This article addresses the rise of faith-based emergency relief by examining the US President’s Emergency Plan for HIV/AIDS (PEPFAR), a public health intervention focused on the AIDS epidemic in sub-Saharan Africa. It argues that the theological turn in humanitarian aid serves to amplify ongoing dynamics in the domestic politics of sub-Saharan African states, where social services have assumed the form of chronic emergency relief and religious organizations have come to play an increasingly prominent role in the provision of such services. In the context of an ongoing public health crisis, PEPFAR has institutionalized the social authority of the Pentecostal and charismatic churches, leading to a semantic confluence between the postcolonial politics of emergency and the Pentecostal/Pauline theology of kairos or event. Far from being confined to the space of foreign aid, however, the faith-based turn in humanitarianism is in keeping with ongoing reforms in domestic social policy in the United States. While on the one hand the sustained welfare programmes of the New Deal and Great Society have been dismantled in favour of a system of emergency relief, on the other hand the federal government has intensified its moral, pedagogical and punitive interventions into the lives of the poor. The wilful transfer of welfare services to overtly religious service providers has played a decisive role in this process. The article concludes with a critical appraisal of the links between African and North American Pentecostal-evangelical churches and questions the revolutionary mission ascribed to Pauline political theology in recent political theory.