President’s Obama’s fiscal year (FY) 2017 Budget Request was released earlier this week.  A brief overview of the full budget can be found here.  While the President’s Budget request does not have the force of law, it does outline the Administration’s priorities and begins the annual Appropriations process.

Overall funding for STD and HIV Prevention

The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) received a $5 million increase in this budget proposal.  The Division of STD Prevention, the Division of HIV Prevention and the Division of Adolescent and School Health were all flat funded in this request as compared to current funding levels.  The Division of Viral Hepatitis received a $5 million proposed increase.  Additional information on funding for NCHHSTP contained in this proposal can be found starting on page 65 of the Centers for Disease Control and Prevention’s Congressional Justification.

New PrEP Demonstration Project

The budget proposal includes $20 million for a new innovative pilot program to increase access to PrEP and allow grantees, as the payer of last resort, to use a portion of funds to purchase the medication and other related healthcare services.  As stated on page 69 of the CDC’s Congressional Justification: “This demonstration project will allow health departments to use up to 30 percent of available funds to pay for PrEP medications as the payor of last resort.  This is consistent with the updated National HIV/AIDS Strategy, which calls for providing more people with highly effective prevention services such as pre-exposure prophylaxis (PrEP) to reduce new HIV infections.  PrEP has been shown to reduce the risk of HIV infection by greater than 90 percent when taken as prescribed.”

Since the Division of HIV Prevention did not receive additional funds in this proposal with which to implement this PrEP demonstration project, it is believed this new grant program is using existing funds, possibly a re-allocation of the Category C section of existing health department HIV prevention grants.

Antibiotic Resistance

Existing activities for monitoring gonorrhea resistance also gets a mention in this proposal under the section on current antibiotic resistance activities, saying: “The CDC Prevention EpiCenters will continue to conduct a variety of breakthrough research on…antibiotic resistance topics including: Better monitoring gonorrhea (GC) treatment and supporting rapid response GC prevention teams to ultimately reduce the spread of drug-resistant GC. These actions ensured high-risk jurisdictions had appropriate response capacity to rapidly detect treatment failures, evaluate treatment effectiveness, determine transmission patterns and risk factors for resistant infections, and evaluate the value of tests of-cure for surveillance and clinical treatment through implementation and evaluation of routine tests of-cure” (CDC Congressional Justification, page 131).

Reproductive Health Services for Adolescents and High Risk Youth

This budget proposal also includes $17 million within CDC’s Safe Motherhood and Infant Health functions to “conduct research and translate science into practice to reduce sexual risk behaviors and teen pregnancy; develop innovative interventions for 15- to 24-year old young men to reduce their risk of fathering a teen pregnancy; and collaborate with health centers and youth serving organizations to implement evidence-based reproductive health services for adolescents and high risk youth.”  Again, these functions will be fulfilled with existing money through the continuation of two cooperative agreements for teen pregnancy prevention.  Additional information can be found on page 201 of the CDC’s Congressional Justification.

While NCSD is pleased that this proposal did not contain a cut for STD prevention and control, we are also aware that current funding does not meet the needs of the field at a time of ever-increasing STD rates and diminishing workforce capacity to respond to these growing needs.  NCSD is currently firming up our FY17 appropriations request documents, but know that we are engaging with members of Congress to outline the needs of our members.