Budget sequestration will undermine fight against HIV

On March 1, federal budget sequestration went into effect. This will result in across-the-board cuts of 5.3 percent in most non-defense discretionary programs, including Ryan White, HIV prevention, HIV research, AIDS housing support, and prevention and treatment programs for people with substance abuse problems.

By withholding vital funding from essential HIV programs that have seen minimal increases in recent years, these looming cuts will undermine efforts to achieve the targets set forth in the National HIV/AIDS Strategy. The most severe effects will be felt in Black America, which has been more heavily affected by the HIV epidemic than any other racial or ethnic group.

We are at a deciding moment in the trajectory of the AIDS epidemic. We are either going to decide to do what’s necessary to end the epidemic in this country, or we’re going to decide to continue to see American citizens get infected, get sick and die from AIDS.

The decision to let sequestration go into effect is a decision to let people get sick and die. Sequestration will have a devastating impact upon the fight to end the HIV/AIDS epidemic in Black communities.

Cuts to vital HIV programs will not contribute to deficit reduction. Discretionary health spending of any kind accounts for only 1.5 percent of the nearly $4 trillion in federal spending and domestic HIV-related spending ($22.25 billion in FY2013, as proposed in the president’s executive budget) represents a mere 2.4 percent of total federal outlays on health ($920.0 billion in FY20135).

Black America will feel the effects of these cuts the most. Although Black Americans represent approximately 13 percent of the U.S. population, Blacks account for 44 percent of all new HIV infections. Effects of these cuts are likely to be most pronounced in the South, where Black people account for only about a quarter of the total population but are the large majority of people living with HIV.

Sequestration will deprive at least 3,241 HIV-positive Black Americans of life-saving HIV treatment. With Black people accounting for 32 percent of all ADAP clients in 2011 — and with the epidemic’s disproportionate toll in Black communities increasing over time — under the sequester we can assume that at least 3,241 Black Americans living with HIV will lose access to essential antiretroviral treatments and other HIV drugs in Fiscal Year 2013 alone.

Fewer Black Americans will learn their HIV status. Black Americans are more likely to seek HIV testing than other Americans — the percentage of Black adults who have ever been tested is more than twice as high as for Whites. So Black America will account for a disproportionate share of the 424,000 Americans who fail to access HIV testing as a result of across-the-board budget cuts.

This will mean delayed entry to care for hundreds, perhaps thousands, of Black Americans, and will also contribute to unknowing HIV transmission among individuals who would have learned their HIV-positive status had these cuts not gone into effect. Assuming that recent epidemiological patterns continue, at least 350 Black Americans would needlessly acquire HIV as a result of diminished access to critical HIV prevention services.

Budget sequestration will undermine the search for a preventive vaccine. Almost 300 HIV-related research grants will be without funding, including 32 for vaccine-related research.

We have the tools to end the AIDS epidemic. We have better surveillance, better diagnostics, better treatment and better prevention tools. Our president is committed to better health for all Americans, including those of us living with or at risk of HIV infection.

Clearly having the tools is not enough. Having a National HIV/AIDS Strategy is not enough. Having the Affordable Care Act is not enough. Ending the AIDS epidemic is going to require greater level commitment on our part-all of us — including our national leadership.

To learn more about the impact of sequestration on Black America, visit www.blackaids.org/docs/fs-sequestration.pdf.

— From a Black AIDS Institute press release