The $2.57 trillion budget by President George W. Bush for fiscal year 2006 proposes an increase of $300 million for international AIDS programs and virtually no increase in domestic spending on HIV/AIDS.
AIDS services funded under the Ryan White CARE Act will receive no increase, except for an additional $10 million for AIDS Drug Assistance Programs ( ADAP ) . That is half the amount the administration threw into an emergency effort last summer during the presidential campaign to meet then current shortfalls in ADAP programs.
AIDS Research at the National Institutes of Health will increase 0.4 percent, significantly less than the cost of living. Those research activities continue to shift into the elusive quest for an AIDS vaccine, with much of that going to build up research infrastructure in Africa.
AIDS prevention programs funded by the CDC will actually lose money, some $4 million compared with this year. It is part of an overall reduction of 9 percent, or $6.9 billion at CDC. However, the administration did find an additional $38 million for abstinence only sex education programs run out of the Department of Education.
Despite all of the talk about cuts, the proposed budget is about a third bigger than the one four years ago when Bush took office. The increased spending is going to Iraq; the cuts are coming from domestic programs.
The Washington Post in a Feb. 8 editorial called the overall budget 'breathtaking,' both as 'farce' and 'tragedy' in trying to cut the overall budget deficit in half by 2009, without re-imposing tax cuts passed early in the administration.
'The President's budget proposals, if enacted, will threaten the health care safety net for HIV care and treatment, and undercut prevention and research efforts,' said Dr. Paul Volberding, chairman of the board of the HIV Medicine Association.
'This budget does not reflect the concern President Bush showed during his State of the Union address for HIV and AIDS prevention and care,' said David Smith, vice president of policy at the Human Rights Campaign. 'Unfortunately, the President's actions do not match his words.'
'Programs that focus on abstinence as the sole means of preventing HIV/AIDS put our young people at tremendous risk,' Smith said. 'We have to question [ the President's ] commitment when his ideology consistently outweighs sound scientific facts.'
'The President focused on African Americans and AIDS in his State of the Union Address,' said Paul Feldman, spokesman for the National Association of People With AIDS ( NAPWA ) , 'And yet it has not one new dollar for the Minority AIDS Initiative.' For the second straight year there is a significant cut in housing support for people living with HIV. 'This is not a response to AIDS.'
'There really has been no new money for five years,' said Marsha Martin, executive director of AIDS Action. During that time an additional 200,000 Americans are estimated to have become infected with HIV. 'Maybe within the context of reauthorization of Ryan White we can put forward the case to the Congress, with the challenge to increase the support necessary to meet those demands.'
Most Washington observers see the President's proposal as just the opening round of the budgetary process, with Congress generally shifting and adding funding. However the spending pressures of Iraq, combined with a reticence to raise taxes, even while the deficit grows, makes that game even more difficult to play this year than in the past.