The State Department appears to be partially heeding calls to allow life-saving aid exemptions from the foreign aid freeze Secretary of State Marco Rubio imposed last week. How so? In communication first reported by Reuters, Rubio said aid groups may continue using U.S. funds for “life-saving humanitarian assistance.” That applies to "core life-saving medicine, medical services, food, shelter, and subsistence assistance, as well as supplies and reasonable administrative costs as necessary to deliver such assistance,” POLITICO’s Nahal Toosi reports. Rubio said the waiver does not cover work related to abortions, family planning conferences, gender or DEl ideology programs, surgery for transgender people or other non-life saving assistance. U.S. law has for decades banned foreign aid from being used to provide or promote abortion as a family planning method. But confusion persists. Many humanitarian aid groups, including those working on global health, haven’t received updated guidance about which parts of their work are exempt from the freeze. A congressional aide told Toosi that the move clearly broadened exemptions beyond emergency food assistance, which was initially exempted. But there were still questions, the aide and others said. For example, a former U.S. Agency for International Development official said it wasn’t clear if the President’s Emergency Plan for AIDS Relief, or PEPFAR, the anti-HIV/AIDS program, was exempted, due to technical questions about its funding sources and how the State Department legally defines life-saving aid. The Trump administration has put so many top USAID officials on leave that getting questions answered is even harder, the congressional aide noted. Rubio's decision came as the World Health Organization and the Bush Institute, among others, raised concerns about the freeze. A prolonged freeze, the WHO warned, “could lead to rises in new infections and deaths, reversing decades of progress and potentially taking the world back to the 1980s and 1990s when millions died of HIV every year globally, including many in the United States of America.” The George W. Bush Institute’s executive director, David Kramer, said Tuesday that “a pause in its funding risks interrupting life-saving access to treatment, potentially placing millions of lives in danger.” Why it matters: More than 20 million people living with HIV, including half a million children under 15, depend on PEPFAR for HIV treatment, according to the WHO. If people lose access to their HIV drugs, they face increased risk of developing AIDS, dying from complications and transmitting the virus to others. The WHO acknowledged in its statement that countries providing treatment to their citizens without relying on much donor support is crucial over the next few years, but “a sudden and prolonged stop to programs does not allow for a managed transition and puts the lives of millions at risk.” A State Department spokesperson said in an emailed statement to reporters that the freeze was necessary to evaluate programs because otherwise participants in them, both inside and outside the government, would have no incentive to share details about those with the new administration. “A temporary pause, with commonsense waivers for truly life-threatening situations, is the only way to scrutinize and prevent waste,” the spokesperson said.
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