The President's Emergency Plan for AIDS Relief (PEPFAR) is the U.S. government's global effort to combat HIV and the largest global health program devoted to a single disease (for more information, see the KFF fact sheet on PEPFAR). It was first proposed by President George W. Bush in 2003. Three major pieces of authorizing legislation govern PEPFAR's HIV response, as well as U.S. participation in the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and bilateral assistance for tuberculosis (TB) and malaria programs: The Leadership Act, The Lantos-Hyde Act, and The PEPFAR Stewardship Act (see Table 1). These legislative vehicles have permanently authorized much of the program within U.S. law but have also created some time-bound provisions. PEPFAR's current authorizing legislation goes through Fiscal Year (FY) 2018, which ended on September 30, 2018, and most of these time-bound provisions have expired. On August 3, 2018, the House introduced a bill (H.R. 6651) to reauthorize PEPFAR through FY 2023 and FY 2024, depending on the provision. The Senate introduced a similar bill (S. 3476) on September 18, 2018. The House passed H.R. 6651 on November 13, 2018, and the Senate passed it on November 28, 2018. The bill is now headed to the White House for the President's consideration and signature. This brief identifies the PEPFAR authorities that expired at the end of FY 2018 and notes how they are addressed by the proposed reauthorization bills (see Table 2). It also provides a detailed comparison of PEPFAR's authorizing legislation over time (see Table 3). It will be updated as needed.
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