I’m also unsure about how much substance there is to it, but what I’ve read so far agrees with your impression. From this Foreign Policy article last month:
In a statement, Rep. Chris Smith, chair of the House global health subcommittee, cited a letter signed by 131 African religious leaders and lawmakers in countries with some of the harshest laws around abortion including Nigeria and Uganda. Quoting the letter, he urged that PEPFAR “not cross over into promoting divisive ideas and practices that are not consistent with those of Africa.”
Yet there is no consensus coming from Africa on restricting PEPFAR. In September, more than 350 African church leaders asked for PEPFAR to be reauthorized. They wrote that the assertions that PEPFAR was being used in Africa to fund or promote abortion were “unfounded and grossly unfortunate” and that they were “not aware of any such instance.”
African civil society groups argue that, given the restrictive abortion laws in many African nations, the chances of PEPFAR money being used to fund or promote abortion in those states are slim to none.
Around 35 percent of PEPFAR funding in Uganda goes to civil society organizations—many of which are faith-based or affiliated with U.S. evangelical institutions. The region has one of the highest rates of unsanctioned backstreet abortions in the world due to its prohibitive laws. Lobbying by U.S.-based evangelical groups in the country has also led to restrictions on condom access, a higher burden of unwanted pregnancies, and, according to a 2021 report by the British Medical Journal, a lack of preparedness by health facilities to treat abortion complications, leading to increased maternal deaths.
I’m also unsure about how much substance there is to it, but what I’ve read so far agrees with your impression. From this Foreign Policy article last month:
FWIW, the WH after some delay put out a policy position on the Ugandan legislation, with specific language around PEPFAR.