Top House Democrat presses Marco Rubio over Trump’s gutting of successful global HIV program

The top Democrat on the House Oversight Committee is demanding that Secretary of State Marco Rubio account for money Congress approved for the President’s Emergency Plan for AIDS Relief, warning that the Trump administration has undermined a program credited with saving tens of millions of lives.

California U.S. Rep. Robert Garcia, the committee’s ranking member, is asking Rubio for a detailed accounting of PEPFAR funds released and withheld since President Donald Trump returned to office, along with communications about the program and records concerning HIV funding decisions involving Zambia, Ghana, South Africa and Zimbabwe. In a letter sent Wednesday to Rubio, Garcia gave the State Department until August 26 to respond.

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

PEPFAR, created under President George W. Bush in 2003, has been credited with saving about 26 million lives. But its infrastructure has faced repeated disruptions since Trump ordered a 90-day pause on most foreign assistance in January 2025 and moved to dismantle the U.S. Agency for International Development.

“The Trump Administration has remained opaque about the status of funds appropriated for the PEPFAR program and whether they have been disbursed,” Garcia wrote to Rubio.

As The Advocate reported at the time, Rubio soon issued a waiver intended to preserve “life-saving humanitarian assistance.” But subsequent State Department guidance limited PEPFAR-funded PrEP during the review to pregnant and breastfeeding women, excluding other people at high risk of acquiring HIV, including many LGBTQ+ people. Later that year, Congress and the administration preserved $400 million in PEPFAR funding that had been targeted for rescission, even as internal State Department documents contemplated a broader transformation of the program.

The consequences have continued to emerge. The Advocate reported last month that an amfAR survey of 166 PEPFAR-funded organizations found delayed or terminated funding contributed 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 amfAR’s methodology and said in April that PEPFAR still supported 20.6 million people living with HIV.

“The Trump Administration’s gutting of PEPFAR is the latest in a long string of attacks on programs that are designed to save lives. The dismantlement of a program that has saved tens of millions of lives is both horrific and inhumane, and part of a larger pattern of the Trump Administration’s cruelty toward people living with HIV. Donald Trump must comply with the law and release the funds Congress rightfully approved for this crucial program immediately,” Garcia said in a statement.

Garcia told The Advocate in an interview on Monday that the retreat comes just as years of U.S. investment have brought the world closer to controlling HIV.

“PEPFAR has been so successful,” Garcia said, calling what has happened “really shameful.” He argued that global health investments also advance U.S. security and diplomacy.

“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,” Garcia said.

Garcia said congressional scrutiny will continue.

“We’re a global world,” he said. “And if we’re going to eliminate HIV/AIDS around the world, that’s going to be a good thing for us here in the U.S. as well.”