The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) represents the largest financial commitment ever made by a single country to combat a single disease. Established in 2003 by President George W. Bush, PEPFAR has had overwhelming bipartisan support through 10 Congresses and four presidential administrations. Over the past 20 years, the U.S. government has invested more than $100 billion in the global HIV/AIDS response, saving more than 25 million lives and providing treatment to millions more.  Since 2003, PEPFAR has been a cornerstone of global health efforts. However, its future is currently uncertain. In March 2024, PEPFAR received a one-year reauthorization, a departure from the program’s historical five-year extensions,…