COMMENTARY

Congress Prioritizes Funding to End HIV in the United States

Carl Schmid

Disclosures

November 09, 2021

Carl Schmid

The leadership of the US Senate Appropriations Committee delivered welcome news recently to HIV and public health advocates with the release of their fiscal year 2022 spending bills. Like their colleagues in the House, the Senate has proposed significant funding increases to the Ending the HIV Epidemic in the U.S. initiative with at least $245 million more to focus on increased testing, prevention, treatment, and research programs. This matches the amount proposed in President Biden's budget and approved by the House.

The Ending the HIV Epidemic in the U.S. initiative, initiated by the last administration, provides enhanced funding to 57 priority jurisdictions with the greatest number of new HIV diagnoses. The initiative aims to reduce the number of new HIV infections in the United States by 75% by 2025 and 90% by 2030. Included in the efforts is an increase of $50 million for the Community Health Centers to expand access to preexposure prophylaxis (PrEP), the drugs that prevent HIV. This is on top of the existing $102 million already invested in this new initiative to expand PrEP access to people most at risk for HIV.

The Senate also prioritized increases at over $85 million more for the Ryan White HIV/AIDS Program, which provides care and treatment to low-income people living with HIV. The program focuses on ensuring that people taking antiretroviral medications adhere to their lifetime course of treatment, which brings the virus in their system to undetectable levels. Studies have demonstrated that virally suppressed people cannot transmit the virus to others. Therefore, treatment is another form of prevention.

Lawmakers also allocated additional increases for the National Institutes of Health for AIDS research, a Department of Housing and Urban Development housing program for people living with AIDS, and HIV and hepatitis prevention activities for the Indian Health Service.

If the bill passes at these levels, funding for the Ending the HIV Epidemic in the U.S. will total almost $700 million. This increased investment is pivotal to address the ongoing disparities in the ongoing HIV epidemic, 40 years after researchers first discovered this infectious disease.

The Senate Committee leadership also proposed increases to existing federal domestic HIV programs to address their growing caseloads and expenses over the years. For example, they recommended an additional $31 million for the Ryan White HIV/AIDS Program, which currently serves over 550,000 people living with HIV.

However, the House, in its funding bills, does a much better job at increasing funding to these ongoing HIV programs.

In another positive sign, the bill removes the federal funding ban on the purchase of sterile syringes and includes an increase of $17 million for the CDC's Eliminating Opioid Related Infectious Diseases program. Both will be beneficial in preventing new cases of both HIV and hepatitis.

The federal government is currently operating under a continuing resolution until December 3, and the House and Senate appropriators still must settle their differences and decide on final spending levels. But it is reassuring that Congress, in a bicameral and bipartisan fashion, is in agreement that we can and must end HIV, and are prioritizing funding increases for programs to ensure its success.

Carl Schmid is executive director of the HIV+Hepatitis Policy Institute, which promotes high-quality, affordable healthcare for people living with or at risk for HIV, hepatitis, and other serious and chronic health conditions. Follow the HIV+Hepatitis Policy Institute on Twitter: @HIVHep

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