This article is part of our series exploring the role of faith-based organizations in providing vital support and care to those affected by HIV/AIDS through PEPFAR. Throughout this series, we will highlight the importance of a clean, five-year reauthorization of PEPFAR to ensure the stability and continuity of lifesaving treatment.
The Current State and History of PEPFAR
As of this writing, the President’s Emergency Plan for AIDS Relief (PEPFAR) is facing significant funding cuts. PEPFAR is a vital avenue and program that has facilitated the life-saving treatment of approximately 25 million people around the world, a significant portion of whom are children and mothers. Through PEPFAR, the U.S. has invested billions of dollars to better respond to HIV/AIDS infections and accelerate “progress toward controlling the global HIV/AIDS pandemic in more than 50 countries.”
On January 20, 2025, amidst the wake of executive orders that significantly reduced foreign aid, including substantial cuts to the United States Agency for International Development (USAID), President Donald Trump suspended PEPFAR funding for at least 90 days. During this period, PEPFAR, along with other foreign aid programs, will be reviewed, with final decisions not likely to come for about 180 days. In the meantime, PEPFAR’s current authorization expired on March 25, 2025, and as of this writing, there is no further clarity about the future of the program.
If Congress does not act to extend it, certain time-bound provisions will lapse.
This situation is extremely detrimental for individuals reliant on PEPFAR-funded care and the overall well-being and stability of countries affected by the spread of HIV/AIDS.
In response to these challenges, the U.S. Secretary of State announced an “Emergency Humanitarian Waiver” on January 28, allowing a partial resumption of services. Before the executive order and waiver, however, PEPFAR had already faced controversy earlier this year in 2025 when news broke that four nurses in a PEPFAR-funded facility in Mozambique performed a total of 21 abortions since January 2021.
While PEPFAR identified the incident in Mozambique as a violation of its explicit goal to treat families and babies living with HIV/AIDS and “took immediate corrective action with the partner,” some lawmakers and think tanks called for significant defunding and substantial restructuring of the program. Such concerns about funding groups that perform abortions had resulted in a one-year reauthorization of PEPFAR in 2024 instead of its typical five-year cycle. The next reauthorization deadline was on March 25, 2025. Since President George W. Bush passed PEPFAR in 2003, the program has largely garnered bipartisan support, as one of the most successful and cost-effective programs, saving approximately 25 million lives at less than 0.08 percent of U.S. spending (defense spending made up 13 percent of federal spending in FY 2024). Not only has PEPFAR improved individual lives across the globe but has also led to greater per capita GDP growth in participating countries.
A complicated restructuring of PEPFAR could interrupt the lifesaving treatments already taking place and threaten the stability of many countries. Moreover, it threatens to thwart the 2030 goal of ending HIV/AIDS as a public health threat, a sustainable development goal that PEPFAR has made strides in achieving. As many have warned, reducing funding now would hinder this goal, endangering many lives and rolling back years of progress. For example, a recent New York Times article reported that if PEPFAR were to end, an estimated 600,000 lives could be lost over the next decade in South Africa alone. South Africa relies on PEPFAR for only 20 percent of its HIV budget, whereas countries with less means are almost entirely dependent on the program.
Former President George W. Bush addressed similar concerns about PEPFAR’S continuity in a 2023 Op-ed. Responding to claims that PEPFAR isn’t sufficiently pro-life, he writes “there is no program more pro-life than one that has saved more than 25 million lives.” He cited the journal entries of his late chief of staff Michael Gerson. Gerson asks, “Among evangelical Christians, what definition of being ‘pro-life’ does not include saving millions of lives from preventable disease and death?”
For Christians of all denominations, however, the reauthorization of PEPFAR mines a greater question within the life and teachings of Christ: to what extent are we willing to face suffering and enter into it? How might a reflection on this question inform a faith-based support of PEPFAR?
Gerson’s words, poignant at the time, resonate even more today as PEPFAR’s future stands on shaky ground yet again, partly due to the criticism from some Christian groups.
