Congress has outlined a framework for enacting major cuts to the federal budget over the next decade that could have far reaching consequences for people living with, and at risk for, HIV infection here and abroad. We urge members of Congress to seriously consider the human impact of the funding and policy decisions that they will be making in the coming months.

This year remarkable scientific advances have offered a clear path to make real headway against HIV disease in the U.S. and around the world. We now have the tools to end the pandemic but are stymied in our ability to apply them on the frontlines where they are urgently needed. We know that access to HIV care and treatment not only saves the life of the individual with HIV infection but also reduces HIV transmission by 96 percent. Yet only 50 percent of people with HIV in the U.S have reliable access to HIV treatment, and as many as 15 million people in developing countries wait for access to lifesaving therapy.

As funding decisions are made that will chart our country's course for many years to come, we urge Congress to prioritize investments critical to individual and public health. We must take an equitable and balanced approach to deficit reduction that incorporates revenue generation, does not disproportionately rely on non-security discretionary spending cuts, supports biomedical research, protects vulnerable populations, such as people with HIV disease, and maintains a strong federal commitment to the Medicaid and Medicare programs.

A retreat in the battle against HIV disease will be costly whether measured in lives lost or federal dollars. As the deficit reduction process moves forward, we urge members of Congress to consider the impact of their decisions on people with HIV disease and other medically vulnerable populations.

Kathleen Squires, M.D., is HIVMA chair. Jim Raper, D.S.N., C.R.N.P., J.D., F.A.A.N.P., F.A.A.N., is RWMPC co-chair.