May 17, 2023

Washington, D.C. — As the debt ceiling negotiations take center stage this week, the O’Neill Institute for National and Global Health Law released a new brief highlighting the far-reaching implications of potential cuts to discretionary spending on HIV programs and prevention. It explains how these cuts would significantly undermine the tremendous progress achieved through federal investments that have moved the nation closer to ending the HIV epidemic. 

According to the CDC, effective prevention interventions, such as treatment as prevention, PrEP daily medication (pre-exposure prophylaxis), and condoms, have led to a decrease in new HIV diagnoses in the United States from 47,500 in 2010 to 35,940 in 2019, resulting in 10,560 fewer cases.

There is a great potential risk of reversing the progress that has been made if discretionary funding is reduced. Republican lawmakers want the Biden Administration to make deep spending cuts to health care, housing programs, and food assistance as a compromise to raising the debt ceiling. As part of their proposal, the Congressional Budget Office estimates that federal discretionary spending in 2024 would be reduced to fiscal 2022 levels, amounting to about $3.6 trillion in cuts over the next decade. 

“Consistent federal funding for HIV prevention, care, research, and social services is critical and has moved us closer to ending the HIV epidemic as a public health threat,” emphasized Jeffrey Crowley, director of O’Neill’s Infectious Diseases Initiative. “Failure to invest in HIV funding would reduce HIV testing, lessen access to PrEP and condoms that prevent transmission, and decrease the number of people linked to care and treatment. Federal funding cuts would lead to even more people with HIV and result in increased public spending to treat preventable conditions.”

The new resource outlines five ways potential HIV funding cuts would cause harm:

  1. Progress in combating HIV through the Ending the HIV Epidemic Initiative (EHE) would be reversed, and the need for public HIV treatment services would increase, as well as costs.
  2. The HIV housing crisis would be exacerbated, leading to more homelessness and transmissions that would drive up preventable health care costs. 
  3. Overdose deaths and concentrated HIV outbreaks tied to injection drug use would increase because state and local health departments would have fewer resources to identify outbreaks.
  4. NIH HIV research into mRNA technology and antiretroviral treatments made the rapid development of COVID-19 vaccines and therapeutics possible. Scientific breakthroughs in cures for HIV, cancer, and emerging infectious diseases could be stifled if this research is reduced.
  5. During the pandemic, HIV experts provided critical expertise and capacity to educate, test, vaccinate, and treat people with COVID-19 and mpox. The nation’s capacity to respond to the next infectious disease threat would be weakened if HIV funding were reduced. 

Read the resource here.


To schedule an interview with Jeffrey Crowley, please contact Cynthia Sun at