The Senate State Foreign Operations and Related Programs (SFOPS) Committee’s Budget for Fiscal Year 2023 (FY23) falls well short of the commitment needed to meet the global goals of ending HIV/AIDS as a public health threat by 2030. While we continue to celebrate the U.S. government’s commitment to increase its contribution to the Global Fund to Fight AIDS, Tuberculosis, and Malaria to $2B (pending donor country match), these resources cannot come at the detriment to 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. Funding for PEPFAR has remained stagnant for over a decade – the current investment of $5.4 billion mirrors investments made in 2009. With inflation, that effectively gives PEPFAR $1.5B less in purchasing power over the last 12 years. With 1.5M new infections each year, this funding level simply cannot meet the demand imposed upon the program.

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 previous allocation to PEPFAR ($4.39 billion) is already $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, close the gaps in access to HIV/AIDS services, repair and rebuild programs that have been set back by COVID-19 and other global health crises, and make it over the plateau in prevention progress. We hope that as new data from UNAIDS sounds the alarm, Congressional leaders step up to safeguard decades of U.S. investments in HIV/AIDS and fill in gaps made by inequitable access to health services. We urge Congress to increase funding for these successful programs that save millions of lives every year.