President's Budget Funds Domestic HIV & Hepatitis Programs

AIDS Service Organizations are pleased by President Barack Obama's new budget, which continues funding for HIV and Hepatitis prevention and funds the Ryan White HIV/AIDS Program at its current level. But they are concerned by proposals to eliminate dedicated Party D funding for women and infants, allocating those funds to Part C early intervention services instead.

"The budget President Obama released demonstrates his strong commitment to ending infectious diseases by increasing funding for HIV and hepatitis prevention at the CDC and maintaining funding for lifesaving HIV health care and medications for those who cannot afford them in the United States," commented Carl Schmid, Deputy Executive Director of The AIDS Institute.

"President Obama and his Administration recognize the pivotal opportunity we now have and the federal government's role in ending AIDS in the U.S. by providing care and treatment to people with HIV/AIDS to keep them healthy and reduce new infections. By doubling funding for hepatitis prevention, he also is acknowledging the huge unmet need to combat viral hepatitis. We now urge Congress to show the same level of support as it considers federal spending priorities for the upcoming year," continued Schmid.

Under the President's budget, funding for the Ryan White HIV/AIDS Program would continue at $2.3 billion. The Ryan White HIV/AIDS Program provides health care, medications, and coverage completion services to approximately 554,000 low-income, uninsured and underinsured individuals living with HIV. This represents about 60 percent of all people diagnosed with HIV in the US. Funding for the Ryan White AIDS Drug Assistance Program (ADAP) would be maintained at $900.3 million.

According to the CDC, only 40 percent of the 1.2 million people living with HIV in the U.S. are retained in HIV care, 37 percent have been prescribed antiretroviral treatment, and 30 percent are virally suppressed. In order to improve the continuum of care for people with HIV and progress toward an AIDS-free generation, continued funding for all parts of the Ryan White Program will be necessary along with ACA implementation, and strong Medicaid and Medicare programs. According to HRSA people living with HIV who receive services under the Ryan White Program have better health care outcomes with an estimated 75 percent of Ryan White clients being virally suppressed.

The budget again proposes to eliminate dedicated funding for Part D of the Ryan White Program, which serves women, infants, children, and youth with HIV/AIDS.

"While we are pleased with the overall commitment to domestic HIV programs, we are shocked the President is again proposing to abolish the well-established system of care that has worked since 1988 in nearly eliminating perinatal infection and providing medical care and family-centered support for women, children and youth that helps ensure these populations remain in care and adherent to their medications," said Marylin Merida, President of The AIDS Institute and a Part D grantee in Florida. "Congress rejected this proposal last year and we are surprised the Administration is resurrecting it." Under the President's proposal, Part D funding would be redirected to Part C of the Ryan White Program.

In order to help achieve the goal of the National HIV/AIDS Strategy to reduce the number of new HIV infections, which now stands at over 50,000 per year, the President is proposing to increase HIV funding at the Centers for Disease Control and Prevention (CDC) by $12.6 million for a total of $799 million. The Budget focuses HIV resources on implementing evidence-based interventions and focusing on those people who are at highest risk for HIV, including gay men, African Americans and young people. The AIDS Institute is pleased that included in this increase is $6.3 million more for the Division of School and Adolescent Health and the CDC is proposing to allocate up to $8 million to assist HIV prevention grantees to increase their capacity to seek reimbursement for covered services.

Funding for Hepatitis Prevention at the CDC would be doubled to $63 million.

"This long overdue action is an acknowledgement of how historically underfunded our Nation's hepatitis prevention efforts have been," noted Michael Ruppal, Executive Director of The AIDS Institute. The CDC estimates that there are up to 5.3 million people living with hepatitis B and/or hepatitis C in the U.S. and as many as 75 percent are not aware of their infection.

"With increased resources, the CDC can improve surveillance and increase testing, which will bring more people with hepatitis into care and treatment especially now that new hepatitis C treatment options actually result in a cure," added Ruppal. But the only way the 3.2 million people living with hepatitis C can take advantage of this treatment is by knowing their status through testing.

Under the President's proposed budget, AIDS research at the National Institutes of Health (NIH) would receive an increase of $100 million for a total of $3.1 billion while the Housing Opportunities for Persons with AIDS (HOPWA) program at HUD, which provides housing for low-income people with AIDS, would receive an increase of $2 million for a total of $332 million. Additionally, the formula for distributing HOPWA money would be modernized in order to better distribute funding to areas most in need.

The President is requesting that Congress allow federal funding of syringe exchange programs, a scientifically proven HIV and hepatitis prevention service, and proposes to eliminate funding for failed abstinence-only until marriage programs.

"The President has put forth a budget that replaces some of the harmful sequestration cuts that domestic HIV/AIDS programs have experienced in recent years. He upholds his commitment to making progress to ending AIDS and ramps up our Nation's response to viral hepatitis. Now it is up to the Congress to do its part and adequately fund these critical public health programs, including those that prevent HIV and hepatitis and provide care and treatment for people living with HIV and hepatitis. This includes implementing the ACA and ensuring both Medicaid and Medicare remain strong," Ruppal concluded.

The AIDS Institute is a national nonprofit organization that promotes action for social change through public policy research, advocacy and education.