The President’s FY23 Budget Puts HIV/AIDS Progress at Risk

The President’s Budget for Fiscal Year 2023 (FY23), released Monday, fails to show the ambition needed to end the global HIV/AIDS pandemic by 2030. The only bright spot in yesterday’s announcement was the pledge to commit $2 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria as part of the multilateral organization’s seventh Replenishment. While we celebrate this increased funding, these resources cannot come without robust investments in the corresponding bilateral accounts. 

By proposing a cut of $20 million from the President’s Emergency Plan for AIDS Relief (PEPFAR) and $5 million from UNAIDS, this budget would put hard-won gains in the fight against HIV/AIDS in jeopardy. Furthermore, it would send the wrong message to our global partners and greatly diminish our ability to leverage the U.S.’s strength as a global health leader.

At the United Nations General Assembly High-Level Meeting on AIDS in June 2021, the U.S. and other member states adopted a declaration, together committing to reach key targets within the next several years in order to keep the world on track to reach the 2030 goal. A recent analysis conducted by the Global AIDS Policy Partnership (GAPP) highlights the gap in U.S. resources required to meet those targets:

  • The current investment in PEPFAR ($4.39 billion) is $2.4 billion less than what is needed by 2025 for 23 priority countries;
  • For all low and middle income countries, the total global investment—including, but not limited to PEPFAR—will need to increase by $7.5 billion by 2025 in order to reach the targets.

Without the necessary resources, we will not be able to reach the global goal of ending HIV/AIDS as a public health threat by 2030.  The cost of inaction in PEPFAR countries alone, shown below, would be devastating

With additional bilateral funding, PEPFAR could improve and expand upon programs that work, and repair and rebuild programs that have been set back by COVID-19 and other global health crises. We hope, as FY23 budget discussions move forward, that Congressional leaders will not only match the President’s request for $2 billion for the Global Fund but go farther to safeguard decades of U.S. investments in HIV/AIDS and protect the hard-won progress achieved to date. We urge Congress to robustly fund successful programs that save millions of lives every year.