The Good Samaritan: Two Motions
In Christ’s parable of the Good Samaritan, these aforementioned questions confront three men, who in the story, are on the road to Jericho. On the side of this notorious road, known as the “way of blood,” a Jewish man lies robbed, beaten, naked, and half-dead. The first man to walk down the road, a priest, sees the man and decides to pass by on the other side. The second man, a Levite, does the same.
The third man, a Samaritan, upon seeing the sufferer, acts quite differently. Scripture states that he “went to him.” He does not cross to the other side [αντι-ερχομια], like the Levite and the Priest, but rather goes to [ερχομια] the sufferer. Emphasized in the original Greek, the opposition and contrast between these two motions, away from and toward suffering, is striking.
PEPFAR’s history overwhelmingly reflects this direction toward suffering. Through the funding and support of PEPFAR, many people, including those belonging to faith-based groups, can go toward the suffering of AIDS and HIV abroad. Not only does PEPFAR enable groups and individuals to go toward suffering but also to enter into this suffering with acts of compassion and care.
The Samaritan reflects this further motion of entering into suffering when, after going to the suffering man, he “bandaged his wounds, pouring on oil and wine,” and “put the man on his donkey” and “brought him to an inn and took care of him.” After staying a night with the man, the Samaritan gives two denarii to the innkeeper and tells him, “Take care of him and whatever more you spend, I will repay you when I come back.” This contrasts with the priest and the Levite, who, when confronted with suffering, choose distance from the sufferer.
Through these acts we see the Samaritan taking on the suffering of the Jewish man as he gives of his valuable resources—his bandages, his oils and wine, his money, his donkey, and even his own life by stopping on such a dangerous road. With these selfless acts the Samaritan not only goes to the sufferer but enters the suffering, communing with the sufferer as a conduit of compassion and care.
Similar to the Samaritan, PEPFAR as a program seeks to bandage the wounds and pour out the oil and wine of care and provision on those suffering from HIV and AIDS. Some may argue that the comparison is inappropriate because PEPFAR is a program, while the Samaritan is an individual. However, there is still a strong basis for faith-based support of PEPFAR when we recognize that it supports and fosters countless opportunities for the parable’s example of person-to-person giving and receiving of care—going to the sufferer and entering into their suffering.
A Faith-Based Support of PEPFAR: The Samaritan Model
Three significant qualities of the Samaritan’s care further inform a tangible Christian support of PEPFAR (and aid in general). These qualities are 1) a grounding of one’s actions in love rather than fear, 2) a rejection of motives rooted solely in religious or national identity, and (3) a dignified vision of the sufferer as both a fellow human and a bearer of the divine image.
1. A Grounding of One’s Actions in Love Rather Than Fear
In the parable of the Good Samaritan, love conquers fear as we see the good to be done in the present moment considering above the possible sins of bad actors in the past or the future. The Samaritan gives off seemingly all his resources regardless of whether this suffering man be friend or foe, and, given the animosity between Samaritans and Jews at the time, it would be fair to conclude that this man was once a foe, or could be one later. There is also no concern over the possible ill-use of the Samaritan’s money by the innkeeper.
This may be attributed to simple naivety on the part of the Samaritan, or it may reflect the actions of someone who knows that only love, not fear, can address present suffering. Love, like suffering, operates in the present. Fear, on the other hand, binds the present to the past and the future, blinding one to immediate suffering and hindering love and compassion.
While this may be easy to translate on an individual level, it does become trickier when applied to national programs such as PEPFAR. As a government program, PEPFAR cannot disregard past or possible future ill-uses of its funds. Indeed, PEPFAR demonstrated this in light of the abortion controversy by investigating past infractions and committing to keeping more detailed and transparent records in the future. The calls to end or substantially hinder PEPFAR assistance, however, seem grounded not in a commitment to meet present suffering with love and compassion, but rather in retreating out of fear, allowing past or future errors to influence present action.
