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State Department directive pauses most US foreign aid spending

PEPFAR among impacted programs

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U.S. Sen. Marco Rubio (R-Fla.) during his confirmation hearing to become the next secretary of state on Jan. 15, 2025. (Washington Blade photo by Michael Key)

Secretary of State Marco Rubio on Friday directed State Department personnel to stop nearly all U.S. foreign aid spending for 90 days.

A copy of the directive that Politico obtained requires State Department staffers to immediately issue “stop-work orders” on nearly all “existing foreign assistance awards.”

President Donald Trump on Jan. 20 issued an executive order that paused U.S. foreign aid “for assessment of programmatic efficiencies and consistency with United States foreign policy.”  

“All department and agency heads with responsibility for United States foreign development assistance programs shall immediately pause new obligations and disbursements of development assistance funds to foreign countries and implementing non-governmental organizations, international organizations, and contractors pending reviews of such programs for programmatic efficiency and consistency with United States foreign policy, to be conducted within 90 days of this order,” it reads. “The Office of Management and Budget (OMB) shall enforce this pause through its apportionment authority.”

Politico reported Rubio’s directive is more expansive than the executive order, although it does not stop military aid to Egypt and Israel, emergency food assistance and “legitimate expenses incurred prior to the date of this.”  The President’s Emergency Plan for AIDS Relief, known as PEPFAR, is among the programs impacted.

“This is a matter of life or death,” said International AIDS Society President Beatriz Grinsztejn in a press release. “PEPFAR provides lifesaving antiretrovirals for more than 20 million people — and stopping its funding essentially stops their HIV treatment. If that happens, people are going to die and HIV will resurge.

The promotion of LGBTQ and intersex rights was a cornerstone of the Biden-Harris administration’s foreign policy.

The decriminalization of consensual same-sex sexual relations was one of the previous White House’s priorities in these efforts. The U.S. Agency for International Development in 2023 released its first-ever policy for LGBTQ- and intersex-inclusive development.

Rubio this week issued a directive that bans embassies and other U.S. diplomatic institutions from flying the Pride flag. A second directive that Rubio signed directs State Department personnel to “suspend” any passport application in which an “X” gender marker is requested.

“This guidance applies to all applications currently in progress and any future applications,” reads the directive. “Guidance on existing passports containing an ‘X’ sex marker will come via other channels.”

The directive stems from a sweeping executive order — “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government” — that Trump signed on Monday after he took office. The president in his inaugural speech noted the federal government’s “official policy” is “there are only two genders, male and female.”

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State Department

Vance swears in gay State Department official

Jacob Helberg is Under Secretary of State for Economic Growth, Energy, and the Environment

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Vice President JD Vance, right, swears in Jacob Helberg, left, as under secretary of state on Oct. 17, 2025, as his husband, Keith Rabois, center, looks on. (Photo courtesy of Helberg's LinkedIn page)

Vice President JD Vance on Oct. 17 swore in Under Secretary of State for Economic Growth, Energy, and the Environment Jacob Helberg.

Helberg stood alongside his husband, Keith Rabois, during the ceremony.

“An unforgettable moment being sworn in by Vice President Vance alongside my husband, Keith Rabois,” wrote Helberg in a LinkedIn post that included two photos of the swearing in ceremony. “VP Vance is a friend and a role model for a generation of patriots who look to the future with excitement and optimism while always putting America First.”

“Grateful to serve under President Trump and Secretary Rubio’s historic leadership, as we unleash America’s economic power — fueling growth, energy abundance, and technological leadership for a new American century,” added Helberg.

President Donald Trump before his inauguration announced he would nominate Helberg.

Treasury Secretary Scott Bessent and former U.S. Ambassador to Germany Richard Grenell, who Trump named as interim executive director of the Kennedy Center in D.C., are among the Trump-Vance administration’s openly gay members. Former State Department spokesperson Tammy Bruce, who Trump has nominated to become deputy representative at the U.N., describes herself as a “gay woman.”

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Congress

State Department urged to restore LGBTQ-specific information in human rights reports

Congressional Equality Caucus sent Secretary of State Marco Rubio a letter on Sept. 9

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Secretary of State Marco Rubio during his confirmation hearing on Jan. 15, 2025. (Washington Blade photo by Michael Key)

The Congressional Equality Caucus has called upon the State Department to once again include LGBTQ and intersex people in their annual human rights report.

U.S. Reps. Robert Garcia (D-Calif.), Julie Johnson (D-Texas), and Sarah McBride (D-Del.), who co-chair the caucus’s International LGBTQI+ Rights Task Force, spearheaded a letter sent to Secretary of State Marco Rubio on Sept. 9.

The 2024 human rights report the State Department released last month did not include LGBTQ-specific references. Jessica Stern, the former special U.S. envoy for the promotion of LGBTQ and intersex rights under the Biden-Harris administration who co-founded the Alliance for Diplomacy and Justice, described the removal of LGBTQ and intersex people and other groups from the report as “deliberate erasure.”

