Devastating Cuts to HIV Program

The new fiscal year will start on Oct. 1, but Congress is unlikely to pass a new budget, instead relying on continuing resolutions to fund the government. But the new fiscal year represents more than an impending deadline: In the upcoming days and weeks as Congress debates the budget, the fates of one million people who are HIV positive hangs in the balance.

The U.S. contributes to the fight against global HIV through two main funding mechanisms: the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. While PEPFAR is a bilateral program in which the U.S. partners directly with recipient countries, the Global Fund is a multilateral mechanism that relies on contributions from multiple donor countries. The U.S. contribution to the Global Fund has been limited this year because pledges from other donor countries fell $300 million short of the U.S. pledge in President Obama’s 2015 budget. By law, the U.S. is only able to contribute one-third of the money in the Global Fund, and as the largest contributor, the U.S. pledge is largely determined by what the other donor countries contribute.

As the successes of science and medicine point ambitiously towards the end of the HIV/AIDS pandemic, American political will is faltering at this crucial juncture. In July, the Senate voted to cut $300 million from the global AIDS budget—a massive blow that comes on top of an aggregate cut to PEPFAR of $600 million since 2011. With an estimated average cost of $200 per patient for antiretroviral therapy, a loss of $300 million to fighting AIDS globally would result in more than 1 million people without lifesaving treatment.

The House of Representatives previously passed a version of the budget that allocated the unmatched $300 million from the Global Fund to PEPFAR; however, in July, the Senate passed a budget that completely scrapped the $300 million from the global AIDS budget. While science clearly shows that the possibility of achieving an “AIDS-Free Generation” is real, the political will to take steps toward it seems to have withered in America.

It is imperative that Congress revive the fight against the AIDS pandemic by putting unmatched funds from the Global Fund toward PEPFAR to prevent a further $300 million cut. Specifically, we call on Massachusetts Senators Elizabeth Warren and Ed Markey to take leadership in these budget negotiations and to ensure that this cut does not become reality.

The immediate task could not be simpler: Keep steady U.S. funding for fighting global HIV/AIDS by allocating the $300 million that will be lost from the Global Fund to PEPFAR.

PEPFAR is one of the most effective programs run by the U.S. government. Prior to the creation of PEPFAR under President Bush in 2003, only 50,000 people infected with HIV in Sub-Saharan Africa were receiving treatment. The program currently provides lifesaving antiretroviral therapy to 6.7 million people worldwide Research proves that people on antiretroviral therapy are significantly less likely to transmit the virus to someone else Treatment is prevention.

PEPFAR also supports HIV testing and counseling for more than 12.8 million pregnant women, and it provided care and support to over 12 million people. UNAIDS (the United Nations AIDS Program) has recently declared that with strong support, it is possible to end the AIDS epidemic by 2030.

As the budget process proceeds, it looks more likely that Congress will continue the trend of passing a continuing resolution in lieu of a new budget. In this situation, no funding has to be lost as long as legislators add a provision to ensure that unmatched Global Fund money is moved to PEPFAR instead of scrapped altogether. It would be a tragedy for life saving funds to be lost because of an oversight or simple lack of will.

Losing these funds entirely would be a death sentence for some of the world’s most vulnerable populations, and a major setback in realizing an AIDS-free generation. Scientific advancements beg resolute political leadership—now.

Chad Benoit ’16 is a social studies concentrator in Leverett House. Maria Smith ’16 is an economics concentrator in Dunster House.