President Trump released his budget proposal for fiscal year 2020 on Monday, and, although details are still coming to light, The AIDS Institute reports that the budget calls for $291 million in new funding for an initiative to end HIV in the United States.

But as Health GAP reports, Trump’s proposal also seeks to cut $63 million from the Housing Opportunities for Persons With AIDS (HOPWA) program and $27 million from the Housing for Persons with Disabilities program. What’s more, the budget proposal includes the highest ever cuts to global HIV programs: $1.22 billion in cuts.

Regarding the request for new funds in the 2020 budget, The AIDS Institute reports that in addition to funding existing domestic HIV programs, the budget requests:

  • $140 million in new HIV funds for the Centers for Disease Control and Prevention

  • $70 million for the Ryan White HIV/AIDS Program

  • $50 million for a new program to help community health centers through the Health Resources and Services Administration agency to provide HIV prevention drug Truvada as PrEP, or pre-exposure prophylaxis

  • $25 million for the Indian Health Service

  • $6 million for the National Institutes of Health’s regional Centers for AIDS Research.

The budget also includes $58 million to address the spread of infectious diseases—including HIV and hepatitis C—fueled by the opioid epidemic.

“While the Trump budget includes several budget cuts that we cannot support, ending HIV is something we can all support,” said Carl Schmid, deputy executive director of The AIDS Institute, in the group’s press release. “This opportunity is too important to squander. Now is the time for Congress to work together and invest the necessary resources to end HIV once and for all.”

Schmid also serves as cochair of the Presidential Advisory Council on HIV/AIDS.

The AIDS Institute’s statement acknowledges that it has not fully reviewed the details of the president’s proposed budget and that the budget reportedly calls for major cuts in programs that help support people living with HIV.

The press statement from Health Global Access Project (Health GAP) was more critical. “Just one month ago, President Trump promised during the State of the Union Address to defeat HIV in the U.S. and beyond. But the president’s budget proposal to Congress today—which threatens to gut life-saving HIV treatment and prevention programs—unmasks his lies. If implemented, Trump’s proposal would wipe out years of progress in the effort to end the AIDS pandemic.… This budget is antithetical to ending the AIDS pandemic.”

Five national HIV advocacy groups working together as the Partnership to End HIV, STDs and Hepatitis released a statement on Trump’s proposed budget. It reads in part:

“The partnership has maintained that ending the HIV epidemic is possible but will require increased resources over multiple years. We are pleased that the Administration has backed up their plan with funding requests for testing, surveillance, treatment and for the first time, to pay for Pre-Exposure Prophylaxis (PrEP), a drug that prevents HIV acquisition. But ending HIV will require robust funding for the entire federal HIV portfolio, including programs like HOPWA.

“The success of Ending the HIV Epidemic: A Plan for America not only rests on our full, thoughtful implementation of the initiative, but also on our ability to firmly elevate and enable strong, whole health policies. The Administration must examine and rescind harmful policies that are incongruent with its efforts to end HIV, including those that contribute to bias and discrimination against LGBT people, immigrants and those seeking asylum, as well as populations especially vulnerable to HIV like young gay men of color. Similarly, we will not end the epidemic without ensuring that people living with and vulnerable to HIV have access to health care, whether through Medicaid, Medicare, or private insurance.”

Groups in the partnership include AIDS United, the National Alliance of State & Territorial AIDS Directors (NASTAD), the National Coalition of STD Directors (NCSD), the National Minority AIDS Coalition (NMAC), and The AIDS Institute. You can read their full statement here.

According to Vox, the 2020 budget proposal calls for a 5 percent cut to nondefense spending while increasing funds for the military, border security and health care for veterans. Notably, the budget requests $8.6 billion to build a wall along the Mexican border while it seeks to cut the nation’s safety net. These are just a few examples pointed out by Vox:

  • An $845 billion cut to Medicare over 10 years

  • $1.5 trillion in cuts to Medicaid over 10 years

  • $25 billion in cuts to Social Security over 10 years, including cuts to disability insurance

  • A $220 billion cut to Supplemental Nutrition Assistance Program (SNAP), a.k.a., food stamps

 

Congress must approve the budget, but Democrats, who control the House, are not likely to pass a budget that funds the wall and cuts programs that help Americans in need. The deadline to pass the funding legislation in order to avoid another government shutdown is October 1, the start of the 2020 fiscal year.

You can download a copy of the 150-page budget here.

Trump announced his domestic HIV initiative—titled “Ending the HIV Epidemic: A Plan for America”—in his State of the Union address last month. Read emerging details about the plan here and how AIDS groups responded here.