How Would Project 2025 Affect Global HIV & Health Programs?
It spells a potentially devastating impact on the lives and health of billions abroad and threatens gains made in HIV prevention and other diseases. It also advances an anti-democratic and Christian fundamentalist agenda abroad.
Project 2025’s radical reach threatens global health: that is not an overstatement. That’s because its foreign policy aims call for rehauling critical US federal agencies and policies that deliver and support effective health funding, programs, and services across the globe for billions, much of this for vulnerable and socially marginalized groups, or needing disaster relief. That includes the US Agency for International Development (USAID), as well as the domestic HHS, CDC, and FDA (see main Healthcare piece). All federal agencies must realign their policies to reflect an extremist pro-life Christian conservative agenda, says Project 2025.
Project 2025 also attacks and seeks to limit the authority and influence of the World Health Organization and UN agencies, and opposes “globalism.” Its conservative foreign policy is nativist, anti-democratic, reflects white supremacist Christian fundamentalism. It would impose an extremist pro-life policy agenda that is anti-choice, anti-LGBTQIA+, and anti-diversity (anti-DEI). No federal funds will go to groups abroad that don’t adhere to that agenda.
The negative impact of Project 2025 will be multiplied for LGBTQIA+ people – and those with HIV – in countries that criminalize gay people, such as Uganda and Ghana; there, new antigay bills also criminalize providers of services to gay people. Meanwhile, Project 2025 tacitly supports -- versus condemns -- state-sanctioned antigay criminalization: it says the US should not oppose or impose sanctions on foreign governments who pass harsh antigay laws.
A punitive agenda driven by hate
That’s not accidental, either. Project 2025’s foreign agenda reflects a well-organized Christian evangelical movement with global ambitions -- and big money and organization (see our papers on Christian Nationalism for more). Some of the key groups and dark money driving Project 2025 are the same actors behind the antigay efforts in Africa, providing money and legal advice. At least seven Project 2025 advisory groups are US hate groups, including the Center for Family and Human Rights (C-FAM) and the Alliance for Defending Freedom, according to a report by Accountable US, and based on data from the Southern Poverty Law Center. (1)
For years, C-FAM leaders, along with Family Watch International – both virulently antigay groups -- have courted and met with foreign government leaders at the United Nations, and annually, at a National Prayer Breakfast, a Christian nationalist pow-wow attended by DC political bigwigs. FWI played a critical role in backing Uganda’s AHA, working closely with Uganda’s First Lady, Janet Museveni, a born-again Christian. FWI, along with Project 2025’s Christian warriors, are now pushing their antigay agenda in Islamic countries, across Latin and South America, in Eastern Europe, and Israel. (See our paper on Christian Zionists.)
They are also aligning with foreign populists such as Hungary’s Catholic leader, Viktor Orban, whose autocratic regime is touted as a model by Project 2025’s architects (see our Special Report, Follow the Dark Money). In March, the Heritage Foundation, which is leading Project 2025, hosted Orban in Washington for a meeting with US conservative leaders; Orban met with Trump the next day in Florida, but did not meet President Biden. Orban has now signed a contract to advise the Heritage Foundation, sharing his ‘illiberal’ roadmap to help steer Project 2025. (2)
The exchange goes both ways, too: Orban’s government has directly funded US hardline conservatives, including Christian nationalist scholar and anti-DEI activist Christopher Rufo at the Claremont Institute, also a Project 2025 advisory group member. The institute serves as an anti-democratic nerve center for the US conservative movement. Other Project 2025 groups are sending Christian scholars to Hungarian legal and think tanks, and vice-versa. It’s all part of a global Christian nationalist network that is especially focused on judicial activism, at home and abroad, to lay the legal groundwork for Project 2025. (See discussion of religious Dominionism in our ‘Who’s Who Among Christian Nationalists?’ paper.)
Militant Catholics and Christians
It’s important to take note of the people, as well as groups, pushing the Christian fundamentalist agenda abroad that now targets LGBTQIA+ people, women, and those with HIV. It’s not accidental that Roger Severino, the author of the Project 2025 chapter on rehauling the US health department, HHS, is a known member of the Catholic sect Opus Dei. So is the ex-director of C-FAM, Austin Ruse, a staunch antigay, anti-abortion US conservative activist. So is John Eastman, former director of the National Organization for Marriage, another Project 2025 advisory group, working closely with the hate group Alliance for Defending Freedom. The Claremont Institute is also affiliated with Opus Dei. So are many key players and groups in Project 2025, including Catholic militant lawyer Leonard Leo.
As we reported in February, 60 of the 80 initial Project 2025 advisory groups received funding from Leo-linked entities in 2022, the same year Project 2025 was being developed. The list may be longer. (See our Special Report and maps: ‘Follow the Dark Money’ on Leo and Project 2025.)
