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Positive Policy

Continuing Our Commitment to Prioritizing HIV/AIDS

By Jeffrey S. Crowley, M.P.H.

August 20, 2010

This article was cross-posted from the AIDS.gov blog. Jeffrey S. Crowley, M.P.H., is director of the Office of National AIDS Policy. (Cross-posted from the Office of National AIDS Policy Blog.)

Today, the Obama Administration is taking new action to prioritize support for Federal HIV/AIDS prevention and care programs. We are sending to the Congress an amendment to the President's FY 2011 budget request to increase HIV/AIDS funding by $65 million. This is comprised of a requested $35 million increase for HIV prevention in order to continue exciting new HIV prevention activities described below to support the National HIV/AIDS Strategy and a $30 million increase for State AIDS drug assistance programs to respond to the ongoing crisis States are facing in operating these essential programs. These resources come on top of proposed increases for HIV prevention and care at the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) that were included in the original budget submission. Ultimately, the Congress will enact a budget that will establish Federal funding levels for the fiscal year that begins on October 1st.

Last month, the Obama Administration released the National HIV/AIDS Strategy. This was the product of a robust dialogue with the HIV community and other members of the public and identifies a small set of priority action steps for moving the Nation forward in responding to the domestic HIV epidemic. On the evening of July 13th, the President hosted a reception for the HIV community at the White House where he spoke about the Strategy and his commitment to fighting HIV/AIDS. He said the following,

Now, I know that this strategy comes at a difficult time for Americans living with HIV/AIDS, because we've got cash-strapped States who are being forced to cut back on essentials, including assistance for AIDS drugs. I know the need is great. And that's why we've increased Federal assistance each year that I've been in office, providing an emergency supplement this year to help people get the drugs they need, even as we pursue a national strategy that focuses on three central goals.

We recognize that times are tough and there are significant challenges faced by people living with HIV/AIDS and other Americans that must be addressed. The Federal government cannot tackle these problems alone, but we can do our part.

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In the current fiscal year, FY2010, Congress appropriated funding of $835 million for the AIDS Drug Assistance Program (ADAP). In July, due to the serious shortfalls in State ADAPs resulting largely from State cutbacks, HHS Secretary Sebelius took an emergency step by re-allocating $25 million for ADAPs for a total of $860 million. Our FY 2011 budget request had included increased ADAP funding, but today's proposed $30 million increase would continue funding in FY 2011 for the emergency supplemental funds announced last month. If the Congress follows our recommendation, Federal funding for ADAPs would rise to $885 million next year -- a $50 million increase from the level appropriated by Congress for this year. This action, alone, will not resolve the challenges faced by ADAPs. We need States to continue to prioritize their funding for ADAPs even in these difficult times, and we need our pharmaceutical company partners, businesses, foundations, and community-based organizations to do their part as well.

On the issue of HIV prevention, Secretary Sebelius announced new investments in HIV prevention when we released the National HIV/AIDS Strategy. To ensure that these initiatives continue, we are requesting $35 million in additional funds for next year. In FY 2010, these resources are supporting:

  • Comprehensive HIV prevention ($11.6 million): This will fund the implementation and evaluation of effective combinations of behavioral and biomedical prevention interventions in the highest prevalence jurisdictions. These jurisdictions will compete to scale-up effective comprehensive approaches in subsequent years. The funding opportunity announcement (FOA) for this initiative is available on Grants.gov. Be sure to type "CDC-RFA-PS10-10181" as the Funding Opportunity Number to download the FOA.
  • Increased testing and linkage to care ($4.4 million): Building on CDC's new Expanded Testing Initiative, these funds will ensure that resources are provided to support targeted testing and linkage services for high prevalence communities, including Black, Latino, injection drug using (IDU), and gay male communities.
  • Expanded HIV surveillance ($5.5 million): This will support work with jurisdictions to ensure that all jurisdictions report CD4 cell counts and viral loads to the public health surveillance system, enable jurisdictions to estimate community viral load, and take other steps to improve the surveillance system.
  • Consultation, evaluation, technical support and annual MSM survey ($6.5 million): These resources will support evaluation and monitoring, assisting with developing and implementing new activities and conducting an annual internet survey for men who have sex with men (MSM) to collect behavioral, HIV testing, and other information.
  • HIV, viral hepatitis, STD prevention and sexual health promotion with Tribal Communities ($1 million): CDC will partner with the Indian Health Service (IHS) to work with Tribal communities on prevention and health promotion.

These activities reflect a new direction that we believe will have a greater impact at lowering the number of new HIV infections in the United States.

Today's announcement demonstrates that we are committed to implementing the National HIV/AIDS Strategy and ensuring that necessary investments in prevention and care services for people living with HIV continue.

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