Modest increases in some areas offset by cuts in Medicaid, HIV research
AIDS activists across the country said that despite proposed increases in some areas of AIDS spending, President’s Bush’s 2007 AIDS budget still falls short because of cuts and flat funding in other areas.
The president unveiled his $2.77 trillion budget proposal on Monday.
The budget is intended to reduce lingering budget deficits, with almost one-third of the cuts in education. But many health programs are also targeted, while the president is asking for large increases in defense spending.
The American Foundation for AIDS Research criticized the Bush budget proposal’s call for slashing AIDS research funds by about $15 million.
Judy Auerbach, AmFAR’s vice president for public policy and program development, said the proposed budget has “grave implications for scientific research to combat HIV and AIDS.”
“Bluntly put, this level of funding means less scientific research will get done by fewer scientists, with fewer new minds entering the field,” Auerbach said.
Auerbach said that funding for the National Institutes of Health, including its AIDS research programs, has failed to keep up with the Biomedical Research and Development Price Index, harming the success rates of approved grants that receive funding and “leaving very little money to fund promising new research.”
“Given the complexity of HIV and AIDS and the devastation it continues to cause around the world, we cannot afford to discourage new scientists with new ideas from working in this field,” Auerbach said.
The president’s budget proposal includes $188 million in new money earmarked to combat the global spread of HIV, particularly in minority communities. The goal for these funds is to test 3 million more people for HIV and to help people on state waiting lists for HIV treatment, according to Mike Leavitt, secretary of Health and Human Services.
The new initiative would fund state projects primarily through faith-based organizations and black churches to increase HIV testing, with $25 million targeted to the African-American communities, according to Jim Towey, director of the White House Office of Faith-based and Community Initiatives.
The budget also has a goal of treating 900,000 more people with HIV in Africa and the Caribbean by 2008.
But activists said the small reduction in Medicaid spending in the president’s proposal, on top of a significant reduction in 2006, would hurt many AIDS patients.
“More people living with HIV get their health care from Medicaid than any other federal programs,” said Terje Anderson, executive director of the National Association of People With AIDS.
“Cuts to Medicaid and increase user costs for Medicare recipients will have an enormous ripple effect on HIV/AIDS care and treatment programs designed to serve as the payer of last resort,” Anderson said.
Anderson also said he is concerned that new domestic funding covers only testing and medication, not HIV prevention programs.
“HIV testing alone is not a substitute for a comprehensive, scientifically-based national prevention strategy. And you can’t get into care when you test positive if the test counselor cannot link you to an HIV specialist,” Anderson said.
The president’s proposed budget calls for the Ryan White Comprehensive AIDS Resource Emergency Care Act to be reauthorized, with funds focusing on providing life-extending care, including anti-retroviral medications as well as targeting it more toward minority communities.
But Mark Cloutier, executive director of the San Francisco AIDS Foundation, said that while the president’s targeted funding initiatives are welcomed, they are insufficient.
“The flat or reduced funding levels provided over the last five years for the Ryan White CARE Act, combined with rising caseloads and medical inflation, have resulted in reduced access to care throughout the country,” Cloutier said.
The president’s proposed budget includes a $14 million increase for the Housing Opportunities for People with AIDS program.
HOPWA authorities said the proposed increase would bring the program’s appropriation to $300 million, the highest level in its 16-year history. That would serve an estimated 71,500 households, according to HOPWA officials.
But at the same time, a HOPWA spokesman said, “many other HUD programs serving vulnerable Americans once again face cuts.”
The Housing for the Elderly program was recommended for a 26 percent cut, and the Housing for Persons with Disabilities program would see a 50 percent cut.
George C. Benjamin, executive director of the American Public Health Association, was also among those criticizing the president’s budget proposal.
“This administration has emphasized the importance of protecting our nation’s citizens, b ironically has put the well-being of millions at risk with cuts to programs designed to improve health and save lives,” Benjamin said.
Benjamin said that controlling federal spending is critical. But, he said, “It is also imperative that our nation’s government do whatever it can to protect the public’s health. Shortsighted and short-term savings will lead to greater health and medical expenditures in the long term.”
The HIV Medicine Association said despite the “modest” increases proposed for the Ryan White CARE Act, “We will not have adequate capacity to provide medical care and treatment to those new identified” as HIV-positive, according to association officials.
This article appeared in the Dallas Voice print edition of February 10, 2006.