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Physicians Applaud President's Commitment to Global Health, Call on Congress to Follow Suit

February 15, 2011 - WASHINGTON - Keeping true to his promise, President Barack Obama released his fiscal year (FY) 2012 budget request Monday, which includes more than $1 trillion in deficit reduction, two-thirds achieved from strategic cuts. Infectious diseases experts applauded the small increases proposed to global AIDS and TB programs, an acknowledgment of the key relationship between supporting global health programs and national security. Unfortunately, on the other side of Pennsylvania Avenue, the Republican leadership of the House seems determined to impose real cuts in these life-saving programs. If enacted, the impact of these cuts will be devastating in terms of lives lost and new infections, even if the Congress adopts the Obama budget request for FY 2012.

Physicians commend the $1.3 billion funding request for FY 2012 for the Global Fund to Fight AIDS, Tuberculosis and Malaria - an increase of $250 million over the 2010 enacted contribution. This strong commitment to the Global Fund is absolutely vital to the global response to AIDS and its deadly twin, tuberculosis. The Fund remains the leading source of funding for TB care and treatment worldwide. Unfortunately, the FY 2012 request includes a marginal increase - $49 million or 0.9 percent increase over the 2010 enacted budget - for the President's Emergency Plan for AIDS Relief (PEPFAR), a program responsible for putting more than 3.2 million men, women and children worldwide on life-saving antiretroviral treatment. This budget is not adequate to scale up HIV treatment and prevention programs.

The PEPFAR program continues to make significant advancements, placing more than 600,000 HIV-positive women on antiretroviral therapy to prevent transmission of the virus to their babies in 2010, resulting in 114,000 infants born HIV-free. Given tough economic times, program administrators are practicing extensive cost-saving measures, such as procurement of generic antiretrovirals, to drive down program costs and grant a greater number of people access to care and treatment. But these cost savings are expected to run out soon, and more funding will be needed to sustain this important program and provide timely access to high-quality, life-saving medication for the two-thirds of people around the world who are clinically eligible but still await access to treatment.

"The progress we have made in the war against AIDS in the past few years speak directly to how smart an investment PEPFAR is," said Kenneth H. Mayer, MD, co-chair of the Center for Global Health Policy's Scientific Advisory Committee (SAC) and director of the Brown University AIDS Program. "In these times of economic distress, PEPFAR provided life-saving treatment to 700,000 new individuals in 2010, restoring them to health and allowing them to return to work, pay taxes and care for their families."

Global TB funding received a modest increase in the president's FY 2012 request, for a total of $236 million through the U.S. Agency on International Development - an $11 million increase for FY 2012 or 4.9 percent over FY 2010 enacted levels. This preventable and curable disease is the number one killer of HIV-infected people, and claimed the lives of 1.8 million people last year alone. While the president's requested increase is appreciated - much more is needed in order to combat this deadly disease that newly infected 9.4 million people in 2009.

"New diagnostic and treatment options are on the near horizon for TB control, and could finally turn the tide on the TB pandemic. Now is not the time to pull back on TB funding," said Carol Dukes Hamilton, MD, co-chair of the Global Center's SAC. "Drug-resistant forms of tuberculosis are on the rise and the less we invest now the more we will pay later down the line, not just in dollars but in lives."

On the domestic front , the president recommended a significant boost to HIV/AIDS programs, supporting his newly created National HIV/AIDS Strategy. However, he also recommended a cut to the U.S. Centers for Disease Control and Prevention (CDC) domestic TB budget by approximately $1.4 million - a cut of about one percent. "Slashing CDC's budget eats into state and local TB programs while at the same time pitting CDC-led research on new TB drugs against the very programs the research aims to help," Dr. Hamilton said.

The National Institutes of Health received a 3.4 percent increase under the president's plan for FY 2012, with biomedical research slated for a total of $32 billion, a $740 million increase over the 2010 enacted level. This includes a $74 million increase from the 2010 enacted level for HIV/AIDS research by expanding funding for intramural and extramural HIV/AIDS related research supported by NIH, for a total request of nearly $3.2 billion in 2012. After an impressive year of innovation in the field of HIV prevention - including encouraging trial results for pre-exposure prophylaxis for high-risk men who have sex with men and microbicidal vaginal gels for HIV-negative women - this investment is key to realize the potential of these innovations in confirmatory trials and among other populations.

"Support for life-saving and ground-breaking medical research is crucial, but a corresponding implementation funding boost is needed in order to speed these medical innovations to those who need them most," Dr. Mayer said.

Infectious diseases experts call on Congress to reject devastating cuts in global health programs in the current fiscal year and continue to provide financial support for these life-saving programs, with their power to transform families and communities.

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For a statement on proposed spending on infectious diseases overall, please visit the Infectious Diseases Society of America's website .

For more information or to schedule an interview with one of our physician-scientist experts, contact Meredith Mazzotta at 703-740-4954 or mmazzotta@idsociety.org.

The Center for Global Health Policy, established by the Infectious Diseases Society of America's Education & Research Foundation in 2008, supports and promotes U.S. efforts to combat HIV/AIDS and tuberculosis around the world. The Center provides scientific and policy information to U.S. policymakers, federal agencies, nongovernmental organizations and the news media, linking decision-makers to the latest evidence-based input and guidance from physician/scientists and other professionals from both developing and developed countries.

The Center for Global Health Policy is a project of the Infectious Diseases Society of America and the HIV Medicine Association. 1300 Wilson Blvd. Suite 300, Arlington, VA 22209 :: www.idsaglobalhealth.org :: Phone (703) 740-4955


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