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Trump's Budget Proposal Boosts Domestic HIV Efforts, Cuts Global Spending

by Kilian Melloy
Friday Mar 15, 2019

Critics of the president's newly-released budget point out that while the Trump administration has vowed to eradicate HIV, and the budget calls for money to pursue that agenda domestically, that aim is potentially undercut by the very same budget's slashing of money for global AIDS initiatives, as well as cuts to Medicare and Medicaid.

The AP reported that while the proposed budget seeks more than $290 more in funding to combat America's HIV rates, other critical funding faces deep cuts, with PEPFAR — a program established by George W. Bush to fight AIDS in Africa and elsewhere in the world — facing reductions that come to more than a fifth of its budget.

While PEPFAR and other global programs would be trimmed back, at home Medicaid and Medicare would face steep cutbacks in the "hundreds of billions," AP reported. Critics fear those cuts could have "devastating" consequences for older Americans.

And while the goal to end the spread of HIV is laudable, those living with the disease could be hurt not only by cuts to Medicaid and Medicare, but also the budget's proposed reduction of the Housing Opportunities for Persons With AIDS (HOPWA) program, which faces $63 million in reduced funding, reports

NBC News reported that while leaders from some HIV and AIDS advocacy groups gave mixed reviews of the budget, the Health Global Access Project (Health GAP) got straight to the essential paradox of beefing up monies for domestic programs to fight HIV/AIDS while at the same time slashing other critical initiatives.

"Without Medicaid expansion, [the Trump administration] will never hit the five- and 10-year targets" in the plan for ending HIV, activist and Treatment Action Groups co-founder Peter Staley said. "This administration's AIDS and health policies are at war with each other, internally. What one hand gives, the other takes away."

Various sources took note that the budgetary proposals look to shift the emphasis on prevention from condom use to medical intervention with pre-exposure prophylaxis, or PrEP, which treats HIV-negative people in order to help protect them from infection.

"After decades of promoting condoms, which the CDC's own data show are effective at stopping about 80 percent of HIV infections, the government is throwing its weight behind PrEP, which is more effective at more than 92 percent," reported NBC.

PrEP has proven highly effective at stemming viral transmission, though the treatment does not protect against all strains of HIV. Though resistant strains are less common and cases of new HIV infection by people using PrEP are rare thus far, some experts fear that over time PrEP-resistant strains could become more commonplace in a manner similar to how antibiotic-resistant strains of other diseases have arisen in recent decades.

Kilian Melloy serves as EDGE Media Network's Assistant Arts Editor. He also reviews theater for WBUR. His professional memberships include the National Lesbian & Gay Journalists Association, the Boston Online Film Critics Association, The Gay and Lesbian Entertainment Critics Association, and the Boston Theater Critics Association's Elliot Norton Awards Committee.


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