The Washington Blade - March 2, 2001
Lou Chibbaro Jr.

But AIDS activists and lobbyists say the increase actually leaves a gap of more than $900 million in the HHS budget that will likely lead to cuts in other HHS programs, including, possibly, important AIDS programs.

In a 207-page budget "blueprint" released by the White House on Wednesday, Feb. 28, following the president's budget speech to Congress Tuesday night, Bush also proposed unspecified increases in funding for the Housing Opportunities for People With AIDS program and for the U.S. Agency for International Development's effort to combat AIDS in developing nations, including those in Africa.

In addition, the Bush budget document proposes a $124 million increase in the federal Community Health Care Centers program, which, among other things, provides assistance to people with AIDS who have low incomes. Another health-related section in the budget document that AIDS activists say can help people with AIDS is a call for an increase of $111 million to expand substance abuse treatment services to people with low incomes.

The budget document makes no mention of proposed funding levels for breast cancer research programs.

White House officials said more details, including the specific "line-item" funding levels for HOPWA and overseas AIDS program, along with all other programs, will become available when the president submits his full fiscal year 2002 budget to Congress in April.

Two national groups that monitor the government's AIDS programs - the national advocacy coalition AIDS Action and the Gay political group Human Rights Campaign - praised the president for proposing funding hikes for NIH and the other AIDS-related programs. But the groups cautioned that the budget numbers in Bush's preliminary budget document suggest that cuts may be in the works for other important AIDS programs.

Bush's proposed funding increases for NIH, the community health centers, and the substance abuse treatment program come to a combined total of slightly more than $3 billion, they note, and constitute the only programs slated for a budget increase within the Department of Health and Human Services discretionary budget, according to the president's "blueprint" budget. (The HOPWA program falls under the Department of Housing and Urban Development budget and the international AIDS program falls under the State Department's budget.) At the same time, officials with the two groups point out, the Bush budget blueprint calls for an overall increase of only $2.1 billion in discretionary health-related programs under HHS - an increase that leaves a gap of more than $900 million in the HHS budget. That gap, said HRC and AIDS Action officials, will likely be reconciled by cuts in other HHS programs.

"We commend the Bush administration for increasing funds for research at the National Institutes of Health at a time when the AIDS epidemic is exacting an enormous toll on people's lives both nationally and globally," said Winnie Stachelberg, HRC's political director. "The initial view of the budget appears favorable in certain areas." But Stachelberg expressed concern that the administration may also cut funds from other important AIDS programs.

"[W]ith a $2.1 billion increase for public health programs and $2.8 billion earmarked for the NIH," HRC said in a statement, "some cuts will need to be made to other public health programs to balance the books."

"Does this mean that funding for other programs in public health will have to be decreased by more than $900 million?" asked Alexis Schuler, AIDS Action's public policy director. "Where will those cuts come from? Will it be the [U.S. Centers for Disease Control and Prevention's] HIV prevention program? Will it come from the Ryan White [CARE Act] program?"

Administration officials said details on which programs will be cut will become available in April, when the administration submits its final budget document. Kevin Ivers, a spokesperson for Log Cabin Republicans, the national Gay Republican group, called on Gay and AIDS activists to wait for the final budget numbers to be released before "jumping to conclusions" about budget cuts.

"It would behoove people to work with this administration and with this Congress to achieve sound public policy instead of looking for things to criticize," Ivers said. "To look at this and to immediately accuse the president of cutting [AIDS programs] is not the most prudent thing to do right now."

Ivers said Log Cabin believes the administration will be open to suggestions on the AIDS programs when it releases its final budget document in April. Stachelberg and Schuler said their groups look forward to working with the administration to fine-tune the AIDS budget. The two said they are hopeful the president will come up with a way to avoid making cuts in AIDS programs. But Schuler added that she does not think that would be possible unless Bush increases overall funding for public health programs.

"Right now, the overall funding is too low," she said. Schuler and Stachelberg said they are also concerned that the section of the budget document calling for the $2.8 billion increase in the NIH budget makes no mention of AIDS research. In its only reference to specific diseases associated with NIH programs, it states that the president's proposal calls for "a substantial funding increase to support the highest levels of research in the diseases that threaten the lives of many Americans, including cancer, diabetes, Alzheimer's, Parkinson's and other diseases afflicting the elderly."

U.S. Health and Human Services Secretary Tommy Thompson and NIH official Anthony Fauci, who heads NIH's AIDS research program, told reporters at a budget briefing Wednesday, Feb. 28, that AIDS research programs will increase significantly under the president's budget.

"We are often asked, can we well spend this money," Fauci said at the briefing. "The answer is a resounding yes."

Thompson, who told reporters he spoke with a person with AIDS while visiting the NIH AIDS clinic just prior to the budget briefing, said he is hopeful that NIH-backed research would soon lead to a scientific breakthrough that will greatly curtail the threat of AIDS.

In response to questions from reporters, Thompson said it would be up to the "scientists and the researchers" at NIH to decide how the increased funds should be divided between AIDS and research into other diseases.

Information released by the House Appropriations Committee, which oversees budget matters, shows that Congress approved $1.8 billion in funding for the NIH AIDS research program in fiscal year 1999, $2.0 billion in fiscal 2000, and $2.2 billion in fiscal 2001.

Don Ralbovsky, an NIH spokesperson, said proposed spending levels for AIDS research with the NIH budget will be released in April as part of the president's budget proposal to Congress.

Ralbovsky said past spending levels for breast cancer research at NIH came to $474.7 million in fiscal year 1999, $523.8 million in 2000, and $560 million in 2001.

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