WH budget chief pressed on PEPFAR funds, says Africa ‘needs to absorb more of the burden’

Office and Management Budget Director Russell Vought on Wednesday was pressed on proposed cuts to the President's Emergency Plan for AIDS Relief (PEPFAR) pursued as part of a new rescissions request from the Trump administration. 

During a budget hearing Wednesday, Vought defended proposed reductions as targeting items like "teaching young children how to make environmentally friendly reproductive health decisions" and efforts he claimed were aimed at strengthening "the resilience of lesbian, gay, bisexual, transgender, intersex and queer global movements."

“We can find waste, fraud and abuse there that the American people would not support, and it’s one of the reasons why it’s in the package, but it will not lead to life saving treatment being denied,” he said during the hearing. 

Congress, under the Biden administration, appropriated approximately $7 billion for PEPFAR in fiscal 2024. The program is considered to be one of America's most consequential programs in Africa and is credited with saving 25 million lives and scaling back the AIDS epidemic. 

During the hearing, Rep. Mark Alford (R-Mo.) in a follow-up question pressed Vought again about his comments and potential cuts to prevention efforts.

“Aside from the crazy woke programs, which I agree should be stripped,” Alford asked, “is there any other prevention program, not treatment, but prevention program listed in this rescission package, which is not of a woke nature?”

Vought said in response that the administration seeks to scale “down the program as it pertains to the types of organizations that are providing the examples of the waste, fraud and abuse.”

But he also said "the prevention itself is where an analytical look needs to be done.”

“There's life saving treatment after you already have HIV, but there are prevention programs that PEPFAR does, which are not of the woke nature, which can prevent someone from getting HIV,” Alford countered. “Are those programs going to survive?”

“It is something that our budget will be very trim on because we believe that many of these nonprofits are not geared toward the viewpoints of the administration, and we’re $37 trillion in debt,” Vought responded. “So, at some point, the continent of Africa needs to absorb more of the burden of providing this health care.”

The moment comes as the prospect of PEPFAR cuts has prompted concern from some congressional Republicans as part of a larger request sent by the Trump administration to cut more than $9 billion in congressionally approved funds for foreign aid and public broadcasting programs.

Senate Appropriations Committee Chair Susan Collins (R-Maine) has also voiced opposition to cutting PEPFAR, saying Wednesday that the idea makes “no sense" to her "whatsoever.”

“Given the extraordinary record of PEPFAR in saving lives, it has literally saved millions of lives, and so I do not see a basis for cutting it,” she said.