February 17, 2011
San Francisco, Calif. -- Project Inform has praised President Obama for proposing increased funding for key care, treatment, testing, and prevention programs aligned with the goals of his National HIV/AIDS Strategy (NHAS), and a significant increase in programs to fight the nation's viral hepatitis epidemic. While the proposed budget for 2012 falls short of what will eventually be needed to fully contain the HIV/AIDS epidemic, it reflects the President's insistence upon supporting a more strategic, better planned and coordinated approach to the epidemic with greater accountability for results.
"President Obama has shown exemplary leadership on HIV," said Dana Van Gorder, Project Inform's Executive Director. "Through his National HIV/AIDS Strategy, he has supported significant and much needed new approaches to controlling the epidemic. In a difficult budget environment, he has increased funding for HIV/AIDS programs to set change in motion. But importantly, he has insisted upon greater accountability by directing that existing funding be used to greater effect. Next to his all-important leadership on national health care reform, which represents the most important tool we have to end the HIV epidemic, the President's 2012 budget represents our greatest hope for new strides against HIV."
The President is proposing an $80 million increase to the AIDS Drug Assistance Program (ADAP), which provides access to lifesaving treatment for low-income people with HIV who are uninsured or underinsured. ADAP is currently in a fiscal crisis and many states have been forced to create waiting lists or other cost-containment strategies that have limited treatment access. $60 million of the President's proposed increase will be targeted to these states to improve their ability to serve people in need. The budget also proposes a $5 million increase to expand patient care in outpatient clinics and a $15 million increase to the Minority AIDS Initiative.
The 2012 proposal provides flexibility to both the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) to redirect HIV funding to better meet the goals of the NHAS. The budget authorizes HHS to direct 1 percent of its HIV funding to support innovative approaches to increase testing and linkage to care as a means of improving the health outcomes and preventing new infections. Project Inform has advocated heavily for this initiative.
The budget also redirects $51 million within the CDC's HIV/AIDS budget authority from less effective prevention activities to biomedical and prevention with positives interventions in high-risk populations, as outlined in the NHAS. It proposes funding for demonstration projects to further assess the potential for Pre-Exposure Prophylaxis (PrEP) to reduce new HIV cases among high-risk gay and bisexual men. Recent data showed that PrEP, a strategy in which high-risk HIV negative individuals take an HIV antiretroviral medication daily along with behavioral prevention counseling, achieved a 44 percent reduction in new HIV infections among men who took it half the time and a 75 percent reduction among men who took it 90 percent of the time or more. Project Inform has advocated for demonstration projects to help prevention agencies identify the most effective way to deliver this promising prevention intervention.
Finally, the budget proposes a $5 million, or 25% increase for viral hepatitis programs at the CDC, which will greatly enhance states' abilities to respond to the growing hepatitis B and C epidemics, which affect approximately 6 million Americans.
While Project Inform applauds the President's Fiscal Year 2012 budget, we are greatly concerned about efforts by many in the House of Representatives to make drastic cuts to discretionary programs in the final FY 2011 spending bill, which is currently under debate. These cuts could result in severe reductions in HIV/AIDS and viral hepatitis programs and threaten to undermine viral health care reform implementation efforts. Project Inform will work with our advocacy partners to defeat these harmful cuts while urging Congress to support and expand the President's 2012 HIV and viral hepatitis budget.