While any support of PEPFAR cannot overlook the necessary regard given to addressing and preventing bad actors and misused resources, faith-based support rooted in the example of the Good Samaritan may still acknowledge that the immense good being done by PEPFAR now to meet the suffering of families and children living with HIV is of greater importance than the potential for past or future misuse of funds. For the Christian, this is not so much a reason-driven, Kantian value judgment, but the movement of compassion for another human being. Samaritan-modeled support of PEPFAR recognizes that we must not give evil power over good, or fear over love.
2. A Rejection of Motives Rooted Solely in Religious or National Identity
The next quality informing Samaritan-modeled support of PEPFAR is a rejection of motives rooted principally in advancing national or religious identity. Here, we must carefully delineate PEPFAR as a national program from the Christian individual who participates in PEPFAR-funded aid.
PEPFAR, as a government program, cannot afford to overlook the implications of soft power and American national identity abroad, especially as it may be used to resist the spread of authoritarian/antihumanitarian regimes in supported regions, However, the Christian individual supporting and participating in PEPFAR-funded aid must reject motives rooted principally in advancing one’s own national or religious identity.
During the time of the parable’s telling, the typical Jewish listener would likely never put the words “good” and “Samaritan” together. Historically, Jews derided Samaritans, with their mixed heritage and multiple gods, as impure. This background makes the Samaritan’s action in the parable even more shocking. Unlike the priest and the Levite, whose religious and national identity could have motivated aid but didn’t, the Samaritan had to overlook his own identity as a Samaritan to truly see and go to the suffering of his fellow man.
For the American Christian, this means that one’s identity as an American or, even more shocking, a Christian should not be the principal motive in supporting PEPFAR. The principal motive of one’s support should not be a vision of the self or advancing the identities one belongs to, but rather, (3) a dignified vision of the sufferer as both a fellow human and bearer of the divine image.
3. A Dignified Vision of the Sufferer
Indeed, it is the vision of the suffering man, not a desire to justify his religious or national status as a Samaritan, that moves the Samaritan man to act. For “when he saw him, he had compassion.” We are not given the Samaritan’s exact thought process at that moment of vision, but we might assume that in seeing the suffering Jewish man, the Samaritan did not see an enemy Jew but a fellow man. I believe that it was in this kindred vision that such compassion, such suffering, could burst forth in the Samaritan. We can feel compassion because we too know suffering.
It is not only our fellow man that we see in this kindred vision, but also, the divine image. The Christian’s belief in the imago dei testifies to this. Indeed, Christ tells us that when we visit the sick, we visit him. We see in this image the love we all have been given, and this in turn moves us to love. For in seeing our fellow man not only as a fellow sufferer but a fellow bearer of the divine image, we are able not only to suffer with him but to acknowledge his inherent dignity. We see him for who he truly is. Out of this vision, love springs forth.
It is for the sake of this kindred and glorious vision of our neighbor that the Christian should support PEPFAR. The program that facilitates this vision by supporting the relationships between care providers and local communities, while providing the resources for tangible acts of compassion and love. While the true power behind this vision and love lies in the grace of God, it finds expression through our imperfect yet important human work in the world. PEPFAR is one such imperfect yet important works.
A Model for Sustaining Care
With PEPFAR on shaky ground once again, Christians should affirm a clean five-year renewal of the program based on a Samaritan model of support. In this model, one affirms actions rooted in love rather than fear, rejects motives rooted solely in religious or national identity, and, above all, seeks a dignified vision of the sufferer as both a fellow human and bearer of the divine image.
It is with these tenets in mind that the active going toward and entering into suffering, so central to the Christian story, should be central to our support of PEPFAR. For it is by going toward and entering into suffering that we can both affirm the transcendent worth of the sufferer’s life and provide the necessary provisions to physically sustain that life. In more ways than one, therefore, the Christian may support PEPFAR as fundamentally pro-life and fundamentally pro-neighbor.
Nicole Cage is a senior at Baylor University studying Great Texts and Political Philosophy in the University Scholars program. She serves as editor-in-chief of a campus journal, The Standard, and loves getting to put out edifying and thoughtful issues with her peers.
