By Simon Lewis (JO:LEWJ) and Patricia Zengerle
WASHINGTON (Reuters) - The flagship U.S. aid program on HIV/AIDS is in jeopardy, a senior Republican warned on Thursday, after U.S. officials said four nurses in Mozambique performed abortions that are banned under the multibillion-dollar program that has saved millions of lives globally.
Service providers that get funding through the President's Emergency Plan for AIDS Relief (PEPFAR) are barred from providing abortion services under rules against U.S. foreign assistance being used for abortion-related activities, but the program has still faced criticism from anti-abortion Republicans.
A review of service providers in Mozambique - where abortion is legal - found that four nurses performed a total of 21 abortions since January 2021, said three U.S. officials who briefed members of Congress on the matter on Thursday in a bid to show transparency and demonstrate that measures to ensure compliance with the ban on abortions were working.
The officials said it was the first time a PEPFAR-funded provider had been found to have provided an abortion in the program's 20-year history.
"That's why we wanted to notify Congress right away," said one of the officials, who is involved in administering PEPFAR at the State Department. "It also is an important indication that the compliance measures we have in place have been effective, but could be further strengthened."
PEPFAR-funded programs often help HIV-infected women have babies without the virus using antiretroviral drugs. In Mozambique, nurses are routinely trained to provide abortions because it is legal in the country but measures are taken to ensure those funded by PEPFAR do not provide them, the officials said.
PEPFAR began in 2003 under Republican President George W. Bush and enjoyed bipartisan support until recently. Republican opponents of abortion rights blocked a five-year reauthorization in 2023, alleging without evidence that the program had been hijacked by the Biden administration to empower pro-abortion non-government organizations.
Republican Senator Jim Risch, chairman of the Senate Foreign Relations Committee that oversees the program, said the administration of President Joe Biden, a Democrat, had allowed taxpayer dollars to be used to perform abortions and called for an investigation of the Centers for Disease Control and Prevention, one of the key agencies implementing PEPFAR.
"This violation means that the future of the PEPFAR program is certainly in jeopardy," Risch said in a statement. "I will not support one dollar of American money going towards abortion anywhere in the world, and I will do all I can to ensure this never happens again."
Funding for PEPFAR was extended for one year in March.
Officials warn that millions of lives would be at risk if the program is not extended further. The State Department says PEPFAR, through which the United States has spent more than $100 billion, has so far saved more than 26 million lives globally.
The U.S. officials said the investigation in Mozambique was launched in late October when routine compliance measures found that some of the 2,751 PEPFAR-funded nurses operating in the country had not received required training on the prohibition of abortion in U.S.-funded services. Only four were found to have performed abortions, they said.
U.S. officials immediately froze funding to the providers in question when informed of a potential issue, and going forward would require all staff to sign an attestation that they have been trained and understand the prohibition on abortions, the officials said.