WASHINGTON (AP) — As billions of dollars for a global HIV/AIDS program credited with saving millions of lives remains in limbo, the George W. Bush Institute is urging the U.S. Congress to keep money flowing for it.

In a letter sent to Congress on Wednesday, the former Republican president's institute pleaded with Congress to keep funding the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR. The program works with nonprofit groups to provide HIV/AIDS medication to millions around the world, fund orphanages and support health systems around the world.

“It is one of the most successful international development programs since World War II,” the institute, along with global leaders and humanitarian groups, wrote in their letter. “Abandoning it abruptly now would send a bleak message, suggesting we are no longer able to set aside our politics for the betterment of democracies and the world."

The program, created 20 years ago, has long enjoyed bipartisan support but recently become the center of a political fight: a few Republicans are leading opposition to PEPFAR over its partnership with organizations that provide abortions.

Earlier this year, U.S. Rep. Chris Smith, a New Jersey Republican who has for years supported PEPFAR, said he would not move forward with reauthorization for PEPFAR unless groups that promote or provide abortions were barred from receiving money. Smith chairs the subcommittee with jurisdiction over the program's funding.

Although abortion has become central to the hold up over PEPFAR's funding, the Biden administration's Global Aids Coordinator said he was unaware of any circumstance where money was used to fund abortion services.

PEPFAR is credited with saving 25 million lives in 55 countries, including 5.5 million infants born HIV-free. It was created by then-President George W. Bush and Congress to extend treatment for the AIDS epidemic, which has killed more than 40 million people since 1981, to hard-hit areas of Africa where the cost of treatment put it out of reach.

The number of children in sub-Saharan Africa newly orphaned by AIDS reached a peak of 1.6 million in 2004, the year that PEPFAR began its rollout of HIV drugs, researchers wrote in a defense of the program published by The Lancet medical journal. In 2021, the number of new orphans had dropped to 382,000. Deaths of infants and young children from AIDS in the region have dropped by 80%.

Bush, who firmly opposed abortion and pushed for stricter abortion laws during his time as president, urged Congress to continue funding for the program in an opinion articled published in The Washington Post.

"The reauthorization is stalled because of questions about whether PEPFAR’s implementation under the current administration is sufficiently pro-life," Bush wrote. "But there is no program more pro-life than one that has saved more than 25 million lives."