Evidence and Lessons on the Health Impacts of Public Health Funding from the Fight against HIV/AIDS
HIV/AIDS has been one of the largest public health crises in recent history, and the U.S. federal government has spent hundreds of billions of dollars fighting the disease. This study examines the impact of federal funding allocated to U.S. cities through the Ryan White CARE Act, which is the largest program for combating HIV/AIDS in the United States. The empirical approach identifies the impact of the funding by studying funding variation that comes from Ryan White policy features that resulted in large funding differences among cities that were originally on parallel HIV/AIDS trajectories and finds that Ryan White's city-level funding has improved HIV/AIDS outcomes in the cities receiving the funds. The estimates indicate that one HIV/AIDS death has been avoided for every $314,000 allocated through the program and that the program has saved approximately 60,000 lives through 2018. The estimates also indicate that funding differences across cities have contributed to the uneven progress in combating HIV/AIDS across the United States.
I thank Shila Azodi, Kitt Carpenter, Joy Getzenberg, Sherry Glied, Lisa Powell, Joshua Rosenfeld, Lesley Turner, and seminar participants at the LGBTQ+ Econ Seminar, the NBER Health Economics 2021 Spring Meeting, and Vanderbilt University for helpful discussions and comments. The views expressed herein are those of the author and do not necessarily reflect the views of the National Bureau of Economic Research.