Proposed Cuts to US Foreign Aid: Potential Effects on HIV/AIDS

By: Madison Lee

We have now entered year two of the Trump Administration and we continue to see where the President’s values and priorities lie. On February 12, 2018 President Trump’s White House released their second budget proposal, this time for the 2019 fiscal year 6. As seen in the 2018 budget proposal, the President continues to strive for greater defense and border control spending while slashing the budgets of U.S. foreign aid programs 6. It is very clear from the proposed budget that the President is unconcerned about the programs and organizations that rely on US money to continue their work in some of the most undeveloped and under-resourced places in the world. HIV/AIDS is an area of work that would be highly affected by the proposed cuts and over 40 organizations, including Partners in Health and the ONE Campaign, have spoken out about the negative effects the cuts would have 1,4.

Proposed Budget: 2019 fiscal year

State Department and USAID: Decrease Spending from $55.6 billion to $39.3 billion

• The Global Health Programs Account would be decreased from $8.7 billion to $6.7 billion. This would revert funding of the program back to levels seen under Bush in 2007 7.
• HIV/AIDs specific funding through the health department would decrease by $800 million dollars. This would take the budget from the 2017 level of $4.6 billion to $3.85 billion 7.
• Lastly, the Emergency Fund maintained by the state department is proposed to be completely slashed on its $70 million budget. In the event of an epidemic or outbreak no emergency funding would be available to assist already strained agencies 7.

CDC:

• The CDC’s global HIV/AIDS funding is proposed to be decreased by $58.9 million, thus taking the budget from $128.4 million in 2017 to $69.5 million 7.

PEPFAR:

• Specific 2019 budget request numbers have not been released on PEPFAR but are suspected to be in line with 2018 proposed budget cuts which cut PEPFAR funding from $6.5 billion to $5.3 billion 5.

Many organizations are hoping that congress follows last year’s actions and makes no moves towards following the President’s proposed budget agenda. Despite the likelihood of the cuts not occurring the trend of the President’s budgets should concern the American people. The White House budget director, Mick Mulvaney, released a statement saying “We seek to spend the money consistent with our priorities.”3 The President and Nikki Haley, the U.S. ambassador to the UN, have both blatantly said that US aid will only be going to countries who side with us on voting 4. This new “requirement” for aid means the U.S. will use its large financial power to leverage countries into decisions favorable for the U.S. and maybe not for themselves.

Should our aid really depend on those countries we deem “friends”? What about the people who live in “enemy” countries, but rely on US funded organizations for medical care and clean water?

There has been a massive amount of positive progress made in the HIV/AIDS epidemic in the last 15 years due to U.S. aid. In 2000 less than 1 million people had access to antiretroviral therapy, but in June of 2016 that number had grown to 18.2 million, with a target of 30 million by 2020 2. New cases of HIV in children had declined 50% since 2010 according to data released in 2016 2. The ONE Campaign released a statement, following the budget proposal, saying that the proposed budget cuts could lead to millions of new HIV infections and hundreds of thousands of deaths around the world 4. They believe that we could be reverted to a world with HIV levels not seen since 2011 and much of the progress that has been made in recent years would be erased and reversed 4.

While these cuts are not likely to occur we still must reflect on the direction our country is taking and what our actions mean for the international community. We have taken on the responsibility of millions of lives by promising assistance and treatment and we can’t withdrawal that support just because our President wants to build a larger military. U.S. foreign aid is not wasted money as the current administration appears to believe, and as a country we must remember our commitment to help those around the world.

Sources:

1. “Global Fund, Gavi Comment On Trump Administration Budget Proposal To Cut Global Health Funding.” The Henry J. Kaiser Family Foundation, 23 Feb. 2018, www.kff.org/news-summary/global-fund-gavi-comment-on-trump-administration budget-proposal-to-cut-global-health-funding/. 
2. “Global Statistics.” HIV.gov, 27 Feb. 2018, www.hiv.gov/hiv-basics/overview/data-and trends/global-statistics. 
3. Horsley, Scott. “Trump Offers Spending Blueprint, But Congress Already Wrote The Check.” NPR, NPR, 12 Feb. 2018, www.npr.org/2018/02/12/585093915/trump-offers spending-blueprint-but-congress-already-wrote-the-check. 
4. “Trump Administration’s Proposed Cuts To HIV/AIDS Funding Threaten Decades Of Gains, ONE Report Shows; Advocacy Groups Urge Congress To Maintain Funding.” The Henry J. Kaiser Family Foundation, 30 Nov. 2017, www.kff.org/news-summary/trump administrations-proposed-cuts-to-aids-funding-threaten-decades-of-gains-one-report shows-advocacy-groups-urge-congress-to-maintain-funding/. 
5. “The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).” The Henry J. Kaiser Family Foundation, 19 Dec. 2017, www.kff.org/global-health-policy/fact-sheet/the-u-s presidents-emergency-plan-for/. 
6. “What Trump Proposed Cutting in His 2019 Budget.” The Washington Post, WP Company, www.washingtonpost.com/graphics/2018/politics/trump-budget 2019/?utm_term=.ba23c7ed7e33. 
7. “White House Releases FY 2019 Budget Request.” The Henry J. Kaiser Family Foundation, 13 Feb. 2018, http://www.kff.org/news-summary/white-house-releases-fy19-budget-request/