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Making a statement. A red ribbon hangs from the North Portico of the White House yesterday to mark World AIDS Day.

Making a statement. A red ribbon hangs from the North Portico of the White House yesterday to mark World AIDS Day.

Official White House Photo by Chuck Kennedy

Where Will Obama Find $100 Million for the New HIV Cure Initiative?

When President Barack Obama announced yesterday “a new initiative at the National Institutes of Health [NIH] to advance research into an HIV cure,” he noted that the government would “redirect $100 million into this project.” But Obama did not specify where the money would be redirected from, and a subsequent NIH press release offered only a hint of more detail, noting that money “will come from existing resources and a redirection of funds from expiring AIDS research grants over the next three years.”

In an e-mail to ScienceInsider, Jack Whitescarver, director of NIH’s Office of AIDS Research, explained that “existing resources” means NIH’s existing $3.1 billion HIV/AIDS budget: No new money will come from other parts of NIH. About 20% to 25% of NIH grants expire each year and become eligible to recompete, Whitescarver says, and some will not merit refunding because they focus “on areas of AIDS-related research that are now considered less pressing.” As an example, he singled out research on AIDS-associated opportunistic infections, which previously was a high priority. “But with the advent of effective antiretroviral therapy, that research, while still scientifically meritorious, is now of lower priority for funding with AIDS research dollars,” Whitescarver explained.

The official shift in priorities meshes with what has been happening in the field. HIV/AIDS researchers over the past 5 years have put increasing emphasis on studying cure-related issues like viral latency and ridding the body of the small reservoir of infected cells that remain even when anti-HIV drugs fully suppress viral replication. NIH has committed $65 million this fiscal year, for example, to research targeting “eradication of viral reservoirs.”

Obama’s announcement took many HIV cure researchers and advocates by surprise, but it was welcome news—with a decided note of cautious optimism. “I like the idea that they’re recognizing cure research, but who’s going to decide what other areas of research don’t need to be done?” asks Rowena Johnston, director of research at amfAR, a New York City-based nonprofit that long has been at the forefront of funding cure studies. “We’re very strenuously not a fan of robbing Peter to pay Paul, and right now we don’t know who Peter is.”