Though Congressmember Nancy Pelosi announced $1.6 million in new federal funding for San Francisco from the Ryan White HIV/AIDS Program to reduce infections, that doesn't mean the city isn't still facing an HIV funding shortfall from the feds.
As the Bay Area Reporter previously reported, HIV/AIDS advocates are concerned that the dire situation of the city's fiscal picture means that there may be cuts and are fighting to preserve existing services, though they hope for additional funds.
It was unclear from Pelosi's May 13 news release announcing the new funding whether that would take the place of cuts San Francisco is expecting from the Centers for Disease Control and Prevention. Pelosi, a San Francisco Democrat, has long fought for, and secured, federal dollars for HIV/AIDS.
"In my first speech on the floor of the House as a representative of San Francisco, I told my colleagues that the Congress must take leadership to fight the HIV/AIDS crisis," stated Pelosi, who was the first woman to be speaker of the House and stepped down as Democratic leader last year.
But a spokesperson for Mayor London Breed, speaking on background, told the B.A.R. May 15 that the city was already planning on receiving the funds Pelosi announced.
Last year, according to a former leader of the city's HIV/AIDS Provider Network, San Francisco's allocation from the federal program was $16 million, with the city kicking in $24 million in local funds to maintain the full amount for Ryan White HIV services in the city at $40 million, as the B.A.R. noted last July.
During a May 6 teach-in titled "Queering the San Francisco Budget" that the CDC, current HAPN leader Laura Thomas, senior director of HIV and harm reduction policy at the San Francisco AIDS Foundation, said federal health officials had "already let San Francisco know we're going to get a cut in our federal HIV prevention dollars, and it will probably be $500,000-$800,000 in a cut. We don't know exactly yet, but we should know in the next couple of months," as the B.A.R. previously reported.
Asked about the expected decrease in federal HIV funding by the B.A.R. last week, a mayoral spokesperson, discussing the issue on background, said the exact figure is "too early to tell." The person added that the mayor's budget office will "work with the Department of Public Health to address the size of those cuts."
When asked if Breed was committed to backfilling any decrease, the spokesperson said, "It's too early to tell given our budget, but we remain committed to this community."
Typically, the city has backfilled cuts in HIV funding from the federal government; for example, in 2013, then-mayor Ed Lee and the Board of Supervisors unanimously approved backfilling $3 million.
Several of the mayor's opponents in November's election have told the B.A.R. that they would find a way to fill in the donut hole.
District 11 Supervisor Ahsha Safaí stated he'd work to ameliorate the cuts.
"The federal budget cuts are a real threat to our public health efforts in San Francisco and across the state," he stated. "They could seriously set back our progress in combating the HIV and AIDS epidemic. Our city needs the mayor to step up and protect these crucial services. During the budget process, I will continue to fight for HIV programs that protect our most vulnerable communities."
Mark Farrell, who served as mayor for six months in 2018 and wants to return to Room 200, committed to the B.A.R. at his campaign launch he would backfill federal HIV cuts. On May 8 he stated, "I have and will always do whatever it takes to backfill cuts in federal HIV prevention dollars to provide critical services and support to our LGBTQ and other communities. I am committed to filling the gaps left by federal budget cuts to HIV and AIDS prevention programs, ensuring that vital support remains intact."
Levi Strauss heir and former nonprofit executive Daniel Lurie previously told the B.A.R. that he would support a backfill of hundreds of thousands of dollars but wouldn't commit in perpetuity if, for example, Republicans in Congress are able to push through cuts to HIV funds in the hundreds of millions of dollars.
Asked May 8 by the B.A.R. about this year's pending cut, Lurie stated, "Every San Francisco mayor has backfilled Republican-driven cuts to federal HIV funding, and we cannot stop now."
He noted it would be "a few hundred thousand dollars" in a budget that totals $14.6 billion.
"That's a small sum for important services when the City Hall insiders I'm running against continue to throw money at wasteful, unaccountable programs that fail to deliver results. It's time for a new era of accountable leadership from outside City Hall," stated Lurie.
The other leading mayoral candidate, Board of Supervisors President Aaron Peskin, who represents District 3, stated to the B.A.R., "I will do everything I can, as I have done in the past, to backfill any cuts."
A spokesperson for Breed said May 15 the amount of the financial shortfall remains to be seen and that the mayor's hope is to identify funds that can fill it as the budget process gets underway.
"We are thankful to Speaker Emerita Pelosi for securing these funds the city was hoping to get to continue funding critical HIV/AIDS programs, treatment, and services," the spokesperson stated. "The Ryan White HIV/AIDS Program has been instrumental to our overall funding for over 25 years. Given the uncertainty on federal support for our ongoing programs, the Speaker Emerita's continued and historic commitment to people in San Francisco is laudable."
The city has its own budget woes that make backfilling the funds challenging. Breed has until June 1 to submit to the Board of Supervisors her budget proposal for this year and is likely to issue it in late May. Breed last December asked city departments for 10% cuts across the board. A deficit of about $800 million is expected over the next two fiscal years, and Breed said it could reach $1 billion by Fiscal Year 2028.
The San Francisco AIDS Foundation thanked Pelosi.
"San Francisco AIDS Foundation thanks Speaker Emerita Nancy Pelosi for her unwavering support and enduring commitment to HIV/AIDS funding. Her recent announcement of $1,645,787 in new federal funding from the Ryan White HIV/AIDS Program is a testament to her advocacy for the health and well-being of all those affected by HIV," a spokesperson stated. "This vital funding will bolster our efforts to enhance access to care and support the health and well-being of those living with HIV."
Pelosi commented on her long history of fighting for HIV/AIDS funding at the federal level.
"In those dark days of the epidemic, we used the lessons of San Francisco's model of community-based care, research and prevention to have life-saving solutions included in the Ryan White CARE Act," she stated.
"This new federal funding for San Francisco — made possible by that legislation — will save lives by reducing new HIV infections in our city, improving quality of life for patients and promoting health equity in underserved communities," Pelosi added. "As we celebrate the tremendous progress made to defeat this disease, we must continue fighting to finally banish HIV to the dustbin of history."
Updated, 5/17/24: This article has been updated with comments from mayoral candidate and Board of Supervisors President Aaron Peskin.
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