Francis's Quick takes

Update (January 28): Marco Rubio has now issued a temporary waiver for "humanitarian programs that provide life-saving medicine, medical services, food, shelter and subsistence assistance."^[1]

PEPFAR's funding was recently paused as a result of the recent executive order on foreign aid.^[2] (It was previously reauthorized until March 25, 2025.^[3]) If not exempted, this would pause PEPFAR's work for three months, effective immediately.

Marco Rubio has issued waivers for some forms of aid, including emergency food aid, and has the authority to issue a similar waiver for PEPFAR, allowing it to resume work immediately.^[4] Rubio has previously expressed (relatively generic) positive sentiments about PEPFAR on Twitter,^[5] and I don't have specific reason to think he's opposed to PEPFAR, as opposed to simply not caring strongly enough to give it a waiver without anyone encouraging him to.

I think it is worth considering calling your representatives to suggest that they encourage Rubio to give PEPFAR a waiver, similarly to the waiver he provided to programs giving emergency food aid. I have a lot of uncertainty here — in particular, I'm not sure whether this is likely to persuade Rubio — but I think it is fairly unlikely to make things actively worse. I think the argument in favor of calling is likely stronger for people who are represented by Republicans in Congress; I expect Rubio would care much more about pressure from his own party than about pressure from the Democrats.

1. ^{^}

   https://apnews.com/article/trump-foreign-assistance-freeze-684ff394662986eb38e0c84d3e73350b

2. ^{^}

   My primary source for this quick take is Kelsey Piper's Twitter thread, as well as the Tweets it quotes and the articles it and the quoted Tweet link to. For a brief discussion of what PEPFAR is, see my previous Quick Take.

3. ^{^}

   https://www.kff.org/policy-watch/pepfars-short-term-reauthorization-sets-an-uncertain-course-for-its-long-term-future/

^{^}

https://www.reuters.com/world/us/trump-pause-applies-all-foreign-aid-israel-egypt-get-waiver-says-state-dept-memo-2025-01-24/

^{^}

https://x.com/SenMarcoRubio/status/1141694696135245824

Show all footnotes

PEPFAR, a US program which funds HIV/AIDS prevention and treatment in the developing world, is in danger of not being reauthorized.^[1] (The deadline is September 30th, although my current understanding is that even if the House of Representatives misses the deadline, it could still be reauthorized, there would just be a delay in funding.) Over the course of its existence, it's estimated as saving ~25 million lives^[2] for a little over $100 billion, and my current understanding is that (even if the lives saved number is an overestimate) it's one of the most cost-effective things the US government does.

I think it might be worth calling your representative to encourage them to reauthorize PEPFAR, particularly if they've indicated that they're uncertain of how to vote or might vote against it. My main uncertainty here is that I'm not sure how likely calling your representative is to actually change their mind, but I suspect this is fairly tractable compared to most forms of lobbying since it's literally just asking them to reauthorize a program that already exists (as opposed to asking them to pass a new law, majorly change how a program works, etc.)

1. ^{^}

   https://www.politico.com/news/2023/09/05/president-emergency-global-aids-program-00113796

2. ^{^}

   https://www.state.gov/pepfar/ (note that some sources think this is an overestimate - e.g. the comments section here thinks it could be more like 6 million as a low estimate, which would make it not competitive with GiveWell top charities, though still way more cost-effective than a lot of things the US government does (and I currently don't expect that if the program were eliminated the money would be redirected to something more cost effective))