Princeton , New Jersey ( CNN ) -- The stakes in the current budget battles are enormous . As the super-committee deliberates over how to reduce the deficit and other congressional committees struggle to cut spending , the fate of important programs hangs in the balance . While the American public tends to focus on the highest profile issues such as Medicare and defense , some of the smaller , off-radar issues are also vital and ca n't be ignored . The combination of rising deficits , hyper-partisanship , and tea party conservatism has put numerous policies at risk . One of the programs that could suffer is the President 's Emergency Plan for AIDS Relief , otherwise known as PEPFAR . It is one of the less well known creations of President George W. Bush . Started in 2003 , the program began by providing $ 15 billion over five years to combat AIDS around the globe through testing , counseling and medical treatment . The amount initially spent was over three times what the nation had spent on this cause before . President Bush , who believed the idea was like the Marshall Plan , a U.S. program in 1948 that provided economic assistance to Western Europe to help in reconstructing the continent after World War II and prevent the spread of communism , said : `` When we see a plague leaving graves and orphans across a continent , we must act . When we see the wounded on the road to Jericho , we will not -- America will not -- pass to the other side of the road . '' Some , including Democrats who do n't care for the rest of his record , believe that it is his greatest accomplishment . Though the U.S. foreign aid program , where PEPFAR is housed , constitutes less than 1 % of the federal budget , it has helped to save the lives of millions of people and helped to contain a disease that was ravaging the African continent . By 2009 , a study in the Annals of Internal Medicine reported that in African countries receiving PEPFAR funding there had been a 10.5 % reduction in the AIDS death rate . The program has been extended under President Obama . To be sure , it has not been without controversy . Some liberals complained the program pushed for ineffective abstinence measures , to please the religious right , while some conservatives viewed it as a an unneeded expenditure . But in general , it has been considered an example of policy success in an era when Americans love to criticize government . What happens next is uncertain . With Democrats and Republicans focusing on massive foreign aid cuts as part of a deficit deal , with some estimates upward of $ 60 billion , the State Department would be unlikely to continue with humanitarian programs such as these for very long . Proposals to cut this humanitarian spending , noted Charles Lyons , the president of the Elizabeth Glaser Pediatric AIDS Foundation , are `` very , very concerning and comes at exactly the wrong time . '' Lyons added that the program has been a `` game changer . '' In August , the U.S. government announced that anti-retroviral AIDS medicines could reduce the transmission of the disease from infected to non-infected partners by 96 % . Moreover , the United Nations program on HIV/AIDs announced a plan to eliminate pediatric AIDS infections by 2015 . The plan explains that , `` It is possible to stop new HIV infections among children and keep their mothers alive if pregnant women living with HIV and their children have timely access to quality life-saving anti-retroviral drugs . '' The moral weight behind the program becomes clearer in a riveting new documentary by first-time filmmaker Maggie Betts , whose movie , `` The Carrier , '' premiered at the Tribeca Film Festival . The movie follows the struggles of a Zambian woman named Mutinta Mweemba who has become pregnant . Mutinta , who was trapped in a polygamous marriage , learns that she has AIDS . The film follows her effort to protect her child from acquiring the disease as well . One of the most striking aspects of the film is the network of health care workers who come into her life , providing counsel and medicine , seeking to prevent the transfer of the disease to the children . Now , Congress will have to make a decision about whether to increase funds for PEPFAR , whether to reduce its funds or even keep the program alive . Although this program is one of the longest lasting creations of President Bush , many younger Republicans are not supportive of it . House Republicans , moved to the right by the tea party , have little appetite for spending on anything that does not seem to be absolutely essential to the nation . In 2008 , when she voted against the re-authorization of PEPFAR , Michelle Bachmann said , `` The United States is the most generous nation on earth . We have to have a balancing act between our benevolence and our prosperity . And our prosperity today is at risk . We will not survive if our benevolence allows the treasury to not only be empty -- but to have us be a debtor nation greater than we have ever been before . '' But before Congress takes action , America would do well to consider the kinds of transformative impact that government can have . When a program does work , as the evidence suggests that PEPFAR has , and is desperately needed , there should be some kind of security for its future . The opinions expressed in this commentary are solely those of Julian Zelizer .
Julian Zelizer : The Obama administration is considering a plan to allow the CIA and other intelligence agencies to use drones in domestic law enforcement operations for the first time. He says a Bush administration program that provides billions to fight AIDS is in jeopardy . Zelizer : The program saves lives and is an example of government that works .