Bush’s FY 2005 Budget Proposal Requests $2.8B for International AIDS, TB, Malaria Programs

President Bush on Monday submitted his $2.4 trillion fiscal year 2005 budget proposal, including funding for international and domestic HIV/AIDS programs, Reuters reports (Entous/Bohan, Reuters, 2/2). The proposal requests $2.8 billion for international HIV/AIDS, tuberculosis and malaria programs, USA Today reports (Benedetto et al, USA Today, 2/3). That amount includes $1.45 billion for the new State Department Office of the Global AIDS Coordinator, headed by Randall Tobias (Marquis, New York Times, 2/3). Under the proposed budget, the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria would be reduced from nearly $550 million in FY 2004 to $200 million in FY 2005. For FY 2004, Congress approved $2.4 billion for international AIDS, TB and malaria programs, $400 million more than Bush had requested (Kaiser Daily HIV/AIDS Report, 1/29). The FY 2005 proposal also includes $2.5 billion -- a "big chunk of ... new money" -- for the Millennium Challenge Account, an assistance program for developing nations that encourages democracy and development through economic aid, according to the Washington Post (Kessler, Washington Post, 2/3).

Reaction
With a FY 2005 request of $2.8 billion for global AIDS programs, more than $9 billion must be committed to the AIDS relief plan over the next three years to meet Bush's promise of $15 billion over five years, which he made during his 2003 State of the Union address, according to USA Today. However, the administration said that the funding request is "right on track" to meet the five-year, $15 billion goal, according to USA Today. AIDS advocates said that Bush should "put up all the money he promised," USA Today reports (USA Today, 2/3). Jamie Drummond, executive director of the debt, AIDS and trade advocacy group DATA, said that Bush's FY 2005 budget request "aggressively supports exciting new bilateral initiatives on AIDS and poverty. But it reduces funding for the multilateral Global Fund to Fight AIDS by more than half -- down to the level of France's contribution. DATA will work with the administration and Congress to fully fund the Global Fund, as well as the bilateral AIDS program and the Millennium Challenge, without cuts to other live-saving programs" (DATA release, 2/2). The International Association of Physicians in AIDS Care said in a statement that Bush and Congress should "shore up funding" for AIDS, TB and malaria programs. Although both the FY 2004 and FY 2005 budgets include "significant increases" from FY 2003 spending levels, "the request still does not meet the tremendous global need," according to the release. IAPAC President and CEO Jose Zuniga said that if the administration has concerns about the Global Fund, "they are better to articulate them, and to work with the global community to find remedies, as opposed to hastily withdrawing support from this promising institution" (IAPAC release, 2/2).

Domestic Funding
Except for "meager" increases for the Ryan White CARE Act AIDS Drug Assistance Program and the Minority HIV/AIDS Initiative, the FY 2005 budget proposal "continues to underfund the domestic and global" effort to combat HIV/AIDS, the AIDS Foundation of Chicago said in a statement. According to AFC, the FY 2005 budget includes a $35 million increase for ADAP, bringing the program's total appropriation to $783 million for the fiscal year. However, that amount is $284 million short of projected needs, according to AFC. "Thousands of HIV-positive people will be denied access to care, which will simply worsen our nation's AIDS crisis," AFC Associate Director David Munar said. AFC Executive Director Mark Ishaug asked, "How can we possibly reduce the 40,000 infections each year in this country without a greater financial commitment to proven prevention programs?" (AIDS Foundation of Chicago release, 2/2). AIDS Healthcare Foundation President Michael Weinstein said that the ADAP funding included in the FY 2005 budget proposal is "insufficient to address waiting lists, capped enrollments, and other restrictions in 15 states and increased costs and utilization in others," adding, "We call on Congress to appropriate enough funding to ensure that poor people with HIV will have the medications they need to stay alive" (AHF release, 2/2).

Prevention
"Americans living with HIV want and need more from the president," AIDS Action Executive Director Marsha Martin said, adding that budget increases for HIV/AIDS programs "have to be significant, not merely symbolic of his compassion" (AIDS Action release, 2/2). According to a statement from the Human Rights Campaign, the proposal requests $696 million for HIV/AIDS prevention programs under CDC for FY 2005, representing a "slight increase" of $1 million over FY 2004 spending but $4 million less than FY 2003 levels. "We are extremely disappointed that President Bush has proposed spending $4 million less than our nation did two years ago on critical HIV/AIDS prevention programs," HRC President Cheryl Jacques said, adding, "With approximately 40,000 new infections each year in our nation, we cannot go backward in our commitment to preventing new HIV/AIDS infections. ... We must strengthen the entire range of federal HIV/AIDS programs" (HRC release, 2/2). AIDS Project Los Angeles Executive Director Craig Thompson said, "We understand the enormous demands on this budget, especially for increases in funding for national security. But protecting the country against AIDS is also part of national security." He added, "The administration is scaling back on domestic AIDS funding just as the epidemic may be showing signs of resurgence" (APLA release, 2/2).

Abstinence Funding Doubles
The FY 2005 budget proposal also includes $270 million for abstinence education programs, Reuters reports (Kenen, Reuters, 2/2). During his State of the Union speech last month, Bush called for the doubling of federal funding for abstinence programs to fight sexually transmitted diseases. Bush said, "To encourage right choices, we must be willing to confront the dangers young people face -- even when they're difficult to talk about. Each year, about three million teenagers contract sexually transmitted diseases that can harm them, or kill them, or prevent them from ever becoming parents. In my budget, I propose a grassroots campaign to help inform families about these medical risks. We will double federal funding for abstinence programs, so schools can teach this fact of life: Abstinence for young people is the only certain way to avoid sexually transmitted diseases." He added, "Decisions children now make can affect their health and character for the rest of their lives. All of us -- parents and schools and government -- must work together to counter the negative influence of the culture and to send the right messages to our children" (Kaiser Daily HIV/AIDS Report, 1/21). The FY 2005 budget also includes funding for initiatives to promote "healthy marriages" (Reuters, 2/2).

NPR's "Morning Edition" on Tuesday reported on Bush's FY 2005 budget proposal, including funding for HIV/AIDS and Medicare. The segment includes comments from David Moore, board member for the Coalition for Health Funding and president of the Association of American Medical Colleges; Rep. John Spratt Jr. (D-S.C.); and HHS Secretary Tommy Thompson (Rovner, "Morning Edition," NPR, 2/3). The complete segment is available online in RealPlayer.