Here’s how many fewer AIDS patients would be treated after sequestration

Members of Congress have left Washington without having made a deal to avoid the deep across-the-board spending cuts to federal agencies slated to begin March 1, and agency heads are already lamenting the potential damage to both foreign and domestic programs.

Secretary of Homeland Security Janet Napolitano said in a letter to Rep. Bennie G. Thompson (D-Miss.), ranking member of the House Homeland Security Committee, that the reductions would “roll back border security, increase wait times at ports of entry and airports, and require furloughs of up to 14 days for law enforcement personnel, among a host of other consequences,” as the Washington Post's Josh Hicks reported.

And as my colleague Lisa Rein reported, Secretary of State John F. Kerry said in a letter to Sen. Barbara A. Mikulski (D-Md.), chairwoman of the Senate Appropriations Committee,  that sequestration, which would cut $2.6 billion from State Department programs, would “seriously impair our ability to execute our vital missions of national security, diplomacy and development.”

Kerry went on to detail some of the potential damage: The State Department would be out $70 million from the U.S. Agency for International Development budget, for example, as well as $20 million from international peacekeeping operations, “hindering our efforts to stabilize the conflict in Mali and prevent the spread of extremism in the Sahel.”

Now, some foreign-aid advocacy groups are taking things a step further, tallying up how sequestration would impact the people who depend on humanitarian programs.


In a new policy brief, amfAR, an AIDS advocacy group, did the math on how people living with TB, AIDS and malaria in developing countries would be impacted by the 5.3 percent across-the-board funding cut to non-defense discretionary programs. Here are just some of their stats:

  • HIV/AIDS treatment for 171,900 people would not be available, potentially leading to 39,200 more AIDS-related deaths
  • 1.2 million fewer insecticide-treated mosquito nets would be procured; 2 million fewer people would receive treatment.
  • 37,400 fewer people with TB would receive treatment, 200 fewer people with multidrug-resistant TB would get treatment.
  • 836,800 fewer pentavalent vaccines for children would be available, potentially leading to 8,900 more deaths from preventable diseases.

U.S. funding for international AIDS assistance grew sixfold between 2002 and 2008, but it has largely flatlined since the recession started.

Global health programs represent only one quarter of one percent of the federal budget, but because the unit costs are also small (mosquito nets are fairly cheap, as are AIDS treatments in developing markets), the number of people impacted is substantial.


PEPFAR -- the President’s Emergency Plan For AIDS Relief -- alone provides treatment for 5.1 million people in foreign countries. And because the United States is the largest (and in some cases only) donor for many AIDS programs, it’s unlikely that other governments would step in to pick up the slack.

“These would be an unprecedented cuts to global health,” said Chris Collins, amfAR’s director of public policy. “If the U.S. cuts back effort in this area, I’m worried about the signal it sends to other donors.”

It’s worth keeping in mind that we can’t exactly predict future AIDS deaths, how far the existing aid dollars would stretch, or -- for programs that don’t rely purely on U.S. funding -- what the contribution levels from other countries would be.

Still, when the sequestration discussion can get dry and impersonal, this type of calculation puts a face on the cuts.

This post has been updated to reflect a more recent PEPFAR treatment figure.



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Max Fisher · February 18, 2013

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