COVID-19 underscores the necessity of prioritizing public health in policy and practice. COVID-19’s impact will be felt for some time after it has receded from the forefront of day-to-day life in Hawaii. This includes the state budget, which was bolstered by the passage of the American Rescue Plan’s infusion of $1.6 billion. The uptick in tourism is boosting state and local tax revenues.

Yet many of the most vulnerable in our community will remain at risk without a release of funds by state departments, as called for in the budget passed by the Legislature. It’s imperative that Gov. David Ige sign the budget and direct state agencies to release appropriated funds so that sexual assault victims, persons living with HIV and others won’t be left behind as Hawaii’s economy grows.

The state budget outlook was uniformly dire before federal relief. Work furloughs for state employees, including teachers, seemed imminent. Gov. Ige’s proposed budget last December offered a slate of budget cuts, which were anticipated given the precipitous decline in tax revenue.

The severe cuts in vital health services were astonishing, including a 64% reduction in AIDS services’ funding and a 30% cut in funding for treatment for sexual assault victims. Reductions in tuberculosis control were offered despite Centers for Disease Control and Prevention data showing that Hawaii had the second-highest rate of tuberculosis in the nation in 2018 and 2019.

House Finance Chairwoman Sylvia Luke and Senate Ways and Means Chairman Donovan Dela Cruz deserve special commendation for restoring funding to health services that prevent the spread of infectious diseases and provide treatment and care to those victimized. House Speaker Scott Saiki and Senate President Ron Kouchi also demonstrated pragmatic leadership on this front.

The Sex Abuse Treatment Center (SATC), a program established in 1976 by Kapiolani Medical Center for Women & Children, provides comprehensive services for sexual assault survivors, including medical care, crisis counseling, and mental health treatment. Sexual assault examinations and crisis support are available 24/7 so that survivors can always access care while time sensitive evidence can be collected.

The SATC serves all of Oahu and contracts partners on Hawaii island, Maui and Kauai to ensure the availability of specialized care across the state.

Hawaii’s AIDS services organizations (ASOs) operate on Oahu, Kauai, Maui and Hawaii island. Each provides medical case management services for persons living with HIV, facilitating access to daily antiretroviral medications that maintain viral suppression which helps sustain their lives and prevents the passing of HIV to others. ASOs also help ensure that those who test positive for HIV are linked to appropriate medical care and services and provide screening and referral for other sexually transmitted infections.

Hawaii’s publicly funded syringe exchange program makes it a national leader in HIV prevention, having kept rates among persons who inject drugs low for three decades in every county. In contrast, West Virginia recently passed a state law making syringe access more restrictive when one rural county that banned syringe exchange suffered an HIV outbreak.

The already high human toll of COVID-19 must not be exacerbated by preventable outbreaks of HIV or tuberculosis — or leaving sex assault victims without.

We ask Gov. Ige to do the right thing. Please protect the full funding appropriated by the Legislature and maintain access to these critical health services.

Cindy Shimomi-Saito is executive director of The Sex Abuse Treatment Center; Heather Lusk is executive director of Hawai‘i Health & Harm Reduction Center; Peter Silva is executive director of Hawai῾i Island HIV/AIDS Foundation.