1) “Project 2025 Tapped Known Hate, Extremist Groups for Advisory Board,” press release by Accountable US. May 20, 2024. http://accountable.us/project-2025-tapped-known-hate-extremist-groups-for-advisory-board/2) Schifrin, Nick and Dodd, Ethan. “Hungary’s Orban gives Trump an ‘illiberal’ roadmap for American conservatives,” PBS News Hour, March 8, 2024.Criminalizing HIV Care and Prevention
The conservative attack on HIV funding and programs including PEPFAR has been going on for several years. It is linked to the anti-abortion and antigay agenda of conservative Christians. In October 2023, Congress failed to reauthorize the $6.9 billion-a-year PEPFAR program, which is credited with saving 25 million lives. PEPFAR-funded programs provide lifesaving care to those with HIV, with spinoff benefits for other diseases, including STDs, malaria, TB, hepatitis, Covid-19, monkeypox, water-borne diseases, maternal and health, and nutrition programs. PEPFAR programs have also introduced new resources to support public health systems abroad.
To date, House Republicans have refused to reauthorize PEPFAR unless restrictions are added to prevent federal funds from going to organizations that provide abortions, despite a lack of evidence that PEPFAR funds have directly supported abortions, according to the Kaiser Family Foundation, one of many groups tracking PEPFAR. PEPFAR is due to run out on March 25, 2025, and global health officials are sounding the alarm about the threat of cutting off or restricting funding for HIV programs globally. Project 2025 echoes the call to block reauthorization until PEPFAR officials prove they will adhere to a pro-life agenda.
What does this spell for HIV groups and PEPFAR clients?
Project 2025 policies would force PEPFAR programs to adhere to extremist anti-choice, anti-gay, anti-DEI policies. It criminalizes transgender and nonbinary identity, and calls for eliminating all federal protections for LGBTQIA+ people. It would outlaw gender-affirming care, and criminalize providers of this care, along with abortion providers. That means any group receiving US federal funds would either agree to not serve LGBTQIA+ people or sex workers, or lose funding. Either way, gay people, sex workers and women seeking reproductive care that includes abortion would lose access to health services.
That’s not all: Project 2025 also proposes to jail teachers and librarians or anyone promoting gay content that it deems pornographic. It also calls for a change of refugee policy to deny third-country asylum for LGBTQIA+ refugees. This, at a time when gay communities are under harsh attack in many countries and the demand for LGBTQIA+ asylum has risen.
Reports from Uganda and Ghana, among others, show a direct link between the passage of harsh antigay laws and a growing violent backlash against gay people that has included people with HIV in the areas of health care, housing, employment, travel, and more. (3) Transgender individuals have experienced vigilante mob violence and death threats. The result is a backslide in HIV service delivery as providers and clinics have closed their doors, fearing the backlash, while frightened HIV clients stay away, and can’t access medicines or care.
What happens when a population can’t access treatment or prevention services? Those with HIV face the risk of getting sick; AIDS is life-threatening disease. Communities and countries lose their ability to track and curb the spread of diseases. Looking ahead then, Project 2025 advances a health agenda that could prove deadly for people with HIV and threatens global public health.
Criminalization is bad health policy
Criminalization drives people underground, and leads to a cut-off of care, as well as increased danger. That is the trend being reported in Uganda and elsewhere in the wake of antigay laws. Criminalization makes it harder to find, treat and follow up with clients, and provide prevention services, whether for HIV, STD, malaria, or communicable diseases like tuberculosis, or Covid-19. The same is true for abortion. Driving abortion underground doesn’t mean women stop getting abortions, but that face an increased of risk dying of complications from illegal abortions, cut off from professional medical care. Criminalization is poor health policy.
Acting to Prevent Harm
Around the world, health groups and institutions are bracing for the possible backlash if PEPFAR is not reauthorized. HIV activists and funders are also grappling with the prospect of what a major loss of US funding could mean for HIV and health programs around the world, and how to support a continuity of care for clients if they close. If Project 2025 is enacted, the neediest of clients – gay people, sex workers, women needing abortions – would still lose care. What can be done to protect them – as well as health providers?
In May, the Biden administration made public its instructions to NIH officials to protect its agency work from political interference, with an eye to the possibility of a Republican victory in fall 2024, and with an eye on Project 2025. A new Scientific Integrity council is being formed to implement steps to protect the NIH research agenda. Elsewhere, nascent working groups led by Democracy Forward, among nonprofits, are developing strategic plans to counter Project 2025 in key sectors of the federal government. They are uniting federal officials and unions, think tanks, activists, and community organizers who are mobilizing across the country.
As many argue, effective health programs are driven by good science and evidence-based policy, not prejudice. There is no religious or moral exemption for the duty to care. Health care remains a right of all people, no matter how poor or disenfranchised. As Covid-19 has made us freshly aware, and as we saw with AIDS, we live in an interconnected, global world. Borders do not keep out viruses. If we backtrack on HIV or Covid-19, or good science, we are hurting ourselves. That is why fighting Project 2025 represents a national US and global public health priority. – Anne-christine d’Adesky
(3) La Jiwe, Jota. “Human rights advocates condemn Uganda’s ongoing homophobic violence,” 76 Crimes, November 29, 2023. Human rights advocates condemn Uganda's ongoing homophobic violence (76crimes.com)