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.
In the first few months of 2025, the second Trump administration began significantly curbing the global reach of U.S. foreign policy. One of the first agencies to be affected was the U.S. Agency for International Development (USAID), originally created by an executive order under President Kennedy and made independent by the Foreign Affairs Reform and Restructuring Act of 1998.
Among USAID’s most impactful initiatives is the President’s Emergency Plan for AIDS Relief, (PEPFAR), which has helped save more than 25 million lives by providing HIV/AIDS prevention and treatment services around the world. In Fiscal Year 2024, the United States allocated approximately $5.4 billion to global HIV/AIDS programs, with $4.9 billion being directed specifically to PEPFAR.
But as of March 25, 2025, the deadline to reauthorize PEPFAR has passed. While Congress appropriated enough funding for the program to keep running until September, concerns remain that PEPFAR, a program widely celebrated for its life-saving work, could face a complete shut down in the coming months. The consequences would be dire—not only for those receiving life-saving treatment but also for the faith-based organizations (FBOs) that partner with USAID to serve vulnerable populations around the world.
Faith-based partners such as Catholic Relief Services (CRS) rely on PEPFAR funding to carry out their global health programs. On February 28, 2025, the U.S. State Department convened a meeting with several FBOs to discuss new ways of re-envisioning their mission work in light of these recent developments. However, prominent leaders voiced concern that government withdrawal would severely diminish their ability to continue this work. Galen Carey, Vice President of Governmental Relations for the National Association of Evangelicals, underscored this in saying the work of FBOs would be “less effective” without government support, especially when working with programs like PEPFAR.
Carey’s remarks reflect a long-standing collaboration between faith-based organizations and government to promote the welfare of the city, a shared effort rooted in prophet Jeremiah’s writing to the exiled communities in Babylon, as recorded in Jeremiah 29:7:
“But seek the welfare of the city where I have sent you into exile, and pray to the Lord on its behalf, for in its welfare you will find your welfare.”
This biblical call to seek the common good speaks to a vision of shalom, a world as God intended it. However, shalom is not realized through the work of FBOs or government alone. It requires the sustained, collective effort and commitment of institutions, faith communities, and governments alike until God ultimately restores the world. As the Center for Public Justice puts it when defining public justice, government is called to:
- Uphold the common good of the political community in its own right, which includes protecting citizens from domestic and foreign injustice.
- Recognize in law the non-political responsibilities that belong to those who live in the territory of government’s jurisdiction.
These principles are tied to government’s role of ensuring the “safety, welfare, and public order of everyone in its jurisdiction,” which serves as one vehicle of striving towards shalom, or life as intended by God. However, the nature of sin, alienation from God, creates a wedge from the world now as opposed to how God intended it. Public justice, then, becomes a means of striving to God’s rightly ordered world.
These principles also echo the values of Catholic Social Teaching, which holds that every life is sacred and that every person has inherent dignity. Programs like PEPFAR embody this vision, protecting lives and promoting dignity by preventing the spread of HIV/AIDS. However, the Catholic Relief Service’s mission is threatened by cuts in programs like PEPFAR.
PEPFAR Faces Pushback
Historically, PEPFAR has enjoyed strong bipartisan support. That unity began to fracture in 2023 when several Congressional Republicans threatened to halt the reauthorization of PEPFAR due to political disagreements with the Biden Administration.
Representative Chris Smith (R NJ) and other Congressional Republicans were worried that the Biden Administration “politicized PEPFAR by empowering pro-abortion international, non-governmental organizations, which deviated from their life-saving work.” Smith was not entirely wrong in his accusation, as an investigative report found that four nurses in Mozambique, where abortion is legal under specific conditions, were paid with PEPFAR funds to perform abortions. A separate PEPFAR report revealed that these nurses had not been properly trained on the prohibition against using PEPFAR funds for abortion services. In response, PEPFAR suspended funding to Mozambique, which later refunded $4,100 to the Centers for Disease Control. Congressional Republicans reauthorized PEPFAR for a year, rather than its standard five-year reauthorization.
Catholic Relief Services
Despite opposing abortion, organizations like Catholic Relief Services (CRS), did not see that small infraction as a means to jeopardize the wider program. CRS soon found itself defending the program. Meghan Topp Godwin, Senior Policy and Legislative specialist for Catholic Relief Services, noted that in her experience, that “this (abortion services) is not something they have witnessed or experienced in our work with PEPFAR.” Karl Hoffman, of Population Services International, whose NGO also receives PEPFAR money, says “there has been no available evidence suggesting that a single PEPFAR organization” receives money to perform abortions.
Catholic aid organizations are some of the largest recipients of government funds allocated for foreign aid, with Catholic Relief Services being one of the largest groups. More than half of its $1.5 billion annual budget comes from USAID, much of it linked to PEPFAR. Without stable funding, CRS had to cut back on programs that directly supported the life-saving work of caring for their neighbors through HIV/AIDS prevention and treatment efforts. When CRS was notably excluded from the February State Department meeting to discuss the cut in foreign aid, some suspected it may have to do with the fact that they are the largest recipients of foreign aid grants. There was no indication why CRS was excluded, yet someone close to the meeting said their absence was “conspicuous.” By halting foreign aid, the burden shifted to the domestic churches in those countries, who do not have as many resources that the U.S. has at their disposal.
Public Justice: Towards Shalom
One of the lasting hallmarks of the PEPFAR program is that it received bipartisan support, and it also highlighted the cooperation between FBOs and government. One of the main functions of government is providing for the flourishing of society while also restraining sin through law. In a flourishing society, people recognize the welfare of the city, promote that each human is made in the image of God, and that government provides the basic needs for its citizens. Yet, government cannot do this work alone, and it relies on other institutions like the family and the church. As Jeremiah wrote to his people in Babylon, we are called to live where we are and strive for the general welfare of all. FBOs like CRS cannot do the work of tending to the poor alone, which is why they also rely on support from government.
Seeking the welfare of the city does not fall squarely on government or FBOs, rather, it falls on both. As the relationship between these two crucial institutions begin to falter, the imperative to seek the welfare of the city, and the world, becomes even more paramount.
Rev. Thomas Johnston serves as a Lutheran pastor in North Carolina. He interned for the Center for Public Justice in 2020.
