Trump pushed to end HIV. But Republicans want to cut the budget for that effort: the shots

World AIDS Day event at The Wall Las Memorias AIDS Memorial on December 1, 2022 in Los Angeles. There are about 35,000 new HIV infections annually in the United States

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World AIDS Day event at The Wall Las Memorias AIDS Memorial on December 1, 2022 in Los Angeles. There are about 35,000 new HIV infections annually in the United States

Mario Tama/Getty Images

More than four years ago, then-President Donald Trump announced an ambitious goal that received bipartisan support: ending the HIV epidemic in the United States.

Now, Trump’s program is one of several health initiatives targeted for deep cuts by members of his party as they look ahead to next year’s election.

Pushing a list of conservative policy priorities that also target sex education for teens, vaccine mandates for health workers, and more, House Republicans have proposed a spending bill that would cut $1.6 billion from the Centers for Disease Control and Prevention — one-sixth of the agency’s budget. .

Eliminate the CDC part of Trump’s plan

The proposal would eliminate the agency’s share of Trump’s HIV plan, which was more than a third of the program’s budget in the current fiscal year. It would also eliminate funding through other channels, such as the Health Resources and Services Administration’s Ryan White HIV/AIDS Program.

With another budget fight and a potential government shutdown looming on October 1, this particular proposal is unlikely to win approval from Congress. However, former CDC officials said they feared this was the opening salvo in what could nonetheless be debilitating cuts to a strained agency that has lost some public support in recent years.

These cuts follow other recent cuts at the Centers for Disease Control and Prevention, stemming from an eleventh-hour debt ceiling deal, to its budgets for childhood vaccination programs and prevention of sexually transmitted diseases. And it provides an early opportunity for the new director of the Centers for Disease Control and Prevention, Mandy Cohen, to show how well she can persuade members of Congress to protect the agency’s interests in a polarized political landscape.

“Public health is being politicized to a degree we have never seen before,” said Kyle McGowan of the consulting firm Ascendant Strategy Partners, who served as chief of staff at the Centers for Disease Control during the Trump administration. He said cutting public health spending “is not smart.” “These culture wars are now seeping into and damaging public health.”

He called the proposed cuts unprecedented in their targeting of bipartisan public health initiatives.

The Centers for Disease Control and Prevention is targeting cuts again

The House Republican spending proposal, which came from members of the Labor, Health, Human Services and Education subcommittee, targets programs that have angered conservative lawmakers, such as those focused on climate change and gun violence research.

“The cuts to the Centers for Disease Control and Prevention are as outrageous as they are dangerous,” said Connecticut Rep. Rosa DeLauro, the top Democrat on the subcommittee.

But Rep. Kay Granger, R-Texas, who chairs the House Appropriations Committee, said the bill “responsibly funds programs that help improve the health and lives of the American people. It also holds agencies accountable when there is a history of poverty.” Controversial performance or activities.”

Rep. Kay Granger, R-Texas, chairs the powerful House Appropriations Committee.

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Rep. Kay Granger, R-Texas, chairs the powerful House Appropriations Committee.

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Granger and the chairman of the subcommittee that drafted the bill, Rep. Robert Aderholt (R-Alabama), did not respond to requests for more information.

The House Appropriations Committee has not yet voted on the measure, which would also need approval by the entire Republican-controlled House and the Democratic-controlled Senate. The Senate Appropriations Committee approved its health spending bill, which largely preserves the Centers for Disease Control and Prevention’s current funding for HIV and would require the two chambers to work together to produce a consensual measure.

Any spending measure would also need the signature of President Joe Biden, whose most recent budget proposals included a request for $850 million to reduce new HIV cases.

The CDC declined to comment on potential cuts, saying it would be premature to do so amid the ongoing budget process.

Ambitious goals, big headwinds

The Trump administration’s HIV program was launched in 2019 with the goal of reducing new infections nationwide by 90% by 2030. The program has sent more than $1.7 billion, through various federal health agencies, to HIV hotspots all over the country.

