In a positive move in the fight against HIV/AIDS, the spending package Congress unveiled this week more-or-less meets President Trump’s request for an additional $300 million for his plan on the domestic front, but also rejects his proposed draconian cuts for research and global programs.
House and Senate appropriators announced a bipartisan agreement on Monday to keep the government in operation for fiscal year 2020. The deal was reached days before a government shutdown would occur without additional funds and with limited time before Congress is set to adjourn for the holidays.
With respect to the additional $300 million Trump sought in February for his administration’s plan to beat HIV by 2030, Congress just about the hit the request on the nose.
The minibus would provide the Centers for Disease Control & Prevention with an additional $140 million to implement the plan as requested by the administration, as well as $70 million for the Ryan White Health Care Act and $50 million for the Health Resources & Services Administration.
Carl Schmid, deputy director of the AIDS Institute and co-chair of the Presidential Advisory Council on HIV/AIDS, hailed the agreement to appropriate the plan as “very good news.”
“It provides the necessary foundational funding to begin the work of the Ending the HIV Epidemic initiative as laid out by the administration,” Schmid said. “But, in order for it to be successful, HIV prevention and treatment efforts will have to be scaled up dramatically, which will require both the administration and the Congress to support even greater funding increases in the future.”
Jennifer Kates, director of global health and HIV Policy at the Kaiser Family Foundation, said the funds are a good start, but additional money is needed in subsequent years to keep the plan going.
“As a first year installment, it represents a significant increase for these programs and should help to jump start the effort,” Kates said. “But it will be important to see what future funding requests are made, to fully reach targets.”
The administration had also sought an additional $25 million as part of the HIV/AIDS plan for Indian Health Services. However, that money wasn’t included as part of the spending package, according to the AIDS Institute.
Schmid said that omission is “not a good start by the Congress for ramping up Hep C and HIV efforts in Indian country.”
Trump had requested the additional funds for HIV/AIDS programs as part of the initiative to beat HIV he announced at the State of the Union address this year. The plan, which fell on skeptical ears to those familiar with his anti-LGBTQ record, seeks to target specific places with high rates of new infections with prevention and treatment services, including free access to PrEP.
Under the plan, which targets 48 counties in the United States, D.C., and San Juan, Puerto Rico, as well as seven states where the epidemic is mostly in rural areas, the goal is to reduce new HIV diagnoses by 75 percent within five years, and by 90 percent within 10 years.
At the same time Congress approved an increase in funds to combat HIV/AIDS, lawmakers rejected proposed cuts in other areas, including research and the global fight.
For starters, the spending package rejects the draconian $6 billion Trump sought for funding at the National Institutes for Health, including a $424 million cut in HIV/AIDS research. Instead, appropriations increased funds for the agency by $2.6 billion, including $25 million for HIV research.
Benjamin Corb, a spokesperson for the American Society for Biochemistry & Molecular Biology, called the package “a praiseworthy piece of bipartisan legislation” based in part of the additional funds for the National Institutes for Health.
“As the details of spending plan come into focus, lawmakers should be commended for their commitment to investments in scientific research that ultimately will lead to breakthroughs that will improve the quality of life and well-being of not only Americans but also of populations around the globe,” Corb said.
According to Corb, the minibus legislation would make FY-20 the fifth year in a row of multibillion-dollar increases for the National Institutes for Health’s budget, helping it grow to a record $41.7 billion.
In terms of funds for global programs, the agreement also rejects the major cuts proposed by the Trump administration.
PEPFAR funding at the State Department matches FY-19 levels, at $4.37 billion, rejecting a $1 billion cut Trump proposed in his budget. Additionally, the deal includes $1.56 billion for the Global Fund, which is the first installment of a new three year pledge, and reaffirms the U.S. share of 33 percent of Global Fund contributions.
Votes in both chambers of Congress are expected this week. A senior administration official told the Washington Blade after the spending package was made public President Trump is expected to sign the legislation.