AVAC’s Executive director Mitchell Warren today released the following statement on the proposed 2018 budget from the Trump Administration:

President Trump’s 2018 budget request delivered to Congress yesterday would be a disaster for people living with HIV and for those at risk of HIV infection here in the US and around the world.

The budget, entitled “A New Foundation for American Greatness,” would, in fact, devastate health, development and research programs that are hallmarks of America’s profound commitment to advancing knowledge and saving lives at home and abroad. AVAC stands in solidarity with many partner organizations in calling on Members of Congress to restate the long-standing bipartisan support for a comprehensive domestic and global AIDS response.

No HIV treatment, prevention or research program supported by the US government is left untouched in the proposed budget. Critical global and domestic health, development and poverty programs also face devastating cuts. Evidence has shown us that the HIV pandemic is driven by poverty, gender inequality and violence, as are virtually all disease outbreaks. The spectrum of proposed cuts in this budget create conditions where HIV and other health threats will thrive, as America’s superb research and implementation capacities are hobbled and unable to respond.

• The US PEPFAR program and the Global Fund to Fight AIDS, Tuberculosis and Malaria—to which the US is a major contributor—together provide the bulk of funding for HIV prevention, treatment and care programs in sub-Saharan Africa and other parts of the developing world. Both would receive significant cuts of approximately 15 percent in this proposed budget. These proposed reductions would have a disastrous and deadly impact on the fight to bring the AIDS epidemic to a conclusive end, as would cuts in related areas including family planning, reproductive health, and scientific research.

• The proposed budget cuts USAID’s global health programs by a devastating 50 percent, and eliminates long-term investments in critical vaccine and microbicide research.

• A $7 billion cut to the NIH includes a $1.1 billion cut to NIAID–almost a quarter of that Institute’s budget – which would likely have a devastating impact on HIV research overall, research and development of vaccines and other new prevention options, and scientific innovation.

• Cuts to the CDC, the elimination of NIH’s Fogarty International Center, cuts to Medicaid and the Ryan White Program and other devastating and irrational cuts to the budget make it clear that this is nothing less than an assault on the health of citizens everywhere—in the US and abroad.

The budget proposal asserts the US government will continue treatment for “all current HIV/AIDS patients” under PEPFAR. PEPFAR has succeeded by increasing the number of people on treatment every year and providing critical funding for primary prevention programs. Increasing the number of people on treatment every year has contributed to the ambitious global goal of curbing the epidemic and of moving toward universal access to HIV treatment, a fundamental human right. Simply maintaining current treatment rolls is poor science and a poor investment of US resources. We know an increase in antiretroviral treatment (ART) programs with a parallel unstinting investment in additional HIV prevention programs, including voluntary medical male circumcision, condom programs and oral PrEP, will have significant impact on the pandemic. The proposed budget approach, which threatens prevention as well as treatment, will not.

The US government is the largest funder of HIV and global health programs and research. After years of prudent investment, we have seen amazing dividends in lives saved, families kept together, communities revitalized and economies boosted. Global health and HIV programs have enjoyed bipartisan support throughout the previous Bush and Obama Administrations. We call on the Congress to remember why these programs have been consistently supported and ensure they are reinstated in the 2018 budget.

Today the Trump Administration took steps to implement a policy change that will endanger the lives of millions of adolescent girls and young women living in countries supported by US global health development aid. The State Department released a communication on the expansion of the “Global Gag Rule” — also known as the Mexico City Policy. The updated policy applies not only to US global health assistance for family planning—as have previous iterations of the Global Gag Rule—but to all US global health assistance.

The expansion has been erroneously rebranded as “Protecting Life in Global Health Assistance.” This policy is not life-saving; it is the opposite. This expanded rule will force clinics to close and women to lose access to contraception, HIV prevention and maternal health care, resulting in more unintended pregnancies and more unsafe abortions. It will prevent advocates, community health workers and others from sharing important information with women and girls most at risk.

Today’s announcement makes it crystal clear that the new administration does not value the lives of women and girls. US government funding and support for service provision and research and development under long-standing bipartisan leadership from both the legislative and executive branches has saved millions of lives and helped advance human rights for girls and women in Africa. It is infuriating to see Donald Trump roll back advances in health and human rights for women and girls with the stroke of a pen.

We know that because of the George W. Bush administration’s use of the Global Gag Rule many women and girls in developing countries were unable to access family planning and health services and some of them died because of that. With the present “youth bulge” in Africa, there are, in some countries, double the number of young people than there were when the epidemic began. Many of these young people are more concerned about pregnancy prevention than they are about HIV prevention; they need comprehensive services for both HIV and family planning. Today there are millions of girls and young women seeking access to contraception, HIV prevention and treatment and other health services. The Trump administration has just closed the doors to clinics offering comprehensive services that will save their lives and the lives of their children.

AVAC and our partners in Africa will do all that we can to help ensure that lifesaving programs and information for women and girls continue. And we will continue to speak out against the immoral and anti-public health decisions made by this administration.

PLOS Medicine has an open call for papers for the Special Issue: Advances in HIV Prevention, Treatment and Cure publishing in late 2017 and guest edited by Drs. Linda-Gail Bekker, Steven Deeks and Sharon Lewin. Submit by June 9th. For more information click here.