But the program has faced significant headwinds. The COVID-19 pandemic has diverted the attention of public health officials. In addition, the red tape, along with the ongoing stigma and discrimination fueled by anti-LGBT messages from politicians, has many health officials concerned that it will not achieve its ambitious goals.

House Republicans said the HIV program, which was just shy of its first major milestone, in 2025, fell short of its goals.

“This program has demonstrated a lack of results-based performance data, inadequate budget justifications, and vague spending plans. The initiative has not achieved its original goals,” the Republican-led subcommittee wrote in a report obtained by KFF Health News but unable to do so. Verify independently as administrator. Granger and Aderholt did not respond to requests to verify the document.

Trump’s initiative to end the HIV epidemic is not the only Republican-created HIV program being targeted.

PEPFAR was also derailed by Republicans in 2023

Several key provisions of the President’s Emergency Plan for AIDS Relief, known as PEPFAR, are set to expire on September 30. The program, which funds HIV and AIDS prevention worldwide, has saved millions of lives, and is widely viewed. As a success in the field of public health and foreign policy. It was launched in 2003 under then President George W. Bush.

But discussions about reauthorizing the program have been derailed by Republican claims that it funds abortion. Experts say PEPFAR will not shut down immediately, but the missed deadline could point to an uncertain future for the programme.

Regarding Trump’s HIV initiative, providers say any budget cuts would slow the progress it has made in fighting the disease.

“There’s a lot at stake here,” said Justin Smith, of the Centers for Positive Health, an HIV clinic in the Atlanta area. Smith helped Georgia public health officials plan the distribution of funds intended to end the HIV epidemic among the state’s four priority counties.

Smith said the proposed cuts would be “very disruptive” to the work being done in Cobb, DeKalb, Fulton and Gwinnett counties in Greater Atlanta. This work has included scaling up HIV testing and pre-exposure prophylaxis programs, as well as expanding care for transgender people living with HIV.

New HIV money is flowing south, where it is needed

The South has the highest rate of new HIV diagnoses in the country, and many of the areas targeted to end the HIV epidemic are located in the region.

And in Louisiana, which has two HIV priority areas, the program has helped reduce the number of late HIV diagnoses and maintain virus suppression levels, said Samuel Burgess, director of the STD and HIV Prevention Program at the state.

Even if budget cuts do not fully escape the legislative process, Burgess said, it is “extremely troubling” that lawmakers would propose such cuts.

HIV policy advocates oppose the House Republican proposal. In July, the Federal Partnership for AIDS Policy sent a letter to House officials warning of its potential impact.

“We are deeply concerned that this bill will not only halt progress towards the goals set by former President Trump in 2019, but will exacerbate the HIV epidemic that has plagued our nation for 40 years,” they wrote.

Quick challenge for the new CDC director

Cohen, who began working with the Centers for Disease Control in July, is familiar with the budget process, having spent time in senior leadership positions within the US Department of Health and Human Services.

But McGowan said she is new to the CDC, and regardless of her experience inside the Beltway, she will need time to get up to speed, which could leave the agency vulnerable. “It’s a difficult time to have a change of leadership at the CDC,” he said. But he added, “Dr. Cohen does a great job meeting with everyone in Congress, Democrats and Republicans alike.”

The battles over HIV programs revolve around Tom Frieden, who served as CDC director under former President Barack Obama. He estimated he made more than 250 trips to Capitol Hill over nearly eight years to sell the agency’s work to lawmakers.

The CDC’s website, based in Atlanta outside Washington, called it a “double-edged sword.”

“People used to say to me, ‘Oh my God, isn’t it great that we’re not being wiretapped by politicians here in Atlanta?'” Frieden said.

While the site helps shield the agency from politics, it also makes it difficult to get support from members of Congress, he said.

But the Centers for Disease Control and Prevention’s response to the coronavirus has brought her back into the political fray. Frieden said he hoped the Democratic-controlled Senate would serve as a “hard stop” against Republican attacks — but warned that deep cuts could slip through the cracks.

“It’s always a risk that some important thing won’t happen at the eleventh hour,” Frieden said.

KFF Health Newsformerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism on health issues and is one of the core drivers of KFF – The independent source for health policy research, opinion polls and journalism.

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