The President’s FY26 Budget Request released on Friday proposes draconian cuts to HIV prevention, care, housing, and research which would jeopardize decades of effective programs that have consistently delivered outstanding results by saving lives, preventing new cases of HIV, and reducing health care costs. In addition to proposing dramatic funding reductions, the Administration suggests a new health care agency – the Administration for a Healthy America (AHA) – lead on major HIV workstreams without providing details on how this new agency will continue to support and deliver the same high level of HIV programming with outstanding outcomes and valuable returns. Congress must reject these devastating cuts as well as halt efforts to move federal HIV activities into the poorly defined AHA. 

Though the full request reveals little more than was already known from the so-called “skinny budget” last month, it is now clear that the administration will not fund HIV prevention at CDC going forward. It also proposes axing housing for people living with HIV by eliminating the HOPWA program. While the budget documents leave $300M for CDC to create a new viral hepatitis, STI, and TB block grant for states, this masks $77.3M in funding cuts, resulting in a loss of capacity to prevent and respond to outbreaks nationwide. Over $70M would be cut from the Ryan White HIV/AIDS Program, likely eliminating needed dental, training and education programs – critical health services for people living with HIV; training that expands and improves provider knowledge to treat HIV nationwide, especially in rural jurisdictions; and ending research into evidence-based programs that enhance the effectiveness of HIV treatment and prevention services. 

Although funding for President Trump’s 2019 Ending the HIV Epidemic (EHE) initiative appears to remain intact, this program relies on the existence of the HIV prevention, care, and treatment infrastructure which the budget proposes to cut. The budget also would move EHE activities into AHA, further undermining this work by disrupting and dismantling the expert staffing and infrastructure that has overseen the successful initiative for the past six years. Though EHE has  reduced the number of new HIV cases and connected thousands of people with HIV to critical care, these cuts would erase these accomplishments and future progress will be impossible without foundational federal HIV programs the budget request proposes to eliminate and devastate.

The Administration has proposed the largest cuts ever to HIV programs, and if implemented, these program cuts and eliminations will harm people living with HIV by robbing them of health and the ability to lead long, productive lives caring for their families and communities. These proposals also will foster a resurgence of the HIV epidemic, resulting in thousands of more people dying, many more HIV outbreaks, increasing numbers of new HIV cases overall after recent years of reductions. And without an adequate HIV prevention, care, treatment and research systems, states and localities will face a disastrous combination of higher costs and stress on the already strained health care system and more illness and death in communities nationwide. 

In this month of Pride, people living with or vulnerable to HIV, their allies, and communities call upon Congress to fully reject this cruel and costly proposal by maintaining existing funding and infrastructure for effective HIV programs. For over 35 years, these programs have produced exceptional results serving rural, urban, and suburban communities all across America. Now is not the time to throw away so much progress and waste billions of dollars of federal investments that have showcased America’s innovation and success. Instead we must double down and strengthen our effort to finally end the HIV epidemic once and for all with the highly effective tools and interventions currently available as well as those yet to be delivered by government funded research.