U.S. Representative Robert Garcia Demands Accountability for PEPFAR Funding

Ranking member of the House Oversight Committee, Rep. Robert Garcia (D-CA), sent a letter to Secretary of State Marco Rubio asking for a detailed accounting of funds released and withheld under the President’s Emergency Plan for AIDS Relief (PEPFAR) since President Donald Trump returned to office. The letter gives the State Department until August 26 to respond. Garcia seeks records on disbursements, communications, and decisions affecting HIV programs in Zambia, Ghana, South Africa and Zimbabwe.

The Advocate

PEPFAR was created in 2003 under President George W. Bush and is credited with saving about 26 million lives. The Trump administration ordered a 90-day pause on most foreign assistance in January 2025 and moved to dismantle the U.S. A State Department waiver later preserved limited humanitarian assistance, but guidance restricted PEPFAR-funded pre-exposure prophylaxis (PrEP) to pregnant and breastfeeding women, excluding many high-risk groups, including LGBTQ+ individuals.

The Advocate

An amfAR survey of 166 PEPFAR-funded organizations reported that delayed or terminated funding led to the closure of at least 1,700 HIV service sites and the loss of more than 16,000 full-time workers. The State Department disputed the survey’s methodology and, in April, asserted that PEPFAR still supports 20.6 million people living with HIV.

The Advocate

Garcia told The Advocate that the program’s retreat occurs as global HIV control gains momentum, emphasizing that “PEPFAR has been so successful.” He argued that U.S. global-health investments advance national security and diplomacy, and warned that continued underfunding would undermine both international health goals and U.S. interests. Garcia pledged ongoing congressional scrutiny, stating that eliminating HIV/AIDS worldwide benefits the United States as well.

The Advocate

• “The Trump Administration has taken unprecedented steps to disassemble the PEPFAR program and withhold or delay crucial, lifesaving funds,” — S. Rep. Robert Garcia

The Advocate

• “The Trump Administration has remained opaque about the status of funds appropriated for the PEPFAR program and whether they have been disbursed,” — S. Rep. Robert Garcia

The Advocate

• “The president just doesn’t believe in investing in global health and doesn’t understand what investing in global health actually does for our own safety and our own standing in the world,” — S. Rep. Robert Garcia

The Advocate