Outrage, confusion caused by potential loss of $600 million for public health

In mid-February, health departments, public health agencies, and community nonprofits across California, Colorado, Illinois, and Minnesota were stunned to hear word that more than $600 million in public health funding was proposed to be cut by the Trump administration. The “rescission package” to be sent to Congress would terminate existing grants and funding previously appropriated by Congress to these four Democratic-led states, in a move widely assumed to be politically and ideologically motivated. 

Excel spreadsheets were leaked showing funding streams at the Centers for Disease Control and Prevention (CDC) to be canceled. Community-based agencies and health departments scrambled to assess the potentially devastating impacts. Millions of dollars of funding to HIV and STI prevention and treatment programs, LGBTQ+ healthcare, sexual health services, and other public health programs through CDC grants were on the chopping block. 

Rumors and speculation were confirmed the next day, on February 12, as organizations and health systems received funding cancellation notices from the Department of Health and Human Services (HHS). San Francisco AIDS Foundation received a notice canceling our High Impact HIV Prevention grant, for nearly $500K annually, which supports the clinical services and PrEP program at our health center Strut. We learned that partner organizations and health systems received similar notices. 

The notice from HHS explained that the grants were being canceled, “in order to better prioritize agency resources.” 

The letter went on to list some of the priorities of the Centers for Disease Control and Prevention (CDC): vaccine safety and efficacy research; advancing our understanding of autism spectrum disorder, neurodevelopmental disorders, and chronic disease; modernizing public health infrastructure while enhancing our approach to health data; and otherwise ensuring compliance with the goals and priorities of the Trump Administration and HHS.

The cancellation letter did not explain why funding for an HIV prevention program, designed to reach the goals of the Ending the Epidemics Initiative (an initiative launched by the first Trump administration in 2019!), was no longer a priority.

In a statement online and to media partners, SFAF quickly condemned the cuts and committed to maintaining HIV services for our communities. 

“We are deeply concerned about the decisions by the Trump administration to defund and deprioritize HIV, sexual health, and LGBTQ+ programs and care,” said Tyler TerMeer, PhD, CEO of SFAF. “Local community nonprofits and public health systems rely on federal funding to provide critical safety net services to our communities, and cannot sustain our work long-term without this funding. These continued attacks on our public health infrastructure are dangerous, short-sighted, and will cost lives.”  

The same day that HHS sent cancellation letters, the four states affected filed a lawsuit in federal court in Chicago, saying that they were unlawfully subjected to cuts “based on political animus.” The federal judge assigned to the case ruled that the plaintiffs had provided enough evidence that the cuts were “based on arbitrary, capricious, or unconstitutional rationales,” and halted the funding cuts to government agencies for 14 days.

Behind the scenes over the next week, SFAF’s policy and advocacy team mobilized with agency leaders to share information with local and national coalitions, advance advocacy opportunities, and strategize on steps forward. 

Organizations, coalitions and community members across the country quickly spoke out against the attacks–sending alerts and letters to members of Congress and speaking out in defense of the public health funds at risk. Advocacy communications emphasized the shortsightedness and devastation that would result from crippling necessary public health systems.   

The National Minority AIDS Council (NMAC) shared, “The Administration has vowed to end the HIV epidemic in the United States by 2030. Yet, slashing funding for the lifesaving services people living with HIV rely on undermines that promise. Ending an epidemic requires strengthening public health infrastructure—not dismantling it. NMAC is also concerned about the concentration of cuts in four Democratic led states. Public health should never be treated as a political lever. Viruses do not respect state lines or party affiliations. Strong public health systems protect everyone.” 

In response to the loss of HIV prevention and surveillance funding, STI prevention and control, and capacity building assistance for HIV programs, the Federal AIDS Policy Partnership HIV/AIDS Prevention Action Coalition (HPAC), shared that these grants, “strengthen community health systems and reduce long-term federal costs by preventing avoidable HIV and STD transmissions and the lifelong treatment expenses associated with them.”

Nearly 200 HIV advocates responded to SFAF’s advocacy alert, sending in an email to members of Congress urging them to protect HIV prevention funding.

Mid-February, agencies and health systems affected by the grant cancellations received a follow-up notice sharing that in compliance with the Court Order issued on February 12, the termination of award “is officially rescinded for 14 days,” and that “activities and funding under this award are no longer terminated.”

Now, the court order halting the funding cuts to government agencies has been extended to March 12, 2026. 

At this point, it is unclear whether or not the administration will be able to cancel these grants without an official approval from Congress, said SFAF’s senior advisor, Ernest Hopkins.

“My understanding is that if they are ultimately successful in their argument that they are only terminating grants that are no longer consistent with the policy direction of the Department, they will be able to terminate those funds and redirect the appropriated money,” said Hopkins. “But if the Administration submits the rescission package, the legislative process begins and the Congress will need to act.” 

What is clear is the determination of the current administration to destroy the public health infrastructure we are relying on to advance our mission to reach an end to the epidemic.

“The continued loss of federal funding will devastate the HIV response in this country,” said Dr. TerMeer. “And we know that communities of people who are most at risk, including LGBTQ+ people, Black and Latine people, people with economic disadvantages, and people who use substances will be the most impacted. SFAF will not back away from the lifesaving prevention, care, and support we provide, but our mission becomes increasingly more difficult in the face of these devastating changes.”