The GOP's Foreign Policy Idiocracy

Yes, I'm laughing/crying at the Heritage Foundation again.

Photo by David Clode on Unsplash

One of the running themes in my public writing in recent years has been that the United States can claim few unambiguous foreign policy accomplishments in the 21st century. That said, one of those unambiguous wins was the 2003 creation of the President’s Emergency Plan for AIDS Relief, known as PEPFAR.

Back in 2015 Vox’s Dylan Mathews argued that, “PEPFAR is one of the best government programs in American history, probably the best since the Great Society.” If that sounds like hyperbole, you should hear what elected officials on both sides of the aisle say about it. Back in January, President Biden marked the program’s 20th anniversary with a statement noting:

Since 2003, PEPFAR has saved more than 25 million lives and dramatically improved health outcomes in more than 55 partner countries. AIDS-related deaths have declined by 68 percent since their peak in 2004, and new HIV infections are down 42 percent. PEPFAR investments have ensured that 5.5 million babies have been born HIV-free. And two decades of investment in partner nations’ health systems played a critical role in countries’ ability to respond to other health crises such as COVID-19, Mpox, and Ebola.    

GOP Congressman Chris Smith, who authored the 2018 PEPFAR Extension Act, released a statement echoing Biden’s words: “Saving more than 25 million lives, PEPFAR is widely viewed as the most successful U.S. foreign aid program since the Marshall Plan…. The US leadership and support for this global response to the HIV/AIDS pandemic must continue and ensure cost-effective, accountable, and transparent American foreign assistance.”

In these crazy, polarized times, it’s nice to see a program that brings together Democrats on the left and Republicans on the right— excuse me, my hard-working staff has told me to read this Dan Diamond story in the Washington Post:

For two decades, the United States has pursued a far-reaching global agenda to fight HIV and AIDS, an initiative credited with saving more than 25 million lives. But the President’s Emergency Plan for AIDS Relief, better known as PEPFAR, has been abruptly bogged down in a domestic political fight, with Republicans citing allegations that the program’s funding is being used to indirectly support abortions — claims that health advocates, Democrats and PEPFAR officials say are baseless.

As a result, lawmakers have spent months wrangling over whether Congress will reauthorize the program for five years, for one year or not at all — a decision that experts warn has both practical and symbolic consequences.

“If PEPFAR doesn’t get reauthorized, the program can continue — but it could send some pretty chilling messages to people in the field who depend on PEPFAR for life support,” said Jennifer Kates, director of global health and HIV policy at KFF, a health policy organization that has tracked the provisions set to expire Sept. 30….

Heritage, Family Research Council and Susan B. Anthony Pro-Life America have warned lawmakers that if they vote for the Biden-backed bill, they will be docked on the organizations’ scorecards — a key metric that many antiabortion Republicans rely on when campaigning for reelection.

Please excuse me for a second:

So what happened? According to Diamond, a May 2023 Heritage Foundation report, along with an open letter from 31 conservative leaders, alleged that PEPFAR was… was…

You know what I’m going to quote directly from the open letter and the Heritage report, because their language on the allegations is extremely slippery. The open letter states, “grants from [PEPFAR] are used by nongovernmental organizations that promote abortions and push a radical gender ideology abroad.”

The Heritage report by Tim Meisburger is even more oblique in its allegations:

Although created by a Republican President, and despite generally receiving bipartisan support in Congress, PEPFAR has always been controversial. Except in cases of rape or maternal transmission, HIV/ AIDS in the U.S. and in developing countries is primarily a lifestyle disease (like those caused by tobacco) and as such should be suppressed though education, moral suasion, and legal sanctions. For conservatives committed to personal responsibility, it also should not enjoy greater priority than deadlier and more unavoidable diseases receive in the allocation of public funds.

Early in the program, Republicans argued that, as with any venereal disease, education and abstinence could end the AIDS epidemic; Democrats argued that condoms and antiretrovirals were the answer and that expecting populations to change their behavior was a form of colonialism. Although abstinence has been stripped from PEPFAR programs, Democrats have now added—in a practice decried by locals as neocolonialism—their own social priorities like abortion and promotion of LGBTI issues….

On the Left, “sexual and reproductive rights” and “reproductive health services” are code for abortion. After Roe v. Wade was overturned, PEPFAR’s second largest recipient expressed its support for “equal access to reproductive health services, including safe and legal abortion care,” and its fifth largest partner stated that the overturning of Roe v. Wade was “undermining what Jhpiego has been working towards since our founding” even though the Helms Amendment specifies that foreign aid shall not “be used to pay for the performance of abortions as a method of family planning or to motivate or coerce any person to practice abortions.”

