Obama 2014 budget: Continued support for Global Fund, paired with PEPFAR cut leave Blueprint goals in question

The budget allows $1.65 billion for the Global Fund, the same amount as last year’s budget request. But while global health watchers had hoped to see the Obama administration restore funding to PEPFAR to support the Blueprint for an AIDS-free generation it released in December, the flagship bilateral program is slated for $4.02 billion, a cut from FY 13 continuing resolution amount of $4.067 billion, in turn a drop from FY12 levels of $4.24 billion. The amount represents an improvement by the 2013 level following the 5 percent sequestration cut, but it remains the lowest funding request for PEPFAR in four years of continued decreased spending on the plan.

The budget request leaves questions of how the lofty goals of the Blueprint can be achieved. In addition, advocates point out that the the success of Global Fund programs depends on  support from PEPFAR programs as the two programs work hand in hand to deliver life-saving services. PEPFAR also provides technical support to in-country programs supported by the Global Fund, in order to help them to become self-sustaining.

“We applaud the Global Fund increase, but the continued cutting of PEPFAR resources undermines our ability to achieve the vision laid out in the Administration’s own Blueprint for an AIDS Free Generation,” said Chris Collins,  Vice President and Director of Public Policy of amfAR, the Foundation for AIDS Research.

AmfAR has tallied the effects of  sequestration cuts on the FY 2013 budget showing their toll in human lives and progress in the fight against HIV/AIDS.

“We applaud maintaining funding for critical Global Fund programs as an important step. But reaching the President’s promise of an AIDS Free Generation means implementing his analysis that spending now will save billions in the long run by halting new infections, and this budget does not do that,” said Matthew Kavanagh, Senior Policy Analyst for Health GAP. “To reach the tipping point in the epidemic we need to expand programs in Zimbabwe, Malawi, Democratic Republic of Congo, and many other countries, but now PEPFAR will not have the funds to do so.”

The  budget also requests $2.6 billion for USAID global health programs, which includes $330 million  for HIV/AIDS programs, a drop from the $350 million enacted in FY 12. According to the Kaiser Family Foundation tuberculosis programs under USAID will receive $191 million, a massive cut from FY 12 levels and amounts already diminished by recent sequestration cuts.

Global health programs under the Department of Health and Human Services budget request will receive $393 million, of which $132 million will be available for global HIV/AIDS through September, 2015. This is a significant increase from the $348 million received under the FY 2012 budget, and the $350 received under the FY 2013 CR.

Allaying concerns voiced by research advocates at Monday’s rally in Washington D.C., the President’s proposal includes a boost of $472 million for the National Institutes of Health over the FY 12 request. The institutes’ Office of AIDS Research gets $312 million of that, a boost of $46.0 million.

The budget request, however, also would slash funding at the Centers for Disease Control and Prevention by $432 million.

Source: Science Speaks