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February 2016
Federal Budgets: What Lies Ahead in Funding for HIV/ID Priorities
Significant Increases for IDSA Priorities Included in Fiscal Year 2016 Funding Law
President Obama signed a spending bill for FY 2016 in mid-December that included new resources for several IDSA priorities. The new law provides roughly $379 million in new funding to combat antimicrobial resistance including:
  • $160 million in new funding for the Centers for Disease Control and Prevention (CDC) Antibiotic Resistance Solutions Initiative
  • $100 million increase for National Institute of Allergy and Infectious Diseases (NIAID) AR activities
  • $97 million increase for Biomedical Advanced Research and Development Authority (BARDA) AR efforts
  • $10 million increase for Agency for Healthcare Research and Quality (AHRQ) AR efforts
  • $8.7 million increase for Food and Drug Administration (FDA) AR efforts
  • $3 million increase for CDC’s National Healthcare Safety Network
Congress also increased funding for the CDC’s Section 317 Immunizations Program, which the administration proposed cutting – citing decreased need because of the Affordable Care Act requirements for increased immunization coverage in health plans.  Funding was also maintained at current levels for the programs of the CDC National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.
Domestic HIV Funding Mostly Fared Well, Global ID Fell Flat
On the whole, domestic HIV/AIDS programs did fairly well, whereas global health funding languished. In a major policy victory, Congress allowed federal funding to support syringe access programs, including program personnel, infrastructure, and other critical services, except for the purchase of syringes. In terms of domestic HIV priorities:
  • The law provides $2.3 billion for Ryan White HIV/AIDS Programs, which is $4 million more than the FY2015 enacted level. Part C gets a $4 million increase, and most other parts are flat funded, with Senate-proposed cuts to Special Programs of National Significance (SPNS) and the Minority AIDS Initiative (MAI) restored -- also, the final law did not consolidate Part D into Part C.
  • In the Veteran’s Affairs section, the treatment of hepatitis C within the VA system is funded at no less than $1.5 billion in fiscal year 2016, which is $810 million above the President's request.
  • AHRQ is funded at $334M – a $29.7M cut below the FY15 enacted level.
  • The HHS Teen Pregnancy Prevention program is flat funded at $101 million, but funding for abstinence-only-until-marriage programs is doubled from $5 million to $10 million.
  • In the Foreign Operations section, the law flat funds PEPFAR at $4.3 billion, provides $1.35 billion for the Global Fund and $330 million for USAID HIV/AIDS programs. Fortunately, the law does NOT include a House policy rider codifying the “Global Gag Rule,” which prohibits non-governmental organizations (NGOs) receiving federal funds from providing women information about the full range of health services.
HIV research advocates remain concerned that none of the $2 billion FY 2016 increase for the National Institutes of Health (NIH) will be allocated to HIV research, despite the Administration’s request for a $100 million increase for HIV research in its FY 2016 budget proposal. HIVMA helped organize two letters sent to Administration officials:  a community organizational sign-on letter as well as an individual sign-on letter.  
Throughout the FY 2016 appropriations process, IDSA and HIVMA members sent hundreds of letters supporting priority programs to their members of Congress through the IDSA/HIVMA Action Center. Those efforts magnified efforts by IDSA and HIVMA staff, including dozens of meetings with congressional offices, congressional testimony, and partnering with other health groups to highlight the importance of federal HIV/ID programs. 
Advocacy for Federal Funding Begins Anew
Without pausing after the recent approval of the FY 2016 spending bill, IDSA and HIVMA’s advocacy efforts are underway for the next fiscal year budget. President Obama will release his last budget request to Congress on February 9.  His Fiscal Year (FY) 2017 budget request is expected to carry forward priorities important to the infectious diseases community, such as continued investment in combating antimicrobial resistance. 
FY 2017 begins on October 1, just a few weeks before the 2016 presidential and congressional elections.  Leaders in Congress have expressed a desire to complete spending bills ahead of the elections.  However, politically sensitive votes such as these typically stall during an election year.  The work of funding the government may be somewhat easier given that a bipartisan budget framework was developed last fall.  The agreement relieved much of sequestration for Fiscal Years 2016-2017 and paved the way for a final FY 2016 spending bill that provided investments championed by IDSA, HIVMA and other health groups, outlined above. 
Once again, IDSA and HIVMA will call on members and other stakeholder groups to join in advocacy for funding of agencies such as the CDC, NIH, and the Health Resources and Services Administration. 

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