As the annual scrap over New York’s next budget gathers steam and agencies nationwide grow wary of cuts mandated by the failure of the “supercomittee”, care for city AIDS patients remains to look secure. The Independent Budget Office has just released a report detailing how changes in the AIDS patient population and the nature of the disease will most likely force City Hall to look for savings elsewhere.
Released just in time for World AIDS day on Thursday, the report is a comprehensive study of how patterns in AIDS cases and the way the city treats them have changed since the disease first appeared in the early 1980s. It puts particular emphasis on providing care in our post-recession austerity era, handled by the HIV/AIDS Services association. Mayor Bloomberg has funded it generously – its budget has nearly doubled from $117 million in 1999 to $222 million last year – and, the report predicts, will have to continue to do so.
Once the terror of bohemian New York, the AIDS scare has dropped off in the last 15 years after the introduction of new retroviral drugs and therapies allowing patients to live much longer: AIDS patients in the city had an average survival time of 109 months post-diagnosis in 2008, compared to 34 months in 1996. Prevention strategies have seen new cases decrease by two thirds over the same time period, allowing the city’s AIDS population to stabilize at around 65,000 in the last few years.
The mayor has attempted to slash AIDS funding in recent years, with some success – spending per case is down 3.3 percent this year. It doesn’t, however, look as if he’ll be able to do so again. The most recent city financial plan, released two weeks ago, doesn’t call for any further cuts to AIDS spending. A small 6.5 increase in the AIDS caseload over the last three years, coupled with fierce opposition from city council members and advocacy groups to most of the cuts Mr. Bloomberg proposed, means total spending has actually increased this year from $222 million to $225 million.
Even with federal and state cuts looming, the IBO doesn’t see any way around the issue. “Looking ahead, fiscal difficulties at the state and federal levels could result in reductions in intergovernmental funding,” the report concludes. “Additional city funds might be needed to minimize service disruptions.” What exactly might face cuts to make up for the AIDS funding shortfall is, as yet, unclear.