In a recent interview with The Associated Press, Dr. John Nkengasong, who currently oversees the United States' global AIDS effort, recounted the bleak state of HIV and AIDS care in Africa before the introduction of the U.S. President's Emergency Relief Plan for AIDS Relief (PEPFAR) in 2004. From his office window at a clinic in Africa, Nkengasong would witness desperate families arriving with dying loved ones, hoping to find help that was almost nonexistent at the time.

The impact of PEPFAR, which has transformed care in some of the hardest-hit countries over the past two decades, cannot be overstated. With an estimated 25 million lives saved, the program has been credited as the largest government effort against a single disease, with more than $110 billion invested in HIV care and treatment, local medical systems, and social programs to curb infection rates.

However, the future of the AIDS program is now in jeopardy due to a recent funding battle in Congress. Some opponents argue that the program indirectly supports abortion abroad, a claim disputed by both the Biden administration and PEPFAR's defenders. After months of threats by conservative lawmakers to block funding, a compromise was reached in late March, extending the funding for only a year.

Advocates of the program raise concerns that without a full five-year renewal, the future of PEPFAR remains uncertain, as political debates over abortion and reproductive rights intensify. Prior to the introduction of PEPFAR, clinics like the one Nkengasong worked at in Abidjan, Ivory Coast, were unable to provide care to families in their loved ones' final hours. The scenes were harrowing, with families left to crouch outside, surrounded by emaciated bodies, and the sound of wailing echoing through the windows.

Nkengasong, who has dedicated his career to combating HIV and AIDS in Africa, now experiences joyous meetings with individuals whose lives were saved through PEPFAR. The program's impact spans from sub-Saharan Africa to other vulnerable regions, having saved an estimated 25 million lives, including 5.5 million children.

Reflecting on the devastating toll of the AIDS epidemic in the 1990s, Nkengasong vividly recalls streets lined with coffins and clinics filled with adults ravaged by the disease. In the mid-to-late 1990s, with the cost of early retroviral medication averaging $10,000 per patient per year, only a fraction of the estimated 10 million people living with HIV and AIDS in sub-Saharan Africa had access to proper treatment.

The turning point came in the spring of 2002 when a delegation led by Health Secretary Tommy Thompson and Dr. Anthony Fauci, a renowned HIV researcher, visited Nkengasong's clinic in Abidjan. The presence of the American delegation signaled the beginning of PEPFAR's comprehensive approach to combating HIV and AIDS.

As the political debate over funding for the AIDS program continues, the progress made in fighting HIV and AIDS in Africa hangs in the balance. The extension of funding for a year provides temporary relief, but sustained support is necessary to maintain the gains achieved over the past two decades.

Without a doubt, PEPFAR's impact on millions of lives in Africa and other vulnerable regions remains a testament to the power of international cooperation and targeted funding. The question now is whether the U.S. government will commit to a full five-year renewal, ensuring the continuation of this vital program that has brought hope and saved countless lives on the African continent.