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HIV Funding – A Legacy Worth Protecting

Julie Patterson
Director, AIDS Funding Collaborative
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August 21, 2023
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The GOP-led Labor, Health and Human Services, Education, and Related Agencies Subcommittee of the U.S. House Appropriations Committee has proposed a series of devastating reductions in funding for programs intended to combat HIV/AIDS, including eliminating all $220 million in funding for the Centers for Disease Control and Prevention's (CDC) portion of the Ending the HIV Epidemic Initiative. Three counties in Ohio, Cuyahoga, Franklin, and Hamilton, have been receiving a portion of these funds. This program was originally created under former President Donald Trump and has continued under President Joe Biden.

Other related proposed funding cuts include:

  • $238 million cut from the Ryan White HIV/AIDS Program, the nation’s safety net for HIV care and treatment
  • Double-digit cuts to the budgets for the CDC (18%) and Department of Health and Human Services (12%)
  • $3.8 billion cut from the National Institutes of Health (NIH) budget
  • $226 million cut from the National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP)
  • $32 million cut from the Minority HIV/AIDS Fund
  • Eliminating funding for Title X and the Teen Pregnancy Prevention Program
  • Keeping funding levels flat for the AIDS Drug Assistance Program (ADAP), which provides FDA-approved medications to low-income people with HIVAdvocates see this appropriations bill as part of an assault on the LGBTQ+ community. The LGBTQ+ community is currently experiencing cuts to critical public health programming alongside bills that restrict access to gender affirming care, prevent discussion of LGBTQ+ people in schools, and limit participation of transgender athletes in sports.

The Ryan White HIV/AIDS Program supports nearly half the HIV population in the US

The Ryan White HIV/AIDS Program provides HIV care for low-income people living with HIV who are uninsured or underinsured. Nearly half of people living with HIV in the United States rely on the Ryan White program for some aspect of their care. The federal Ending the HIV/AIDS Epidemic (EHE) initiative is a program launched by President Donald Trump that targets funds to designated HIV/AIDS “hotspots” within the U.S. with the goal of ending the HIV epidemic by 2030. It has been a key part of his presidential legacy.

The Ryan White HIV/AIDS Program provides HIV care for low-income people living with HIV who are uninsured or underinsured.

Ryan White funding has been prioritized toward Cuyahoga County and Ohio since the mid-1990’s because HIV affects Ohioans. Within it, the Ohio HIV ADAP is truly a life-saver for people who need HIV treatment and because being on treatment and having an undetectable viral load means that people don’t pass HIV on to their partners. EHE funds have been awarded to HIV hotspots in the U.S. facing some of the highest numbers of new HIV diagnoses each year. These funds are sorely needed here. This is our community, our people: friends, family, loved ones, and neighbors.

Funding should support prevention, diagnosis, and treatment

HIV and public health funds should continue to support community-based and healthcare organizations that have the expertise to locate people at risk, provide prevention, get them diagnosed or re-engage them with care, and help them to navigate complex medical systems. Restricting access to HIV prevention, testing, and treatment will lead to increased rates of HIV in our community, greater healthcare expenses, and a sicker community overall.

This House appropriations bill can be seen as part of a broader assault on the LGBTQ+ community that includes cuts to public health programs alongside bills that restrict access to gender-affirming care, prevent discussion of LGBTQ+ people in schools, and limit participation of transgender athletes in sports.

Next the proposal will go before the full House Appropriations Committee for consideration. Ohio Representatives Marcy Kaptur (D-Toledo) and David Joyce (R- Bainbridge Twp.) serve on the full appropriations committee.

More extreme cuts to HIV funding are feared

HIV advocates are hopeful that this legislation will be blocked in the Senate but fearful that these kinds of extreme cuts are being promulgated by some members of the House as part of a larger political agenda that scapegoats people living with and vulnerable to HIV.

We have come too far in addressing HIV as a nation to undermine our progress for short-term political gain.

Meanwhile, the U.S. Senate Committee on Appropriations marked up a bipartisan version of an appropriations bill that includes $616 million for the Ending HIV Epidemic Initiative, $223 million within the CDC’s Domestic HIV/AIDS Prevention and Research programs, and protects funding for reproductive health programs such as Title X and the Teen Pregnancy Prevention Program.

We have come too far in addressing HIV as a nation to undermine our progress for short-term political gain. The Ryan White Program began under the first Bush Administration. The Ending the HIV Epidemic initiative (EHE) was founded by the Trump Administration. HIV funding is part of powerful legacies that Republicans—and all of us—should want to protect.

Julie Patterson is a member of the Cuyahoga Regional HIV Prevention and Care Planning Council and the Director of the AIDS Funding Collaborative.

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