CDC Awards $339 Million to Health Departments for High-Impact HIV Prevention
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CDC press release For Immediate Release: January 4, 2012
Contact: National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
The Centers for Disease Control and Prevention has begun awarding a total of almost $339 million to state and local health departments across the United States to fund HIV prevention activities this year. The awards are for the first year of a five-year funding cycle and represent a new direction for CDC HIV funding designed to achieve a higher level of impact with every federal HIV prevention dollar spent.
The awards are a critical component of CDC's new high-impact approach to HIV prevention and better align resources to reflect the geographic burden of the HIV epidemic today. As part of this funding announcement, CDC is also providing the health departments with new, specific guidance for prioritizing the most effective prevention programs that will have the greatest impact on reducing new HIV infections.
Providing funding to health departments has long been CDC's single largest investment in HIV prevention, accounting for approximately half of CDC's overall HIV prevention budget.
"With 50,000 new HIV infections every year and a tough economic environment, the need to do more with existing resources is greater than ever," said Kevin Fenton, M.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. "This new approach to prevention funding is designed to focus on the places where needs are most urgent and on the programs that will have the most far-reaching impact. It will help us achieve the ambitious goals of the National HIV/AIDS Strategy with the efficiency and urgency the HIV epidemic demands."
Funds were awarded to health departments in all 50 states, the District of Columbia, eight U.S. territories and eight cities with heavy HIV burdens.
The funds are allocated to individual health departments according to a formula that better matches resources to the geographic burden of HIV, as measured by the number of people reported living with HIV in each jurisdiction. This new funding approach ensures that many areas with heavier HIV burdens receive urgently needed funding increases.
CDC will award an additional $20 million to health departments by March 2012 as part of this funding cycle to implement innovative HIV prevention demonstration projects. CDC is currently reviewing applications for this competitive round of funding.
"State and local health departments are the backbone of the nation's HIV prevention efforts," said Jonathan Mermin, M.D., director of CDC's Division of HIV/AIDS Prevention. "This latest round of funding will help them lead the nation to slow, and ultimately end, the HIV epidemic in the United States - a public health imperative that could finally be achieved."
CDC'S NEW HIGH-IMPACT APPROACH TO HIV PREVENTION FUNDING
FOR HEALTH DEPARTMENTS
Advancing the National HIV/AIDS Strategy
In January 2012, the Centers for Disease Control and Prevention began awarding the first year of a five-year HIV prevention funding cycle for health departments in states, territories, and select cities that revises the way the agency funds health departments. The new approach features better geographic targeting of resources and a greater focus on the highest-impact prevention strategies. This approach embodies CDC's commitment to "High-Impact Prevention" - using programs and other scalable interventions that have demonstrated the potential to reduce new HIV infections in the right populations in order to yield a greater impact on the HIV epidemic. High-Impact Prevention is essential to achieving the ambitious HIV prevention goals of the National HIV/AIDS Strategy announced in 2010.
First-year (FY2012) awards will total $358.8 million, approximately level with CDC HIV prevention funding for health departments in the previous year. The majority of the awards, totaling $338.8 million, were made in January 2012. Each jurisdiction will receive at least a minimum annual funding amount of $750,000 by the end of the five years to ensure that even areas with a low burden of HIV can continue basic prevention activities. Additional awards for innovative demonstration projects, totaling $20 million, will be announced by March 2012.
Providing funding to health departments has long been a central component of CDC's HIV prevention strategy, accounting for more than half of CDC's HIV prevention budget. This latest funding represents a new direction designed to achieve a higher level of impact with every federal HIV prevention dollar.
Better Matching Resources to the Geographic Burden of HIV
The new funding approach better aligns resources to reflect the geographic burden of the HIV epidemic today:
Using the latest HIV data: Funding will be allocated to each state, territory, or directly funded city based on the number of people that were reported to be living with an HIV diagnosis in that jurisdiction in 2008 (the best measure of the HIV burden available in every U.S. jurisdiction). This approach, driven by the latest data, improves on prior health department funding allocations, which were based on AIDS cases earlier in the epidemic (this HIV data is a better indicator of the epidemic's current burden than AIDS data, since less than half of all Americans living with HIV have progressed to AIDS).
Expanding direct funding to key cities: To ensure that funding reaches major urban areas where HIV is concentrated in the United States, the number of cities directly funded by CDC increased from six to eight.1
While some health departments will see more significant changes, only about 10 percent of CDC's $284 million for health departments' core HIV prevention programs in FY2012 will be redistributed.
Increasing funding for hard-hit areas: The relatively small change in distribution of CDC's overall HIV prevention funding to health departments will have a major positive impact on the epidemic. Several areas with heavy HIV burdens will see much-needed increases in prevention
funding, including many Southern states and several major cities.
Helping health departments adapt to funding shifts: CDC is taking steps to minimize disruptions due to changes in funding. All funding shifts will be phased in over five years, and CDC will provide technical assistance to help health departments navigate the changes they may need to make. In addition, the funding approach incorporates a minimum funding level to ensure that all jurisdictions, regardless of HIV burden, can continue to meet the HIV prevention needs of their populations.
Prioritizing High-Impact Prevention Strategies
The awards also include important new guidance to health departments about specific prevention strategies to prioritize. This guidance is intended to ensure that prevention funds are directed to the activities that are most likely to have a significant and lasting impact on the HIV epidemic.
CDC will fund health department HIV prevention activities in three categories:
Core prevention programs ($284M in FY2012): The majority of funding will support health departments' core HIV prevention programs. CDC is also directing the use of the funding to achieve maximum impact. For all awarded health departments, at least three-quarters (75 percent) of this core funding must be directed to the following activities with demonstrated potential to reduce new HIV infections:
o HIV testing - including routine opt-out testing in healthcare settings and targeted testing programs for high-risk populations
o Prevention with HIV-positive individuals - helping people living with HIV reduce their risk of transmitting HIV to others
o Condom distribution for people at high risk of acquiring HIV
o Structural initiatives - aligning structures, policies, and regulations to enable optimal HIV prevention, care, and treatment
Up to one-quarter (25 percent) of this core funding may be used to support other recommended activities that can also have a major impact on the epidemic, including interventions for high-risk populations, social marketing efforts, pre-exposure prophylaxis (PrEP) for men who have sex with men, and non-occupational post-exposure prophylaxis (nPEP) for high-risk individuals.
Expanded HIV testing for disproportionately affected populations ($54.8M in FY2012): Jurisdictions with at least 3,000 African American and/or Hispanic residents living with an HIV diagnosis in 2008 were eligible for additional funding to expand access to HIV testing. This funding category builds on CDC's recent Expanded Testing Initiative, which provided nearly 2.8 million HIV tests over a three-year period, more than three-quarters (76 percent) of which reached African Americans or Hispanics.
Demonstration projects ($20M in FY2012, to be awarded by March 2012): For the first time, CDC's health department HIV prevention funding opportunity includes a competitive category for demonstration projects designed to evaluate innovative approaches to HIV prevention. All jurisdictions were eligible to submit proposals for demonstration projects, and award decisions will be made based on merit.
New Direction for the Nation's HIV Prevention Efforts
In today's challenging economic environment, it is more important than ever to ensure that every federal HIV prevention dollar has the greatest possible impact on the national HIV epidemic. CDC's new approach to HIV prevention funding for health departments is an important step toward focusing prevention resources on the areas and interventions where they are needed most.
The original "funding opportunity announcement" is available at http://www.cdc.gov/hiv/topics/funding/PS12-1201.