July 6, 2017

Proposed Trump Budget Would Cut Health Programs

Eric Brus READ TIME: 2 MIN.

The Trump Administration's Fiscal Year 2018 (FY18) budget proposal includes deep cuts to many health programs, including those providing direct services to persons living with HIV. Shortly after the budget was released in late May, various groups, including the American Association for the Advancement of Science, the Treatment Action Group, and The Fenway Institute, published separate summaries of proposed health and science budget changes, including those expected to impact HIV, viral hepatitis, and tuberculosis (TB).

These proposed changes include:

Domestic Programs:

  • a $7.7 billion (22%) reduction to research at the National Institutes of Health;
  • an $838 million (18%) cut to the National Institute of Allergy and Infectious Diseases, which conducts extensive HIV/AIDS research;
  • a 17% funding cut to CDC-funded programs for the prevention of HIV, viral hepatitis, sexually transmitted infections, and TB;
  • $59 million in cuts to the Ryan White HIV/AIDS Program; and
  • eliminating the Minority HIV/AIDS Initiative (MAI), AIDS Education Training Centers, and Special Projects of National Significance (SPNS)

    In addition, the budget would provide flat funding of CDC's hepatitis prevention programs and continue to limit the use of federal funding to purchase syringes.

    International Programs:

  • cutting $700 million from the President's Emergency Plan for AIDS Relief (PEPFAR) and $225 million from the Global Fund to Fight AIDS, Tuberculosis, and Malaria;
  • eliminating the Fogarty International Center, which trains scientists around the world in HIV and TB research;
  • eliminating U.S. funding commitments for the International AIDS Vaccine Initiative (IAVI) and microbicides research; and
  • cutting $62 million from global TB programs at the U.S. Agency for International Development.

    Longer-Term Budget Impacts

    Looking beyond FY18, The New York Times published an interactive chart, How Trump's Budget Would Affect Every Part of Government, that has The Times' projections of federal spending over the next 10 years, based on the Trump budget proposal, compared to projected spending under current policies. These include 10-year cuts totaling $2.02 trillion (28%) to all health programs; $627 billion to Medicaid (a total that does not fully account for the even larger Medicaid cuts under the proposed American Health Care Act); $87 billion to the National Institutes of Health; and $18 billion to the CDC.

    Many policy, research, and health care organizations, news agencies, and patient advocacy groups issued statements responding to the Trump Administration's budget proposal and analyzing its projected impacts. These include a joint statement by AIDS United, the National Alliance of State and Territorial AIDS Directors, the National Coalition of STD Directors, NMAC, and The AIDS Institute.

    For your convenience, we have provided links to selected other statements and analyses that focus on research and health funding here: American Academy of Pediatrics; American Association for the Advancement of Science; Association of American Medical Colleges; American Public Health Association; AVAC; Health GAP (Global Access Project); Project Inform; Science Speaks; The Fenway Institute; and Treatment Action Group. In addition, the Kaiser Health News daily briefings for May 24 link to numerous news summaries of the proposed FY18 budget proposal in the Administration News section.

    Eric Brus writes about HIV policy. His HIV/AIDS Disparities Report is produced by the New England AIDS Education and Training Center Minority AIDS Initiative Project. The full version is available online.

    by Eric Brus

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