On May 28, President Joe Biden unveiled his $6 trillion budget for fiscal year 2022. It commits $670 million to battling HIV/AIDS domestically, a $267 million increase from the previous year. Federal HIV funding will go to the Department of Health and Human Services (HHS) and the initiative titled “Ending the HIV Epidemic: A Plan for America.”
The budget increases funding for Ryan White HIV/AIDS Programs by $46 million and requests $450 million for the Housing Opportunities for Persons with HIV/AIDS (HOPWA). That’s a $20 million increase but $150 million less than the amount requested, according to press releases from The AIDS Institute and the HIV+Hep Policy Institute.
Commits to Ending the HIV/AIDS Epidemic. To help accelerate and strengthen efforts to end the HIV/AIDS epidemic in the United States, the Budget includes $670 million within HHS to help aggressively reduce new HIV cases while increasing access to treatment, expanding the use of pre-exposure prophylaxis, also known as PrEP, and ensuring equitable access to services and supports.
Makes a Major Investment to Help End the Opioid Epidemic. The opioid epidemic has shattered families, claimed lives, and ravaged communities across the nation—and the COVID-19 pandemic has only deepened this crisis. That is why the Budget includes a historic investment of $10.7 billion in discretionary funding in HHS, an increase of $3.9 billion over the 2021 enacted level, to support research, prevention, treatment and recovery support services, with targeted investments to support populations with unique needs, including Native Americans, older Americans, and rural populations. The Budget also includes $621 million specific to the Department of Veterans Affairs’ (VA’s) Opioid Prevention and Treatment programs, including programs in support of the Jason Simcakoski Memorial and Promise Act.
That section of the budget also addresses gun violence (a $2.1 billion investment) and includes the launch of a federal research arm that would focus on health-related breakthroughs in areas such as cancer, diabetes and Alzheimer’s. The budget sets aside $6.5 billion for the Advanced Research Projects Agency for Health, which Biden discussed in April during his first address to both chambers of Congress. For more, see “President Biden Proposes New Agency for Medical Breakthroughs.”
Although the @POTUS proposed a modest increase in funding for the Infectious Disease and Opioid Epidemic Program, we are disappointed that the administration failed to confront the growing viral hepatitis crisis. pic.twitter.com/UGjQOr8xkU— NVHR (@NVHR1) May 28, 2021
Regarding funding for hepatitis, the budget includes $19.5 million for the Infectious Diseases and Opioids Epidemic Program and only $39.5 million for the Department of Viral Hepatitis, according to the National Viral Hepatitis Roundtable. Daniel Raymond, the group’s director of policy, released the following statement:
“Recent data from the U.S. Centers for Disease Control and Prevention (CDC) shows that viral hepatitis cases are increasing, and action is needed now to address the growing crisis. It is disappointing that the Biden administration has failed to appropriately increase funding for the Division of Viral Hepatitis. The modest increase in funding for the Infectious Diseases and Opioid Epidemic Program is a positive advancement, but it is not enough to offset years of underfunding for viral hepatitis amid a worsening epidemic. By failing to provide adequate funding to combat viral hepatitis, patients will continue facing harmful barriers to care, and efforts to eliminate viral hepatitis will continue lagging behind global goals.
“We urge Congress to fully fund the Division of Viral Hepatitis by allocating at least $134 million to improve viral hepatitis testing and treatment, and to strengthen the public health infrastructure. In addition, we urge the full funding of $120 million for the Infectious Diseases and Opioid Epidemic Program to fully prevent and respond to opioid-related infectious disease outbreaks, including hepatitis C.”
Indeed, Biden’s budget for hepatitis is much less than what advocates requested. “If we are to implement the national strategic plan to eliminate hepatitis and do it by 2030, as the president supports, we are going to need a significant commitment of resources and the leadership to make it happen,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, in a press release. “Unfortunately, that is not going to happen with this budget proposal.”
“Public health departments have made herculean efforts to battle COVID over the past year,” said Nick Armstrong, The AIDS Institute’s manager of advocacy and government affairs, in a statement about the 2022 budget. “But now it is time to reinvigorate neglected efforts to end the HIV, opioid and viral hepatitis epidemics. Congress must go above and beyond what the President has proposed to bolster our critical public health infrastructure to protect Americans against infectious disease.”
As CNN points out, Biden’s $6 trillion budget is a starting point for negotiations with Congress. Overall, his proposed budget marks a serious increase in federal spending to boost the economy, invest in infrastructure and secure health care and financial security for more Americans.
Biden’s administration released an outline of the 2022 budget in April. At that time, HIV advocates noted that the funding to fight HIV globally fell short and that it “won’t put the world on track to end AIDS.” For more, read “Biden’s Budget Request Increases HIV Funds by $267M.”
Need a primer on “Ending the HIV Epidemic: A Plan for America”? Launched in 2019, the 10-year federal initiative aims to lower new HIV rates 75% by 2025 and 90% by 2030. This would amount to fewer than 3,000 HIV cases a year. “Reducing new infections to this level,” according to the initiative, “would essentially mean that HIV transmissions would be rare and meet the definition of ending the epidemic.”
The strategy for reaching these benchmarks involves investing federal funding and resources in 57 key jurisdictions. This translates to the 48 counties plus Washington, DC, and San Juan, Puerto Rico, that together account for 50% of new HIV cases, plus seven rural states with high HIV burdens: Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma and South Carolina.
What’s more, the plan focuses on four pillars of action:
- Diagnose all individuals with HIV as early as possible after infection;
- Treat HIV rapidly and effectively to achieve long-term viral suppression;
- Prevent at-risk individuals from becoming HIV positive, including the use of pre-exposure prophylaxis (PrEP); and
- Rapidly detect and respond to emerging HIV clusters to further reduce new transmissions.
How’s your state doing with regard to the nation’s plan to end HIV? Find out with the interactive AHEAD dashboard. To learn more about the “Ending the HIV Epidemic” initiative, read an overview at HIV.gov and visit the official webpage at HRSA.org. For a related POZ article, see “Plans to End the HIV Epidemic at Home and Abroad.”