Proposed CDC Contract Rescissions Threaten Lives
Statement by Dr. José M. Zuniga
The International Association of Providers of AIDS Care (IAPAC) strongly opposes the proposed rescission of dozens of $600 million in Centers for Disease Control and Prevention (CDC) contracts affecting California, Colorado, Illinois, and Minnesota through 2027. These proposed cancellations are not routine administrative adjustments. They are decisions with immediate and measurable consequences for people living with and vulnerable to HIV and STIs.
CDC contracts form the backbone of state and local public health systems. They support HIV and STI surveillance, testing programs, linkage to care, workforce capacity, laboratory infrastructure, and prevention initiatives. When federal funding is withdrawn mid-cycle, services do not simply pause, they are disrupted or dismantled. Staff positions are lost. Community-based organizations reduce programming. Testing declines. Linkage to care slows. Prevention gains stall.
These four states represent diverse epidemiological and demographic contexts, yet all have demonstrated sustained commitment to data-driven HIV and STI responses as well as the federal Ending the HIV Epidemic (EHE) initiative goals. Their public health departments rely on multi-year CDC grants to maintain stability, plan strategically, and implement evidence-based interventions. Rescinding these contracts through 2027 undermines that stability and jeopardizes progress toward national 95-95-95 targets and the goal of ending HIV as a public health threat by 2030.
We have learned from the COVID-19 pandemic that public health systems are only as strong as the investments that sustain them. The HIV response proved resilient because of decades of commitment to community engagement, decentralized service delivery, and long-term care continuity. But resilience has limits. Politically driven funding reversals erode the very infrastructure that has allowed the HIV response to endure.
If federal funding decisions are perceived as politically motivated rather than grounded in epidemiological evidence, the implications extend far beyond these four states. Public health requires predictability. States and municipalities cannot build effective prevention and care systems on unstable financial footing. Uncertainty discourages innovation, weakens workforce recruitment, and undermines trust between federal and local partners.
We have long known infectious diseases do not respect political or geographic boundaries. Weakening HIV and STI surveillance, testing, and prevention capacity in one jurisdiction increases vulnerability nationally. Both responses are interconnected across every city, town, county, state, and territory. Disruptions in any of these jurisdictions affect regional transmission patterns, data quality, and national outcomes.
The proposed rescissions also threaten progress towards health equity. CDC funding supports culturally competent outreach and services in communities disproportionately affected by HIV and STIs, including Black and Latino communities, LGBTQ+ individuals, and people who inject drugs. Removing support from these programs risks widening health disparities that federal policy has pledged to reduce and run counter to public health principles.
IAPAC calls for full transparency regarding the criteria used to identify these contracts for rescission. We urge federal leadership to reverse these proposed cancellations and reaffirm a commitment to science-based public health investment, with the U.S. Congress playing its constitutionally affirmed right to oversight. Ending AIDS as a public health threat requires stability, accountability, and partnership across all levels of government.
Moreover, because public health infrastructure is national health security infrastructure, weakening it erodes our collective ability to detect, prevent, and respond to both existing and emerging threats. Undermining this infrastructure places communities at unnecessary risk. In an interconnected society, instability in one city’s, county’s, or state’s public health system can quickly translate into broader regional and national vulnerability.
The HIV response, alongside the oft neglected STI response, has weathered political headwinds before. It must not be weakened at a moment when sustained commitment is essential to protect lives and safeguard progress. IAPAC urges the Trump administration, which has voiced its continued support for ending the HIV epidemic in the United States, to reverse course on the proposed rescission of CDC contracts affecting California, Colorado, Illinois, and Minnesota and to reaffirm its commitment to stable, science-based public health investment.
Dr. José M. Zuniga is President/CEO of IAPAC and the Fast-Track Cities Institute.
