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Republicans have delayed more than $1 billion in funding for the President’s Emergency Plan for AIDS Relief, better known as PEPFAR, the latest complication facing a lifesaving HIV program that has been ensnared in a broader political fight around abortion.

But Republicans have been placing holds on notifications that the State Department is required to send to Congress before PEPFAR spends any additional money, according to four people with knowledge of the funding delays, three of whom spoke on the condition of anonymity to discuss private negotiations.

The GOP-led House Foreign Affairs Committee in August began objecting to language in PEPFAR’s country and regional operational plan, which offers guidance to partners around the globe about how to administer the aid program, according to the people with knowledge of the dispute.

The Republicans’ funding delays and objections, which have not been previously reported, center on PEPFAR’s use of terms relating to abortion, transgender people, sex workers and other areas, with the committee repeatedly demanding rewrites from the State Department.

The Biden administration has also warned that Congress’s delay to reauthorize the program is “damaging the United States’ image globally, particularly in Africa,” and threatening plans to acquire supplies, roll out innovations and take other steps that require certainty about PEPFAR’s long-term viability.

Sen. Bob Menendez (D-N.J.), who was steering Democrats’ efforts and working with Republicans to find a deal, stepped down last month as Senate Foreign Relations Committee chair after he was indicted over allegations he accepted bribes in exchange for exerting political influence.

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