Funding Request Does not Meet the Moment for Global Health

The Global AIDS Policy Partnership (GAPP) was disappointed to see insufficient funding for key global health priorities in President Biden’s FY 2024 budget request, released on March 9. Though we appreciate the Administration’s commitment to increasing funding for the newly established Pandemic Fund and maintaining its $2 billion pledge to the Global Fund, we were concerned to see a reduction of $25 million in funding for the President’s Emergency Plan for AIDS Relief (PEPFAR) as well as cuts to bilateral programs that address tuberculosis and malaria.

Since its launch in 2003, PEPFAR has saved an estimated 25 million lives and improved health outcomes—including in maternal and child health—in more than 50 countries. Over this time period, the United States has provided nearly $90 billion in bilateral assistance to low and middle income countries. The U.S. government’s leadership on this issue helped turn the tide on an epidemic that has claimed an estimated 40 million lives across the globe.

PEPFAR’s impact extends well beyond the fight against HIV and AIDS. It has been instrumental in responding to the COVID-19 pandemic. By applying decades of expertise, diplomacy, and infrastructure, it has enabled the delivery of diagnostics, care, and vaccines to populations that may not otherwise have been reached. It demonstrated that it could be a tremendous asset in building systems to prepare for health threats we may face down the line.

However, the job is far from complete. The rates of infection and death remain unacceptably high among certain populations. In sub-Saharan Africa, AIDS is still the leading cause of death for women 15-49 years old. In addition, HIV-related deaths among children and adolescents have been stubbornly slow to decline and gaps between children and adults continue to widen. Almost 800,000 children living with HIV are not on treatment; without it, half will die before their second birthday. Worryingly, pediatric access to lifesaving medicines actually declined in 2020.

Rather than letting up now, we must double down on our commitment to saving lives and improving health outcomes of those living with HIV. If we fail to do so, we risk an escalation in new HIV infections globally and making the goal of ending AIDS as a public health crisis by 2030 far more difficult, if not impossible.

President Biden spoke in his State of the Union about “finishing the job” on a wide array of issues over the next two years. Ending HIV and AIDS is one important job we must finish. To that end, GAPP looks forward to working with Congress to ensure the robust funding necessary to do so. Too much is at stake to let up now.