The White House released its FY 2021 budget request to Congress on February 10, 2020, which includes funding for key programs aimed at addressing the domestic HIV epidemic.  Specifically, the request asks for funding for HIV activities at the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration’s (HRSA) Ryan White HIV/AIDS and Health Center Programs, the National Institutes of Health (NIH), and the Indian Health Service (IHS).  Details on additional funding in other departments/agencies is not yet known but will be provided here, when available.

The request supports historic HIV-related activities within the agencies as well as the second year of the Trump Administration’s “Ending the HIV Epidemic (EHE)” initiative.  Key budget highlights are as follows (see tables below for additional detail).

CDC – HIV prevention

Funding for domestic HIV prevention at the CDC, which accounts for most federal funding for domestic HIV prevention, totals $1,160 million in the request, an increase of $231 million (25%) over both the FY 2020 enacted level and the President’s FY 2020 request.

All of the increase is attributed to the EHE. If finalized, CDC EHE funding in the FY21 Request would represent an increase of $231 million (165%) over both the FY 2020 enacted level for the EHE at CDC and the President’s FY 2020 EHE request.

HRSA – Ryan White and Health Center HIV Funding

• The Ryan White HIV/AIDS Program, the nation’s safety net for HIV care and treatment, receives $2,484 million in the FY 2021 request, a $95 million (4%) increase over both the FY 2020 enacted level and the President’s FY 2020 request. All of the increase for Ryan White is attributed to EHE activities, which receive $165 million in the request, an increase of $95 million (136%) over both the FY 2020 enacted level and the President’s FY 2020 request for EHE activities through the program.
• The FY 2021 budget request also includes HIV funding for the Health Center Program at HRSA, all of which is for the EHE initiative, totaling $137 million, an $87 million (174%) increase over both the FY 2020 enacted level and the President’s FY 2020 request for EHE activities.

NIH – Domestic HIV Research

• The National Institutes of Health (NIH) carries out almost all federally funded HIV research activities. In the FY 2021 budget request, domestic HIV research funding at NIH totaled $2,2534 million, which if finalized, would be a decrease of $218 million (-9%) over the FY 2020 enacted level and a 7% increase over the President’s FY 2020 request.
• All new domestic HIV NIH funding in the request is attributed to the EHE. The agency received $16 million in EHE funding in the request. If finalized, NIH EHE funding in the FY 2021 request would be an increase of $10 million (167%) over both the FY 2020 enacted level and the President’s FY 2020 request for EHE activities.

IHS

• The FY 2021 budget request includes $27 million for EHE activities at the IHS. While the FY 2020 budget request included $25 million in EHE funding for IHS, no funding was appropriated by Congress.

The tables below compare federal funding levels for domestic HIV, where specified, in the FY 2021 request to the FY 2020 enacted levels and the FY 2020 request. Funding for the “Ending the HIV” Initiative is included in the overall table (Table 1) and in a dedicated table (Table 2).

Key Documents:

• White House FY 2021 Budget Resources
• CDC Congressional Budget Justifications
• HRSA Congressional Budget Justifications
• NIH Congressional Budget Justifications
• IHS Congressional Budget Justifications