President Joe Biden is seeking a substantial increase in funding for the Ending the HIV Epidemic initiative, which seeks to reduce HIV infections by expanding access to pre-exposure prophylaxis and getting HIV-positive people on treatment.
In his preliminary budget request to Congress for fiscal year 2022, announced Friday, Biden is asking for $267 million over and above the $400 million that's been appropriated annually for the program since 2019. The fiscal year begins October 1.
The initiative was launched under Biden's predecessor with the goal of reducing new HIV infections by 90 percent by 2030, although Biden campaigned on a more ambitious goal of ending the epidemic by 2025.
Its major components are expanding use of PrEP drugs -- Truvada and Descovy are the two approved for this purpose so far -- so that HIV-negative people do not acquire the virus during sex, and making sure HIV-positive people are on treatment. If treatment suppresses the amount of virus in a person's body to undetectable levels, the person cannot transmit it to a sexual partner.
Biden's request won praise from some activists, but they said more needs to be done. "We thank President Biden for demonstrating his commitment to ending HIV in the United States by including this substantial funding increase in his budget to ramp up the Ending the HIV Epidemic Initiative," said a statement from Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. "While it falls short of what the community has requested, if this funding is realized it will continue the momentum already created and make further progress in ending HIV in the U.S. Efforts to end HIV will help eradicate an infectious disease that we have been battling for the last 40 years and help correct racial and health inequities in our nation."
The initiative has already shown positive results, according to the institute's press release. The Ryan White HIV/AIDS Program, which funds local service providers, was able to bring in nearly 6,300 new clients and reengage an additional 3,600 because of the initiative. Community health centers were able to increase PrEP uptake from 19,000 in 2020 to nearly 50,000 people early this year.
Biden is also calling for an increase in global health funding, including the President's Emergency Plan for AIDS Relief, started under President George W. Bush. But the $800 million increase for global health overall "does not permit the major surge in funding for global AIDS funding" through PEPFAR, Matthew Rose, director of U.S. policy and advocacy at Health GAP, said in a press release.
"We know how to end AIDS, but elected leaders still lack the will to make it a reality," Rose continued. "This is not the time to turn a blind eye to the devastating impact of underfunding the HIV response. Biden should lead a renewed global HIV response founded in justice and human rights, dedicated to ending AIDS as a global public health threat. But without sufficient funding, people will continue to suffer and needlessly die preventable deaths. Biden must consider these possibilities and choose to truly lead in this moment, not let it pass by."
Health GAP called on Congress to pass a budget that increases PEPPAR funding at least $750 million for FY22 and $2.5 billion over the next four years to scale up HIV prevention and treatment and effectively mitigate the harms of COVID-19.