PEPFAR has been in the news recently, not to laud its tremendous ongoing impact, but to debate its future. I can’t help but be dismayed by attempts to use PEPFAR to instigate a clash between politics and public health, knowing that the lives and well-being of millions of people are on the line. Failure to continue PEPFAR would immediately imperil individuals, families, communities and societies around the world—and would also needlessly squander the global good will America has won and threaten the social stability we’ve fostered. Attempts to pin unconnected ideological fights onto PEPFAR ignore the fact that PEPFAR is good politics—a historically bipartisan public health initiative that gains us friends and keeps people alive. PEPFAR, with all its faults, is an example of American leadership tackling complex problems, which we should continue to build on.