“We strongly oppose your decision to remove the subsection on Acts of Violence Criminalization, and Other Abuses Based on Sexual Orientation, Gender Identity or Expression, or Sex Characteristics (SOGIESC Subsection) from the State Department’s Annual Country Reports on Human Rights Practices (Human Rights Reports),” reads the letter. “We urge you to restore this information, or else ensure it is integrated throughout each human rights report.”

Congress requires the State Department to release a human rights report each year.

The Congressional Equality Caucus’s letter points out the human rights reports “have been a critical source of information on human rights violations and abuses against LGBTQI+ persons around the world.” It specifically notes consensual same-sex sexual relations remain criminalized in more than 60 countries, and the 2017 human rights report included “details on the state-sponsored and societal violence against LGBTQI+ persons in Chechnya, including extrajudicial killings.”

Immigration Equality in response to the 2024 human rights report said the reports “serve as key evidence for asylum seekers, attorneys, judges, and advocates who rely on them to assess human rights conditions and protection claims worldwide.”

“The information in these reports is critical — not just for human rights advocates — but also for Americans traveling abroad,” reads the Congressional Equality Caucus’s letter. “LGBTQI+ Americans and their families must continue to have access to comprehensive, reliable information about a country’s human rights record so they can plan travel and take appropriate precautions.”

The caucus’s full letter can be read here.

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State Department

PEPFAR to distribute ‘breakthrough’ HIV prevention drug

HIV/AIDS activists have sharply criticized proposed cuts to Bush-era program

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World AIDS Day 2023 at the White House. PEPFAR will distribute a "breakthrough" prevention drug in countries with high HIV prevalence rates. (Washington Blade Photo by Michael Key)

The State Department on Thursday announced PEPFAR will distribute a “breakthrough” drug in countries with high HIV prevalence rates.

A press release notes the initiative will “bring U.S.-based Gilead Sciences’ breakthrough drug lenacapavir to market in high-burden HIV countries.”

“The initiative, which will promote global scale in production and distribution of the medication and catalyze further global investment, has the potential to save hundreds of thousands of lives,” it reads.

Lenacapavir users inject the drug twice a year.

The State Department press release notes nearly everyone who participated in Gilead’s clinical trials remained HIV negative. It also indicates lenacapavir “has the potential to be particularly helpful for pregnant and breastfeeding mothers, as it safely protects them during and after pregnancy to prevent mother-to-child transmission.”

“This U.S. commitment exemplifies Secretary Rubio’s America First life-saving assistance agenda: it champions American innovation, advances the administration’s goal of ending mother-to-child transmission of HIV during President Trump’s second term, and will serve as an important catalyst for greater global and private sector investment in access to this groundbreaking medication,” said Under Secretary of State for Foreign Assistance, Humanitarian Affairs, and Religious Freedom Jeremy Lewin.

The press release notes Gilead is “offering this product to PEPFAR and the Global Fund at cost and without profit.” It does not identify the countries in which lenacapavir will become available.

“The support of the U.S. State Department through PEPFAR will accelerate access to lenacapavir and move us closer to ending the HIV epidemic,” said Gilead CEO Daniel O’Day. “Lenacapavir is one of the most important scientific breakthroughs of our time and the result of nearly two decades of work by Gilead scientists. We are providing the medicine at no profit in this partnership so we can support the U.S. government in delivering life-saving programs where the need is most urgent.”

Thursday’s announcement coincides with the U.S. Conference on HIV/AIDS that is taking place in D.C. this week. It also comes against the backdrop of widespread criticism over the Trump-Vance administration’s reported plans to not fully fund PEPFAR and to cut domestic HIV/AIDS funding.

The New York Times last month reported the Office of Management and Budget that Russell Vought directs “has apportioned” only $2.9 billion of $6 billion that Congress set aside for PEPFAR for fiscal year 2025. (PEPFAR in the coming fiscal year will use funds allocated in fiscal year 2024.)

Bipartisan opposition in the U.S. Senate prompted the White House in July withdraw a proposal to cut $400 million from PEPFAR’s budget. Vought on Aug. 29 said he would use a “pocket rescission” to cancel $4.9 billion in foreign aid that Congress had already approved.

HIV/AIDS activists who rallied in front of the Eisenhower Executive Office Building on Tuesday demanded the Trump-Vance administration fully fund PEPFAR. Housing Works CEO Charles King and five others later blocked traffic at the intersection of 17th and H Streets, N.W.

Incoming National Minority AIDS Council CEO Harold Phillips, U.S. Rep. Maxine Waters (D-Calif.), “RuPaul’s Drag Race” season nine finalist Peppermint, and “Hamilton” star Javier Muñoz are among those who spoke at a rally outside the U.S. Capitol on Wednesday the Save HIV Funding Campaign organized.

“The cuts being proposed will completely erase all of our progress, all of the progress we’ve made since the 1980s. Not just in programs, but in science and in lives saved. These cuts will kill,” said Peppermint.

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