U.S. President Donald Trump has sent the U.S. Congress a proposed budget for the 2019 fiscal year that includes a cut of about $425 million in funding for the Global Fund. The 2019 fiscal year starts on 1 October 2018. The U.S. is by far the largest contributor to the Global Fund, providing about $1.35 billion a year. The proposed budget “has little to no chance of being enacted as written and amounts to a vision statement by Mr Trump,” an article in the
New York Times
declared. Nevertheless, NGOs were quick to speak out against the proposed cuts. The Health Global Access Project (Health GAP) estimated that that the proposed budget would cut well over one billion dollars from global AIDS programs in the State Department, USAID (including PEPFAR and the U.S. President’s Malaria Initiative) and the Centers for Disease Control and Prevention. A cut of $425 million to the Global Fund would have devastating consequences. Friends of the Global Fight Against AIDS, Tuberculosis and Malaria (Friends) estimated that the cuts would result in:

• 565,250 fewer lives saved through Global Fund–supported programs;
• 454,750 fewer people put on antiretroviral therapy;
• 131,750 fewer women on treatment to prevent passing HIV to their babies;
• 650,250 fewer people on TB treatment and care;
• 18,275 fewer people on treatment for multi-drug-resistant TB;
• 26 million fewer mosquito nets distributed to protect children and families from malaria;
• 5.1 million fewer households receiving indoor residual spraying to protect children and families from malaria; and
• The loss of the potential to prevent eight million new HIV, TB and malaria infections.

“These proposed cuts would squander our progress against AIDS, tuberculosis and malaria, and risk resurgence of disease,” said Chris Collins, President of Friends, in a news release. “Divesting from America’s commitment to fighting infectious diseases would have a devastating impact on the lives of millions of people across the globe, and would undermine our own country’s security and economic interests. We cannot stand by and allow epidemics to continue to claim millions of lives, drain billions of dollars from economies, and put our own health security at risk.” In a prepared statement, Health GAP Executive Director Asia Russell said that “if this budget passes as proposed, Donald Trump’s legacy will be millions of new and unnecessary infections and deaths –– and a massive resurgence in the AIDS pandemic.” Russell added: “President Trump’s proposal to cut over a billion dollars from the U.S. global HIV response in fiscal year 2019 shows how very out of touch he is with the American people and their values. Americans from across the political spectrum and every part of the country support the U.S. government’s long-standing leadership in funding life-saving HIV treatment and prevention programs in sub-Saharan Africa and across the developing world.” Russell added that “Congress should treat this proposal the way they treated the President’s first budget –– by declaring it dead on arrival.” Last Fall, GFO reported that the appropriations committees in the U.S. Senate and House of Representatives approved funding for global health programs for the fiscal year 2018 at about the same levels as the previous year. “In so doing, the committees ignored the budget proposed by President Donald Trump which called for cuts of $2.5 billion overall, including $225 million less for the Global Fund and $1 billion less for PEPFAR.”

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