President’s Fiscal Year 2003 Budget Plan Includes ‘Flat’ Funding for HIV Prevention Programs, Ryan White CARE Act

Although President Bush's budget proposal for fiscal year 2003 calls for a "major increase" in spending to prevent bioterrorism, funding will remain "flat" for a number of health programs, including HIV prevention projects and the Ryan White CARE Act, the New York Times reports (Stolberg, New York Times, 2/5). Bush's budget plan, unveiled yesterday, would allocate $12.9 billion to HHS to fight HIV/AIDS in the United States and abroad, an overall spending increase of 8% over the current fiscal year. This funding would be broken down as follows:

• Vaccine and treatment research: NIH would receive $2.8 billion for research on HIV/AIDS, a 10% increase from current funding levels. Included in this allocation is $422 million for AIDS vaccine research, a 24% increase over the previous year's funding.
• HIV prevention: CDC would receive $939 million to fund HIV prevention programs, "about the same" amount that was allocated this year. Of this funding, $795 million would go toward domestic prevention programs and $144 million would go toward foreign prevention programs.
• Care for HIV-positive people: Funding levels for the Ryan White CARE Act will remain the same as last year at $1.9 billion. Approximately $639 million of Ryan White funding would go toward state AIDS Drug Assistance Programs.
• Worldwide efforts: HHS will dedicate $100 million this year to the Global Fund to Fight AIDS, Tuberculosis and Malaria, bringing the United States to its promised two-year allocation of $200 million. USAID also plans to donate $100 million to fight HIV/AIDS worldwide in FY 2003.
• AIDS among minorities: To help reduce the "disproportionate" HIV infection levels among minorities, the budget sets aside $410 million for programs targeted specifically at halting the spread of HIV in minority communities. The allocation includes $105 million to expand treatment and social services at the Substance Abuse and Mental Health Services Administration and $50 million for the Minorities Community Fund. Minority programs will also receive $124 million under the Ryan White program and $116 million for community-based prevention programs at the CDC. The HHS release does not indicate whether this is an increase or decrease in this funding (HHS release, 2/4).
• Housing: The Department of Housing and Urban Development will receive $292 million for the Housing Opportunities for Persons with AIDS program. This allocation is $15 million greater than last year's allotment (HUD release, 2/4).

AIDS Groups 'Disappointed'
AIDS and health groups criticized other aspects of the plan, including its failure to increase funding for HIV prevention programs and the Ryan White CARE Act. The opinions of some organizations are listed below:

• AIDS Action: Marsha Martin, executive director of AIDS Action, stated that Bush's budget proposal sends "a clear message that our nation's public health has fallen off the administration's radar screen," adding, "Homeland security also means investing in prevention and care services for people at risk [for] and living with HIV" (New York Times, 2/5).
• American Public Health Association: APHA states in a release that the president's budget only gives "lukewarm support" to domestic and international HIV/AIDS programs. "[W]e are ... facing an increase in domestic [AIDS] cases for the first time in eight years, yet the president's budget freezes spending at last year's level. More needs to be done to prevent the spread of HIV/AIDS and to provide care for those already infected," the release states (APHA release, 2/4).
• Human Rights Campaign: HRC "expressed disappointment" with Bush's budget proposal, stating in a release that the spending plan "shortchange[s]" the Ryan White CARE Act and HIV prevention programs. "There is a greater demand for care than ever, yet we are not providing the proper resources. People will be hurt if the budget is not adequately funded to meet the growing need," HRC Political Director Winnie Stachelberg said, adding that the budget cuts will most likely affect minorities. However, HRC "applauded" the budget's call for increased spending for the HOPWA program and AIDS research at NIH (HRC release, 2/4).
• Los Angeles Gay & Lesbian Center: The president's budget proposal is "not prioritizing HIV/AIDS programs," an L.A. Gay & Lesbian Center release states. "On World AIDS Day, President Bush promised to provide the necessary resources to combat the AIDS pandemic and ensure that people living with HIV and AIDS would receive effective care and treatment. Did the president only mean those words on World AIDS Day? Where is it in his budget?" L.A. Gay & Lesbian Center Executive Director Gwenn Baldwin asked. The center adds in its release that the "lack of adequate federal funding" for ADAPs has left states "scrambling" to meet treatment demand. The release also states that the president's $200 million allocation to the Global Fund "still falls well below the estimated need" for the fund (L.A. Gay & Lesbian Center release, 2/4).
• Pangaea Global AIDS Foundation: Eric Goosby, president and CEO of the Pangaea Global AIDS Foundation, an affiliate of the San Francisco AIDS Foundation, said, "The amount requested by the administration for the Global Fund is woefully inadequate. Billions of dollars -- not millions -- are needed to address this global crisis, and as the world's richest nation, it is incumbent upon us to lead the way" (SFAF release, 2/4).
• San Francisco AIDS Foundation: SFAF expressed "deep disappointment" with the president's proposal for HIV/AIDS funding, stating that the budget plan "underfunds critical programs that are meant to address the HIV pandemic both domestically and internationally," according to a release. SFAF Director of Public Policy Fred Dillon said, "This budget sends the wrong message to people living with HIV/AIDS in the United States and around the world. With unprecedented increases in the budget for military and homeland security spending, this administration has proven that billions of dollars are available to fight present and imminent threats to our nation. HIV/AIDS is also a global threat and deserves appropriate commitment and attention from this administration" (SFAF release, 2/4).