GUEST COLUMN, Joey Mattingly, University of Utah College of Pharmacy
The federal government is poised to undo years of hard-won progress in the fight against HIV -- a deadly and highly infectious disease that seems to have lost its urgency due to our successes in prevention and treatment.
Firings at the CDC by DOGE and the Trump administration’s 2026 budget request marked the start of this surprising and dangerous retreat. The administration proposed to eliminate all $800 million in funding for the Centers for Disease Control and Prevention’s Division of HIV Prevention -- the backbone of the nation’s HIV response that funds testing, outbreak tracking, and access to PrEP, which are drugs that prevent HIV.
Next, House Republicans approved in Committee their proposed 2026 health spending bill that goes even further. In addition to eliminating all HIV prevention at the CDC, it would defund President Trump’s own "Ending the HIV Epidemic" (EHE) initiative, which he launched in 2019 with the aim of reducing new HIV infections by 90% by 2030. And, it would slash the Ryan White HIV/AIDS Program -- which provides vital support for low-income people with HIV -- by 20%.
These are reckless, short-sighted cuts that would not make America healthy again -- they would reignite the HIV epidemic in America and drive up U.S. healthcare spending in the long run.
We know the value of prevention. Every infection averted saves more than $1,299,000 in lifetime medical costs. One analysis projects that eliminating CDC’s prevention programs would result in more than 143,000 additional infections and 14,700 deaths by 2030 -- and over $60 billion in added medical costs. At a time when we have the tools to prevent HIV -- including new long-acting forms of PrEP -- abandoning this effort would be nothing short of catastrophic from both a public health and economic standpoint.
The proposed cuts to the Ryan White HIV/AIDS Program are also alarming. The program provides care and medication to more than 500,000 low-income, un- or underinsured individuals with HIV.
Cutting one-fifth of its funding -- roughly $525 million -- would mean fewer patients receiving lifesaving treatment, more people falling out of care, and a greater risk of transmission.
It bears remembering that the United States has made tremendous strides against HIV in recent years. From 2018 to 2022, new infections declined by 12% nationwide -- and by 21% in the communities targeted by the Ending the HIV Epidemic initiative. However, there were still 39,000 new diagnoses in 2023, with over half of them in the South.
Eliminating HIV prevention funding now would squander that progress and contradict President Trump’s original commitment to end HIV by 2030.
The Senate, to its credit, has recognized this reality. In a bipartisan vote, Senate appropriators rejected the proposed elimination of HIV prevention programs and instead maintained funding for prevention, treatment, and PrEP.
The path forward should be clear. The House and Senate must work together to pass a final spending bill that preserves funding for HIV prevention and treatment -- so that we do not retreat to the days of the past and keep the United States on track to end the epidemic once and for all.
Carl Schmid is executive director of the HIV+Hepatitis Policy Institute. This piece originally ran in RealClearHealth.