Political contribution analysis explains why the supposedly neutral and nonpartisan development agencies and government-funded development contractors and NGOs all seem to promote a leftist agenda even when that agenda comes at the expense of the overall health of the marginalized beneficiaries of our foreign assistance. Almost all political contributions from employees of PEPFAR agencies and assistance providers have gone to Democratic candidates and causes, revealing that PEPFAR is in fact an entirely Democrat-run program.

If you read carefully, there is a whole lot of nothing in those paragraphs. It boils down to arguing that if you connect the Biden administration’s general policy preferences with the political giving of employees working for the salient federal agencies and NGOs, you must conclude that PEPFAR under Biden must somehow be funding abortions even though, according to Christianity Today’s Emily Belz, “funding or promoting abortion through PEPFAR would be against US law.”

Unsurprisingly, both the Biden White House and PEPFAR have pushed back on the allegations. One White House official told Diamond, “We are not ‘injecting’ abortion into PEPFAR in any way, shape, or form or seeking to make changes in law related to abortion.” PEPFAR also made it clear in their strategy document that, “PEPFAR does not fund abortions, consistent with long-standing legal restrictions on the use of foreign assistance funding related to abortion.”

So who are you gonna believe, the Newsweek of think tanks or health advocates, PEPFAR officials, and the White House?! Before you answer that question, dear readers, take a gander at what Vox’s Zack Beauchamp discovered about the author of the Heritage report:

The white paper’s author, Heritage fellow Tim Meisburger, is not a public health expert. His career has focused on democracy promotion abroad but has recently taken a turn toward conspiracy theorizing at home.

In 2017, he was appointed by Trump to a mid-level USAID position focusing on democracy — a job he lost in 2021 (per the Washington Post) after saying on a conference call that the January 6 riot was merely the work of “a few violent people.” During the 2022 election cycle, he led a multi-million dollar “election integrity” campaign backed by Michael Flynn and Roger Stone. In January, he wrote an essay for the pro-Trump website American Greatness arguing that there were “many egregious examples of election malpractice and fraud in 2020 and 2022,” including “statistically impossible results” — a seeming reference to long-debunked arguments that Biden could not possibly have won the 2020 election by the margin he did.

In other words, Meisburger is this decade’s Jason Richwine for the Heritage Foundation. The difference is that this time around, Heritage is loudly bragging about the bullshit its fellows are dishing out rather than slinking away embarrassed.

So here we are. Unfortunately, the move by Heritage Action and other interest groups to use the PEPFAR vote for their anti-abortion scorecard has paralyzed House Republicans into demanding things that are either not gonna happen (like the Biden administration adopting the Mexico City policy) or will fatally weaken PEPFAR (like authorizing only one-year budgets for the program).

Lest one think that these concerns are only voiced by those on the left, consider that Rick Santorum co-authored a Newsmax op-ed with his former chief of staff in which they stated unequivocally that, “No [PEPFAR] funds can be or ever have been used to pay for abortion on demand.” and that “without a clean authorization, there will be no reauthorization.” One can say a lot of things about Santorum, but “squishy on abortion” is not one of them. And even he thinks this is a bullshit policy linkage.

Referencing the Heritage report, that op-ed further noted, “We agree that the PEPFAR could be administered better under another agency and that the staff are too left-leaning, but that reasoning would require the elimination of every government program.” And let’s be honest, that increasingly seems to be what the 21st century Republican Party is advocating. We already know that this is part and parcel of how Donald Trump wants to reshape the federal government.

As for his closest competitor, Florida governor Ron DeSantis is, if anything, even more bloodthirsty about incapacitating the federal government. According to The Hill’s Julia Manchester, “DeSantis on Sunday said he would ‘start slitting throats on day one’ when it comes to taking on the ‘deep state.’ DeSantis made the remarks at a barbecue campaign event in Rye, N.H., hosted by former Sen. Scott Brown. ‘We’re going to have all of these deep state people, you know, we are going to start slitting throats on day one,’ DeSantis said.”

A decade ago Foreign Affairs asked me to write about what the GOP needed to do in order to reclaim its traditional foreign policy advantage in public polling. In my essay, I said, “Republicans need to start taking international relations more seriously, addressing the true complexities and requirements of the issues rather than allowing the subject to be a plaything for right-wing interest groups. And if they don't act quickly, they might cede this ground to the Democrats for the next generation.”

Congrats to Republicans on doing the exact opposite thing and embracing your inner idiocracy without reservation. You might actually succeed in destroying one of the few good things your party has produced in foreign policy for the last generation.