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Trump-Proposed FY18 Budget Cuts to HIV Funding Exceed $1Billion Globally


Recently I wrote an article chronicling the past year of the Trump administration operating with no strategy on HIV and AIDS. The article stated several pivotal moments that have occurred including the ending of ONAP, the resignation from six members from PACHA, and the initial statement that funds would be cut for HIV in the U.S. by $50 million. However, after being notified by ABAC, it has now been brought to our attention that the budget submitted by the Trump administration is calling for more than $1.08 billion to be cut from HIV/AIDS funding globally, which would be a crippling blow to over 30 plus years of work.

As with most things in this administration, nothing can be trusted until it is actually on paper. Back in March, the initial statement from the Trump administration was that HIV funding would be slashed by $350 million globally, with $50 million affecting work domestically. This was met with pushback from congress members who insisted that they were not willing to touch HIV funding, and who, at a minimum, would keep it where it was. However, in May the official budget was submitted and much to the devastation of us all, the proposed cuts were much more severe across the board -- nearly quadruple the $350 million suggestion.

According to Poz.com and the AIDS Institute, the domestic setbacks include:

  • In one of the biggest setbacks, the president has proposed to cut HIV prevention programs at the CDC by $149 million, which translates to a 19 percent cut.
  • The budget proposed to entirely eliminate the AIDS Education and Training Centers (AETCs) ($34 million) and the Special Projects of National Significance (SPNS) ($25 million).
  • In another disappointment, the budget maintains CDC Hepatitis Prevention funding at only $34 million [at a time when new infections have nearly tripled].
  • Given that racial and ethnic minorities are disproportionately impacted by HIV/AIDS, The AIDS Institute was shocked that the budget eliminates the Secretary of Health and Human Services Minority AIDS Initiative (MAI) Fund ($54 million).
  • The budget also cuts $26 million from the Housing Opportunities for Persons with AIDS (HOPWA) program at HUD.
  • Funding for the National Institutes of Health would be cut by over 20 percent, which will certainly result in a dramatic cut to AIDS research.

CEO Jesse Milan Jr. of AIDS United states that he is “shocked” by this budget request. He goes on to say that “[i]nvestment in targeted approaches are effective and save money at a time when 1 in 2 and 1 in 4 Black and Latino gay and bisexual men respectively are at substantial risk for HIV infection in their lifetime. How can we reduce funding to programs that address these disparities? The president’s budget isn’t just a set of numbers, it’s a disturbing statement of values.”

The numbers are even more egregious on a global front:

  • A 17 percent cut to the Global Fund, which will result in $450 million less to be leveraged from other countries through the $2 to $1 matching agreement that governs the U.S. contribution;
  • Bilateral PEPFAR programs were also cut by 17 percent overall, including: 
  • An approximate 10 percent cut to State Department HIV/AIDS funding;
  • Eliminating entirely the global AIDS programs at the U.S. Agency for International Development (USAID), a $330 million cut;  
  • Cutting in half the Centers for Disease Control’s (CDC) global AIDS budget; and 
  • Eliminating all funding for the International AIDS Vaccine Initiative (IAVI), which will stop 10 current promising candidates from progressing and halt research toward the development of a preventative HIV vaccine.  

In a joint statement released by The Federal AIDS Policy Partnership AIDS Budget (FAAP) & Appropriations Coalition (ABAC) to Congress:

“The undersigned 174 organizations of the AIDS Budget and Appropriations Coalition (ABAC), a work group of the Federal AIDS Policy Partnership (FAPP), and others urge you to reject the proposed $1 billion in cuts to HIV/AIDS and related programs in President Trump’s FY2018 Budget and to ameliorate the sequestration caps for non-defense discretionary programs. Now is not the time to decimate HIV/AIDS programs. Decreasing funding for these programs will result in more infections, increased lifetime medical costs, and ultimately more deaths from preventable and treatable diseases.”

Several other groups including NMAC, TAG, and Fenway Health, have released similar statements condemning these proposed 2018 budget cuts, as they could spell the end of many community based organizations that are dependent on these funds to continue operations, as well as the danger to Black and Brown communities. Although the plan is not likely to pass Congress, it is indicative of the fact that HIV/AIDS will not be a concern of this current administration.

Organizations continue to push back as the budget is being revised and voted on. The assumption is that funding won’t increase, but will not have the severe decreases that have been suggested. This story is one that we all must keep a close eye on, as for many of us the epidemic has never ended.