This program was started in the 1990s and Uganda was able to lower its HIV rate among pregnant women from 31% in 1993 to 14% by 1998 and to 6.7% in all adults by 2005. According to a Hearing on Global Disease published in the Political Transcript Wire on December 13th, 2007 the age at which people began having sex and the use of condoms both increased, while the rate of infection decreased.  In 2003 the Bush administration began to implement President’s Emergency Plan for AIDS relief (PEPFAR). The ABC Program is used in the prevention aspect of PEPFAR.

PEPFAR was enacted on May 27th, 2003 with the signing of the bill entitled the “United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003” or H.R. 1298 . The bill creates a 5 year program to deal with the HIV/AIDS epidemic. The program focuses on prevention (ABC Program), treatment, and care. H.R. 1298 places limits on the implementation of ABC. Twenty percent of the program’s money must be spent on prevention. One third of the prevention budget must be spent on abstinence before marriage programs and the use of condoms is only promoted for those who engage in high-risk behaviors including prostitution, couples in which one person is HIV positive, and substance abusers. The prevention aspect of PEPFAR set a goal to prevent 7 million new AIDS infections during the first 5 years of the program. According to the PEPFAR website, as of September 30, 2007, the program was able to prevent the transfer of HIV from mother to child in 10 million pregnancies from 2004 to 2007. While this is a great achievement, there are no facts on the PEPFAR website that speak to its success in stopping the initial contraction of HIV by Africans. An argument as to why PEPFAR has not been more successful in this area are the limits set by H.R. 1298, especially the minimum amount to be spent on abstinence before marriage programs and the promotion of condom use to only the “high-risk” population.

A clear indication of this is the success that Uganda had in lowering its HIV rate through an equal promotion of ABC to the total Ugandan population. “Uganda currently risks reversing this progress because of the Bush-driven shift away from education on condom use” (Allafrica.com February 18, 2008 "The PEPFAR 'Record"). Since the US has been funding PEPFAR in Uganda there has been a shift to teaching abstinence in order to prevent the spread of HIV. As of 2005, the Bush administration cut the funding of condoms in Uganda which has resulted in a condom shortage throughout the country (USA Today “U.N. Official Blames US for Condom Shortage in Uganda). Some argue that this lack of condoms has caused the HIV rate to rise from 6% in 2002 to 7.1% in 2008.
 
The newest legislation in Congress concerning PEPFAR is Tom Lantos and Henry J. Hyde US Global Leadership Against HIV/AIDS or S. 2731 . It passed in the House on April 2, 2008 and has been scheduled for debate in the Senate. The bill refers to the Institute of Medicine of the National Academies’ report entitled ‘PEPFAR Implementation: Progress and Promise.’ This report states “that budget allocations setting percentage levels for spending on prevention, care, and treatment have adversely affected implementation of the U.S. Global AIDS Initiative, have been counterproductive, have limited PEPFAR’s ability to tailor its activities in each country to the local epidemic and to coordinate with the level of activities in the countries' national plans, and should be removed by Congress and replaced with more appropriate mechanisms.” The bill argues that PEPFAR must be more flexible overall in order to be more effective.