Each year, the U.S. government spends billions of dollars to help people in the United States and countries around the world who are living with HIV/AIDS.
By law, Federal programs must provide information on how they spend the funds they receive. Transparency in government promotes accountability, and provides meaningful access to information so that citizens can know what their government is doing and how Federal dollars are being spent. Review the chart below for an overview of Federal budget allocations for domestic HIV/AIDS programs and research in FY2018 and FY2019. This chart is being updated. In the meantime, for information about FY2019 resources supporting Ending the HIV Epidemic (EHE) initiative preliminary activities, FY2020 budget allocations for additional resources for EHE activities, and EHE funding in the FY2021 budget proposal, see Ending the HIV Epidemic Funding.
Federal Domestic HIV/AIDS Programs & Research Spending
The U.S. government investment in the domestic response to HIV has risen to more than $28 billion per year.
Funding for HIV services and activities is spread across multiple federal departments, including Health and Human Services (HHS), Housing and Urban Development (HUD), Justice, Veterans Affairs (VA), and Defense. Within HHS, in particular, responsibility for HIV programs is spread across multiple agencies including the Centers for Medicare & Medicaid Services (CMS), Health Resources and Services Administration (HRSA), Centers for Disease Control and Prevention (CDC), Substance Abuse and Mental Health Services Administration (SAMHSA), the Indian Health Service (IHS), the Food and Drug Administration (FDA), the Office of HIV/AIDS and Infectious Disease Policy (OHAIDP), the Office of Minority Health, and others. Responsibility for HIV research is led by the National Institutes of Health (NIH); in addition, CDC, VA, Defense, and the United States Agency for International Development also support research initiatives. This distribution of responsibility is appropriate, as each agency has its own expertise, and different agencies operate different programs with varying legislative mandates, purposes and with unique histories. (Read more about Federal agencies engaged in HIV activities.)
The table below summarizes the Congressionally enacted budgets for FY2018 and FY2019 (October 1-September 30).
U.S. Federal Funding for HIV/AIDS: FY 2018 – 20191
(Info in USD $ Millions. Source: Kaiser Family Foundation fact sheet, U.S. Federal Funding for HIV/AIDS: Trends Over Time )
Program/Account | FY 2018 | FY 2019 |
---|---|---|
Ryan White Program 2 | $2,318.8 | $2,318.8 |
ADAP (non-add) | $900.3 | $900.3 |
CDC Domestic Prevention (& Research) | $788.7 | $788.7 |
NIH (domestic only) 3 | $2,430.7 | $2,455.0 |
SAMHSA | $181.0 | $181.0 |
VA | $1,160.4 | $1,204.1 |
Housing Opportunities for Persons w/ AIDS (HOPWA) | $375.0 | $393.0 |
Other domestic discretionary 4 | $410.8 | $410.8 |
Subtotal discretionary | $7,665.4 | $7,751.4 |
Medicaid | $6,070.0 | $6,340.0 |
Medicare | $10,320.0 | $11,040.0 |
Social Security Disability Ins. (SSDI) | $2,099.0 | $2,099.0 |
Supplemental Security Income (SSI) | $580.0 | $580.0 |
Federal Employees Health Benefits (FEHB) Plan | $211.0 | $211.0 |
Subtotal mandatory | $19,280.0 | $20,270.0 |
Total domestic | $26,945.4 | $28,021.4 |
NOTES: (1) Data are rounded and some data are still considered preliminary. FY 2019 funding levels for SSDI, SSI, some USAID funding, and some accounts included in “other domestic discretionary” are not yet known; for comparison purposes, these amounts are estimated using prior year levels. (2) Ryan White totals include $25 million for Special Projects of National Significance (SPNS). (3) The NIH does not define HIV research as “domestic” given its broad application. However, for purposes of this analysis, all HIV research funding not designated as “global” was considered domestic research. (5) “Other domestic funding” includes amounts at: HHS Office of the Secretary; Health Resources and Services Administration; Food and Drug Administration; Indian Health Service; Agency for Healthcare Research and Quality; and the Departments of Defense, Justice, and Labor.
U.S. Investment in the Global Response to HIV/AIDS
The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is the U.S. Government initiative to help save the lives of the more than 36 million individuals living with HIV/AIDS around the world. PEPFAR was launched in 2003 with strong bipartisan support from the U.S. Congress.
Through PEPFAR, the U.S. government has invested over $85 billion in the global HIV/AIDS response, the largest commitment by any nation to address a single disease in history, saving over 18 million lives, preventing millions of HIV infections, and accelerating progress toward controlling the global HIV/AIDS epidemic in more than 50 countries. For details on current and recent funding, view PEPFAR’s Results and Funding page. The PEPFAR Dashboards allow users to view and utilize PEPFAR planned funding, program results, and expenditure analysis data in an accessible and easy-to-use format.