Today, the House Committee on State, Foreign Relations and Related Programs (SFOPS) finalized its fiscal year 2023 (FY23) budget. The Global AIDS Policy Partnership (GAPP) was pleased to see significant resources directed toward global health ($10.98B), including $2B for the Global Fund and $4.395B for the President’s Emergency Plan for AIDS Relief (PEPFAR). This level of funding demonstrates the ongoing commitment to ending the HIV/AIDS epidemic even amidst several other health crises. We thank Representative Barbara Lee (D-CA) for her continued, long standing leadership in efforts to respond to HIV/AIDS and for being a champion for the platforms, like PEPFAR, that we know work.

Over the past twenty years,  the U.S. has been a leader in driving progress in the fight against HIV/AIDS. Today, 28.2 million more people are accessing life-saving treatment that did not exist 30 years ago. New HIV infections have declined 31% since 2010.

However, even before COVID-19, global HIV prevention goals were unacceptably off-target. According to the most recent report from UNAIDS, of the 38 million people living with HIV, 10 million lack access to the medicines they need to live healthy lives. Prevention also remains a key challenge and unmet target, with 1.5 million new HIV infections in 2020 alone. In the face of COVID-19, the negative impact on those living with increased risk for HIV is exponentially elevated.

Since it was established, PEPFAR has consistently contributed roughly one fifth of the global resources to fight HIV/AIDS. Furthermore, throughout the COVID-19 pandemic, PEPFAR has been instrumental — helping countries prepare for effective vaccine delivery, strengthening surveillance and case finding systems, and providing critical laboratory and supply chain capacity, among other essential support. However, despite its extraordinary success and critical role in fighting current and future pandemics, PEPFAR has been flat funded for decades. The FY23 SFOPS budget essentially continues that trend with only a $5 million increase, which is woefully inadequate.

This year is a prime opportunity for the U.S. to recommit to leading the fight to end HIV/AIDS around the world. By hosting the Global Fund’s 7th Replenishment in the fall, it has signaled its willingness to do so. But PEPFAR also serves a crucial role in ensuring an equitable, safe world and must not be overlooked. Throughout its existence, PEPFAR has had enormous global influence and improved overall health outcomes that extend far beyond HIV/AIDS, including gender equality, health workforce recruitment and retention, and laboratory capabilities in the countries in which it operates. That transformative work, as well as the important diplomatic work that is carried out through global health, requires substantial resources.

Today’s budget is an encouraging step. However, more is still needed. In addition to a fully funded Global Fund, PEPFAR requires an additional $7.5 billion to fight HIV/AIDS in low and middle income countries. Without this funding, we will not be able to meet the 2030 goal of ending HIV/AIDS as a global health threat. While we are appreciative of these efforts, we encourage legislators to not only continue but redouble efforts to end HIV globally. With focused effort and adequate resources, ending HIV/AIDS is within reach.