Congress narrowly avoided—at least for now—a federal shutdown thanks to a stopgap funding bill approved on Sept. 30. But throughout the whirlwind of activity on Capitol Hill to keep the government running, the deadline passed to reauthorize a vital global health program that’s been credited over the last two decades with saving more than 25 million lives across some 50 countries.
The long-term prospects for the President’s Emergency Plan for AIDS Relief (PEPFAR)—launched in 2003 by President George W. Bush and reauthorized with broad bipartisan support in 2008, 2013, and 2018—are now uncertain. Reauthorization is mired in a bitter political struggle over abortion. House Republicans are trying to block PEPFAR funding to organizations offering abortion-related service, which the Democratic majority in Senate strongly opposes.
In the meantime, health experts and administration officials warn that non-reauthorization will erode the program’s ability to purchase affordable care and weaken the U.S.’s role as a leader in global health.
A State Department official tells TIME that the non-reauthorization will not “jeopardize PEPFAR’s operations” during fiscal…