Big cuts to US AIDS prevention feared as NIH axes HIV research grants

More than 200 federal grants for research related to HIV and AIDS have been abruptly terminated in the past few weeks

The Trump administration is merging a federal office that funds HIV testing with another programme, raising scientists’ concerns about AIDS-prevention efforts.Credit: Kevin Wurm/*New York Times*/Redux/eyevine

The administration of US President Donald Trump has hollowed out one of the federal offices aimed at ending the nation’s HIV epidemic. The move comes as the administration has also cut hundreds of grants funding HIV and AIDS research.

The changes leave researchers bewildered: during Trump’s first presidency, his administration launched a plan to eradicate HIV in the United States by 2030.

Late last week, multiple people in the US Office of Infectious Disease and HIV/AIDS Policy lost their jobs, according to a person at the US Department of Health and Human Services (HHS), the agency overseeing the infectious-disease office. That person asked for anonymity because they had not been cleared to speak to the media. Lay-offs at the infectious-disease office were confirmed by a second source familiar with the administration’s efforts to shrink and restructure the HHS.

In addition, the US National Institutes for Health (NIH) has cancelled more than 230 research grants funding HIV and AIDS research in the past few weeks, according to a Nature analysis of a crowdsourced spreadsheet of terminated grants. And the US Centers for Disease Control and Prevention (CDC) is losing a key office for HIV prevention as part of the restructuring.

All of this adds up to “devastating” cuts to research and HIV services in the United States, says Julia Marcus, an infectious-disease epidemiologist at Harvard Medical School in Boston, Massachusetts, who has had several grants terminated. “The likely outcome is going to be a resurgence of HIV.”

In response to questions from Nature, the HHS issued a statement saying that the infectious-disease office is not closing. Instead, work on HIV and AIDS “is being consolidated and streamlined” to avoid having “multiple offices that do the same work across multiple divisions”, the statement said.

Abrupt reversal

The lay-offs are part of the Trump administration’s effort to shrink the size of the federal government. HHS secretary Robert F. Kennedy Jr announced last week that his agency would lose 20,000 employees, almost one-quarter of the workforce. Kennedy has also repeatedly called for the federal government to focus more attention on chronic disease and less on infectious disease.

Asked by Nature about the administration’s commitment to addressing HIV and AIDS, a person familiar with the changes at HHS said that the remaining programme “is going to continue the very important work to end HIV. That was a big priority of President Trump during the first administration.”

The HHS infectious-disease office was responsible for coordinating and supporting a policy called Ending the HIV Epidemic in the U.S. and for the Minority HIV/AIDS Fund. The office employed roughly five dozen people, according to US media reports.

When news of the lay-offs hit, “I got tears in my eyes”, says Carl Schmid, who co-chaired the Presidential Advisory Council on HIV/AIDS during the first Trump administration. “These are people who have devoted their lives to ending HIV.”

The person familiar with the HHS restructuring said that the infectious-disease office is being merged with an HHS programme that provides treatment to people living with HIV/AIDS. The person said they did not know how many people from the infectious-disease office still have jobs. The CDC’s Division of HIV Prevention is also being merged with that programme, the person said.

But Adrian Shanker, who worked on health policy during the administration of former US president Joe Biden, says that the merger is “deeply problematic”. The existing HHS programme focuses on treatment, whereas the CDC’s division focuses on prevention and the HHS infectious-disease office coordinates surveillance of the HIV epidemic across the country. They cannot absorb each other’s responsibilities, Shanker says. “This is not going to get us closer to end the epidemic,” he says.