Credited with saving 25 million lives, the AIDS programme PEPFAR now faces an uncertain future in a divided US Congress.
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Secretary of State Antony Blinken says legislation, which includes the death penalty, is deeply troubling.
Updated guidelines will replace three-month abstinence rule that LGBTQ advocates had long decried as discriminatory.
Case could decide whether Obamacare can require insurance providers to cover preventive services for cancer and HIV.