The Cable

Proposed U.S. Cuts to AIDS Funding Could Cause Millions of Deaths: Report

While the Trump administration praises its progress on the AIDS fight, health campaigners warn they are making the fight that much harder.

The Kenwa Center for HIV positive women in Nairobi, Kenya in December, 2006. (Brent Stirton/Getty Images)
The Kenwa Center for HIV positive women in Nairobi, Kenya in December, 2006. (Brent Stirton/Getty Images)

The State Department is trumpeting U.S. progress combating HIV and AIDS worldwide, but nongovernmental organizations warn that the Trump administration’s plans to slash AIDS funding could lead to millions more infected, with many dying.

“The U.S. government, under the leadership of President Trump, continues to lead the way in the global HIV/AIDS response,” said Deputy Secretary of State John Sullivan at a State Department event on Thursday commemorating World AIDS Day, which is Dec. 1. “We are closer than ever before to ending this pandemic,” he said.

A blistering new report from the ONE Campaign, an international nonprofit focused on poverty and preventable disease, argues that the administration’s proposed budget cuts would derail all the progress made to date, just when an end to the disease is in sight.

The Trump budget “would have led to the first global increase in new HIV infections since 1995, with nearly 200,000 additional HIV infections in the first year,” according to the report, “Red Ribbon or White Flag? The Future of the U.S. Global AIDS Response.”

In its budget proposal for fiscal year 2018, the Trump administration proposed cutting some $800 million from the global fight against HIV and AIDS, including the President’s Emergency Plan for AIDS Relief (PEPFAR), a program former President George W. Bush established in 2003. PEPFAR has provided treatment to nearly 8 million HIV-infected people in developing countries and is estimated to have saved some 11 million lives.

New proposed cuts, if enacted, could force initiatives such as PEPFAR to scale back their treatment programs, potentially leading to 26 million additional infections and 4 million additional deaths in the next 15 years in sub-Saharan Africa alone, the report said. “The billions of dollars that Congress has already invested in fighting AIDS would be squandered at the very moment when control of the disease is in sight,” it said.

The Trump administration’s proposed budget request calls for eliminating PEPFAR funding entirely to seven countries — Brazil, Djibouti, Liberia, Mali, Nepal, Senegal, and Sierra Leone — and reducing funding to 17 countries, including the Democratic Republic of Congo and other sub-Saharan African countries still struggling to recover from the disease: South Africa, Zimbabwe, Mozambique, and Namibia. Seventy percent of the nearly 37 million people with HIV/AIDS globally are in sub-Saharan Africa, and only half receive treatment.

U.S. Global AIDS Coordinator Ambassador Deborah Birx declined to respond to the ONE Campaign report, but told reporters Thursday that the United States has “dramatically increased results” in 2017 even with a flat budget, and that lower funding doesn’t mean a lessened commitment.

“Translating that money into the most effective programs that we can, that reaches the most lives in the most impactful way — that’s our job,” she said.

ONE Campaign spokesman Sean Simons said advocacy groups are pinning their hopes on Congress to stop Trump’s plan. “If the Trump Administration once again tries to cut funding for global HIV/AIDS programs in the future, Congress must do the responsible thing and restore the money,” he said.

On Wednesday, a group of nearly 40 advocacy groups sent a letter to Congress urging them to push back against the Trump administration’s plans to slash global health funding. “We are writing to sound the alarm,” the letter said.

Lawmakers from both sides of the aisle have pushed back on the Trump administration’s budget proposals, especially the drastic cuts to the State Department and USAID. Sen. Ben Cardin (D-Md.), ranking member of the Senate Foreign Relations Committee, took aim at the proposed PEPFAR cuts on Friday.

“Success is possible,” he said. “Cutting funding now – shrinking from our commitment now, instead of sustaining it – will negate the investments and progress we have made so far.”

Robbie Gramer is a diplomacy and national security reporter at Foreign Policy. @robbiegramer

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