July 22, 2013
Fiscal Year (FY) 2013 sequestration and budget cuts threatened HIV research, prevention, and care even though lower HIV funding would result in "small deficit reduction benefits," according to Kali Lindsey, director of legislative and public affairs for the National Minority AIDS Council. amfAR: The Foundation for AIDS Research estimated that sequestration would eliminate AIDS Drug Assistance Program (ADAP) funding for more than 15,000 HIV-infected people, cause loss of housing for 5,000 households, eliminate 460 research grants, and cut HIV prevention services. Funding cuts for CDC's HIV prevention programs would total $64.7 million, with $27.6 million less for HIV prevention and $2.4 million less for HIV adolescent and school health programs. The AIDS Institute estimated that sequestration and budget cuts have reduced federal government domestic HIV/AIDS spending by $375 million.
In response to ADAP funding shortfalls, the Obama Administration transferred $35 million in emergency funding to cover medications for HIV patients in 2013. On July 11, the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies passed an FY14 spending bill that would increase Ryan White HIV/AIDS program spending by $51 million more than FY13 levels, provide an additional $47 million for ADAP, increase National Institutes of Health research funding, and maintain CDC HIV prevention funding at $755 million. Only four percent of domestic HIV spending targeted prevention.
In contrast, the U.S. House of Representative's budget recommended an additional $1.1 billion in funding cuts for domestic HIV/AIDS response. It was not clear how the Senate and House of Representatives would resolve the difference in their budget reduction approaches.
HIV advocates outlined research breakthroughs that would not have been possible without federal funding: progress in HIV vaccines, pre-exposure prophylaxis, development of microbicides, treatment as prevention, prevention of vertical transmission, and research into voluntary circumcision for prevention. In 2012, the United States supplied 70 percent of HIV prevention research worldwide.