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National HIV/AIDS Strategy Supported in Priorities Reflected in President's FY2012 Budget

By Howard K. Koh, M.D., M.P.H.

February 24, 2011

National HIV/AIDS Strategy Supported in Priorities Reflected in President's FY2012 Budget

At a White House event on Monday, Mr. Jeffrey Crowley, Director of the Office of National AIDS Policy (ONAP), released the operational plans prepared by the six Federal agencies tasked with lead responsibility for implementing the National HIV/AIDS Strategy (NHAS). During the event, he and I also discussed some of the important HIV/AIDS related elements of the President's FY2012 budget that was also released Monday. As complement to the review of domestic HIV/AIDS funding contained in the President's FY 2012 budget that Mr. Crowley shared last week, I wanted to highlight several features of the Department of Health and Human Services (HHS) FY2012 budget that will support implementation of the Strategy.

The President's budget invests approximately $3.5 billion for domestic HIV/AIDS activities across HHS to expand access to affordable health care and prevention services and align activities with the Strategy. The budget also incorporates a number of policy changes designed to support and accelerate our efforts to achieve the goals of the NHAS. Below are summaries of three of the most significant ones.

  1. Strategy Implementation Funds -- The Budget authorizes the Secretary of HHS to transfer 1% of domestic discretionary HIV/AIDS program funding to support the implementation of the NHAS through new and innovative cross-agency collaborations. This will establish a pool of approximately $60 million that will be administered by my office, the Office of the Assistant Secretary for Health (OASH). HHS leadership will identify, pursue, and leverage high-impact collaborative activities that can most benefit from the strengths and capacities of the different agencies and offices working together in new ways to address issues such as combination prevention, interventions for high-risk and underserved populations, improving linkages to care; and increasing our capacity to monitor implementation of the Strategy.
  2. Refocusing Minority HIV/AIDS Initiative (MAI) Fund -- This component of the MAI is administered by the HHS Secretary, through OASH, and totals approximately $53 million in the 2012 budget. To ensure that these funds are having the biggest impact on reducing the disproportionate impact of HIV in minority communities and are responsive to the highest risk populations, we will develop a strategic approach for using the funds to complement other public and private efforts consistent with the goals of the NHAS. Priority consideration will go to funding activities that have been previously evaluated and demonstrated to have high impact. For example, resources could be used to focus on reducing the disparate infection rates of HIV among women of color or to support interventions to address high rates of undiagnosed HIV infection among Black and Latino gay youth.
  3. Shifting Prevention Resources from Low to High Impact Activities -- In pursuit of the Strategy's call for us to redirect resources to the most effective programs, CDC will redirect approximately $51 million from less effective and efficient programs to programs that are better aligned with the goals of the Strategy. This will be achieved by:

    a. Placing greater emphasis on effective interventions for people living with HIV including those addressing linkage to and maintenance in medical care; adherence to antiretroviral treatment; and interventions that reduce transmission risk placing greater emphasis on effective community-level, structural, and single session interventions and public health strategies;

    b. De-emphasizing intensive individual and small group interventions for at-risk populations that are difficult to bring to scale; and

    c. Within CDC's HIV prevention portfolio, combining biomedical, behavioral, and structural approaches and integrating them through program activities and demonstration projects.

As demonstrated by the President's budget, at the Federal level we're doing the hard work of changing how we operate in response to this epidemic. The President's budget reflects these changes, directing resources toward clear priorities consistent with the Strategy, and will support us in advancing efforts toward the Strategy's goals.

Read more about the President's budget and the provisions related to HIV/AIDS.

Howard K. Koh, M.D., M.P.H is the Assistant Secretary for Health at the U.S. Department of Health and Human Services.




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