Congress finalizes FY 2013 budget with PEPFAR cut, Global Fund boost

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capitolThe President’s Emergency Plan for AIDS Relief  took a hit while the Global Fund to Fight AIDS, Tuberculosis and Malaria got a boost last week when the House and Senate passed a Continuing Resolution bill to avoid a government shutdown and continue funding the government through Oct. 1, the end of fiscal year 2013. The House voted 318-109 to approve a version of the resolution that was passed by the Senate earlier this month. For the first half of FY 2013, Congress had funded most federal programs at FY 2012 levels, with an end date of March 27.

Under the resolution, PEPFAR is slated to receive $4.067 billion, a $176 million – 4 percent — cut from the FY 2012 level of $4.243 billion. An additional 5 percent cut from the automatic across-the-board budget cuts known as sequestration, means PEPFAR’s total is $3.863 billion — $380 million below FY 2012 spending and the lowest funding level since FY 2007.

In contrast, the Global Fund’s new funding under the resolution is $1.648 billion, up 27 percent, or $348 million from the $1.3 billion received in FY 2012. With the 5 percent cut from sequestration, the Global Fund will still get more than last year: $1.566 billion for FY 2013.

PEPFAR was initially allocated $4.493 million for FY 2012, while the Global Fund was allocated $1.05 billion. During the fiscal year, however, the Obama Administration transferred $250 million from PEPFAR to the Global Fund.

The USAID global tuberculosis program will also see reduced funding thanks to the sequestration cut, losing $12.8 million from its FY 2012 allocation of $256 million. The Centers for Disease Control and Prevention’s Division of TB Elimination, which houses domestic TB control and the TB trials consortium, will also take a 5 percent cut, losing $7 million from its FY 2012 allocation of $140.1 million.

The National Institutes of Health saw an increase of $71 million over FY 2012 funding, but will still be subject to the 5 percent sequestration cut. This will cause substantial spending reductions at the National Institute on Allergies and Infectious Diseases—home to significant investments in HIV and TB research. HIV clinical trial networks will take a significantly larger hit than 5 percent, with potential adverse impacts on both HIV and TB clinical trials.

Earlier this month, amfAR, the Foundation for AIDS Research, outlined the human toll of global health sequestration cuts in this brief. According to the brief, 162,200 people will lose access to HIV/AIDS treatment, potentially leading to 37,000 more AIDS-related deaths, and 72,800 more children becoming orphans. AmfAR estimates that 63,400 fewer HIV-infected pregnant women will receive prevention of mother-to-child transmission services, leading to more than 12,000 infants becoming infected with HIV.  35,300 TB patients will also lose treatment, leading to 4,200 more deaths from TB.

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