Final FY18 Appropriations Resist Trump Administration’s Anti-Science Rhetoric, Affirm the Value of Research and Programs in the Elimination of HIV, Tuberculosis and Hepatitis C; Prevention Programs Must be Further Strengthened in FY19

Treatment Action Group (TAG) lauds Congress on soundly rejecting the President’s anti-science rhetoric with a fiscal year 2018 (FY18) appropriations bill that affirms the value of research and evidence-based programs to catalyze the elimination of HIV, tuberculosis (TB), and hepatitis C virus (HCV) domestically and internationally.

 “We urge Congress to build on this momentum in FY19 as well, to demonstrate to the President that we must continue to invest in the scientific research that brought us expansive treatment and prevention options for HIV, and investing in their delivery has saved countless lives,” said Mark Harrington, Executive Director of TAG. “Increased investments are vital to ending the epidemic with a vaccine and a cure.”

Under the agreement, the National Institutes of Health (NIH) budget was increased by $3.0 billion, in rejection of the administration’s proposed FY18 $5.8 billion cut that would have paralyzed ongoing research. Saved from elimination in the President’s proposed budget released a year ago, the Fogarty International Center at NIH received an additional $3.5 million to support its important mandate in training U.S. scientists abroad. The bill also provides a critical increase of approximately $353 million to NIH’s National Institute of Allergy and Infectious Diseases (NIAID).

“While these increases to NIH are encouraging, we hope to see this funding support ongoing HIV/AIDS research at NIAID and maximize the potential of research into new priorities,” said Tim Horn, TAG’s Deputy Executive Director of HIV and HCV Programs. On the programmatic side, however, Horn expressed concern over omnibus flat funding for the Ryan White program, which impacts more than half of all people living with HIV in the United States. “If we’re serious about ending HIV and AIDS, particularly with an increasingly fragile health care system, increased funding for Ryan White care, treatment, and support is critical.” 

Viral Hepatitis program at the Centers for Disease Control and Prevention (CDC) received a small boost, with an additional $5 million. But as noted by TAG and partners, the increase is still far short of the $100 million in funding needed to expand viral hepatitis screening and surveillance efforts. Particularly in the context of the well-publicized opioid epidemic with increasing injection drug use, where robust funding for harm reduction, hepatitis treatment and prevention efforts are vital.

The package acknowledges the growing crisis of drug-resistant TB and reaffirms the U.S. government’s important role, in a critical time where increased global political attention on the pandemic will culminate to a High-Level Meeting on TB at the United Nations in New York City later this year. The TB program at the U.S. Agency for International Development (USAID) received an increase of $20 million to support the agency’s work building capacity in highly-burdened countries, deploying the latest advances in diagnostics and treatment, and conducting innovative research.

Disappointingly however, the Division of TB Elimination (DTBE) at CDC was flat-funded at $142.2 million for yet another year. Despite its continued success, resourcefulness, and housing the research pioneering TB Trials Consortium (TBTC) – DTBE has not seen a significant increase since 1994.

“With an estimated 13 million people with TB infection in the U.S., and—thanks to U.S.-driven science—better options than ever to prevent their infection from turning into communicable disease, we need to resource DTBE to increase prevention work,” explains Erica Lessem, Deputy Executive Director of TB at TAG. “TB is on the rise in places like New York, and flat funding means that each year, we are forced to do more with less. Only by increasing DTBE’s budget can Congress put us on the path to elimination.”

Additional highlights include the rejection of proposed cuts to the Secretary’s Minority AIDS Initiative and the minority HIV/AIDS initiative at Substance Abuse and Mental Health Services Administration (SAMHSA). Important research and development institutions such as the Biomedical Advanced Research and Development Authority (BARDA) and the Department of Defense Congressionally Directed Medical Research Program (CDMRP) are now given a mandate to begin work on TB through language in the final bill. TAG will prioritize action and advocacy in FY19 appropriations to ensure that the progress made in the elimination of HIV, TB, and HCV continues.

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