in some of the hardest-hit countries, but since the U.S. pulled funding for data collection and monitoring, there is no way to know for sure.

Historically, the U.S. has provided about 75 percent of all global spending on efforts to fight the epidemic, a reflection of the extent to which there was broad bipartisan support for the allocation of resources for this purpose through programs like the President’s Emergency Plan for AIDS Relief. Trump continued this legacy in his first term, launching the ambitious Ending the HIV Epidemic initiative that was continued under former President Joe Biden.

After returning to the White House, however, the president and his administration have justified their slash-and-burn cuts to the federal government’s work in international development and public health by arguing that funds and resources sent to overseas nations are too often pilfered by corrupt foreign state actors or wasted on ineffectual programs.

Trump and his allies also believe the U.S. should no longer be expected to shoulder such a disproportionate share of the responsibility for foreign aid, and that other countries are likelier to step up and contribute more in response to America’s retreat.

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