Funding for the Ending the HIV Epidemic Initiative
For information about Fiscal Year 2022 (FY2022) HHS budget resources supporting the implementation of the Ending the HIV Epidemic (EHE) initiative, as well as President Biden’s FY2023 budget request for EHE, see Ending the HIV Epidemic Funding.
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 or at risk for HIV.
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 programs and research for Fiscal Years 2020-2022 and President Biden’s budget request for FY2023. For information about federal resources supporting the Ending the HIV Epidemic (EHE) initiative, 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, including discretionary spending as well as mandatory spending for Medicare, Medicaid, Social Security benefits, and other mandatory spending.
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), the Health Resources and Services Administration (HRSA), the Centers for Disease Control and Prevention (CDC), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Indian Health Service (IHS), the Food and Drug Administration (FDA), the Office of Infectious Disease and HIV /AIDS Policy (OIDP), 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 unique histories. (Read more about Federal agencies engaged in HIV activities.)
The table below summarizes the Congressionally enacted budgets for Fiscal Years (FY) 2020, 2021, and 2022 (October 1-September 30) and President Biden’s FY2023 budget request.
U.S. Federal Domestic Discretionary Funding for HIV/AIDS: FY 2020-2023
(in USD $ Millions)
|Program/Account||FY 2020||FY 2021||FY 2022||FY 2023 request|
CDC Domestic HIV Prevention
CDC Domestic HIV PreventionIncluding EHE
HRSA Ryan White HIV/AIDS Program
HRSA Ryan White HIV/AIDS Program Including ADAP (AIDS Drug Assistance Program)
HRSA Ryan White HIV/AIDS Program Including EHE
HRSA Health Centers Program (only EHE funding)
Indian Health Service (only EHE funding)
NIH – AIDS research*
NIH – AIDS research* Including EHE
SAMHSA (all Minority AIDS Initiative)
HHS Minority HIV/AIDS Fund
HUD – Housing Opportunities for Persons With AIDS (HOPWA)
Subtotal: HIV Discretionary Spending
NOTES: *The NIH does not define HIV research as “domestic” given its broad application; the figure listed is for all HIV research regardless of whether it is global or domestic. NIH states that the President’s Budget for FY 2023 proposes an increase over the FY 2022 Continuing Resolution for all of NIH’s 27 Institutes and Centers (ICs). The President’s Budget used the Continuing Resolution as the base of all discretionary budget decisions, including NIH’s ICs.
FY2023 Request for PrEP Funding—In addition to the items above, President Biden’s FY2023 budget request includes $237 million for the first year of a new 10-year $9.8 billion mandatory national program to guarantee PrEP at no cost for all uninsured and underinsured individuals, provide essential wrap-around services through States, IHS and tribal entities, and localities, and establish a network of community providers to reach underserved areas and populations. The FY2023 budget proposal also expands access to PrEP under Medicaid by covering the drug and associated services without cost sharing, while removing utilization management practices that may limit access.
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 37.7 million individuals living with HIV/AIDS around the world. PEPFAR was launched in 2003 with strong bipartisan support sustained across four presidencies and 10 U.S. Congresses.
Through PEPFAR, the U.S. government has invested over $100 billion in the global HIV/AIDS response, the largest commitment by any nation to address a single disease in history, saving over 20 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.