Obama's Budget Maintains Commitment to Domestic HIV/Hepatitis Programs

The AIDS Institute was pleased to see that President Barack Obama had maintained his commitment to domestic HIV and hepatitis programs. The budget proposes new initiatives to prevent HIV and treat people who are co-infected with HIV and hepatitis C.

"The budget President Obama released yesterday demonstrates his Administration's continued commitment to preventing HIV and hepatitis in the United States and providing lifesaving health care and treatment for those who cannot afford it," commented Carl Schmid, Deputy Executive Director of The AIDS Institute.� "While it contains very few program funding increases, there is a new proposed CDC initiative that allows health departments to spend a portion of their funding on pre-exposure prophylaxis (PrEP) and new Ryan White HIV/AIDS Program funding to increase care and treatment for people who are co-infected with HIV and hepatitis C virus (HCV)."

Under the President's FY2017 budget, funding for the Ryan White HIV/AIDS Program would increase by $9 million, for a total of nearly $2.3 billion. The Ryan White HIV/AIDS Program provides health care, medications, and coverage completion services to approximately 512,000 low-income, uninsured and underinsured individuals living with HIV. Funding for the Ryan White AIDS Drug Assistance Program (ADAP) would be maintained at $900 million.�

In order to increase the number of people who are on antiretroviral medications and virally suppressed, which is only 30 percent of the 1.2 million people living with HIV nationwide, it will require continued investments in the Ryan White Program. As a comparison, nearly 82 percent of Ryan White clients are virally suppressed.

The $9 million proposed increase will be dedicated to a demonstration project to increase HCV testing and care and treatment for people with HIV who are co-infected with HCV.� It is estimated that one quarter of people living with HIV are co-infected with HCV, and there now exists medications that can cure HCV, which all people living with HIV should access.

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.

"Congress rejected this proposal two years in a row, and we are surprised the Administration is resurrecting this proposal again that is opposed by so many," commented Michael Ruppal, Executive Director of The AIDS Institute and AIDS Alliance for Women, Infants, Children, Youth & Families.� Under the President's proposal, Part D funding would be redirected to Part C of the Ryan White Program.

In order to help achieve one of the goals of the National HIV/AIDS Strategy, to reduce the number of new HIV infections, which now stands at 50,000 per year, the President's budget maintains HIV funding at the Centers for Disease Control and Prevention (CDC) at $789 million. This includes $33 million for the Division of Adolescent and School Health. Funding is focused on implementing evidence-based interventions and in the communities who are at highest risk for HIV, including gay men, African Americans, and young people.

It includes $20 million of existing funding for a new innovative pilot program to increase access to pre-exposure prophylaxis (PrEP) and allow grantees, as the payer of last resort, to use a portion of funds to purchase the medication and other related healthcare services. PrEP has been shown to reduce the risk of HIV infection by up to 92 percent in people who are at high risk.

Funding for Hepatitis Prevention at the CDC would increase by $5 million, for a total of $39 million.

"While we appreciate the proposed increase, it is far from what is needed to adequately fund our Nation's hepatitis prevention efforts," commented Ruppal. CDC estimates that there are up to 5.3 million people living with hepatitis B and/or hepatitis C in the U.S. and over half are not aware of their infection.

"Resources are needed in order to improve education, surveillance and increase testing, which is the only way to link people to care and treatment, and for HCV, cure them of their virus," continued Ruppal.

Under the President's proposed budget, AIDS research at the National Institutes of Health (NIH) would be maintained at $3 billion. The Housing Opportunities for Persons with AIDS (HOPWA) program at the Department of Housing and Urban Development, which provides housing for low-income people with AIDS, would be maintained at $335 million. Additionally, the formula for distributing HOPWA money would be modernized in order to better distribute funding to areas most in need.

"We appreciate President Obama's continued focus on HIV and hepatitis in the U.S., and his commitment to making progress to ending both. Now it is up to the Congress to do its part and adequately fund these critical public health programs," concluded Schmid.

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