WASHINGTON — Top federal health officials sought to flesh out President Trump’s announcement Tuesday night of a new goal to eliminate HIV in the U.S. by 2030.
On a call with reporters on Wednesday morning, officials provided some details on the administration’s plan, but left one critical question unanswered: How much will it cost?
“My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years,” said Trump to applause from both sides of the aisle.
When prodded by reporters about the scope of that “commitment” on Wednesday, Adm. Brett Giroir, MD, assistant secretary for health at the Department of Health and Human Services, said that he wasn’t able to provide “specific budget numbers at this time.”
However, Giroir was “confident” the amount is “sufficient to support our 2020 activities.”
He noted, however, that Congress would have to provide “the increased resources that we asked for.”
When explaining the impetus for the multi-agency initiative, Giroir said candidly, “our progress against HIV as a new infection has plateaued.”
Since 1981, about 700,000 Americans have died from HIV, and another 400,000 are at high risk of becoming infected over the next decade, he said. About 40,000 people acquire HIV across the country each year.
The plan is to zero in on clusters of infection in certain U.S. counties where rates of new infection have grown, to expand the use of highly effective anti-retroviral therapies, and to leverage preventive therapies such as pre-exposure prophylaxis (PrEP), which has been shown to reduce infections among high-risk individuals by 97%, Giroir said.
The initiative will also harness proven models of care delivery, such as the Ryan White/HIV Aids Program, he noted.
“In short, we’re going to diagnose all people as early as possible … treat the infection rapidly and effectively… protect those at highest risk… respond to any outbreaks with overwhelming force … and we’re going to create a public health workforce throughout this country with the specific goal of reducing new diagnoses by 75% within 5 years and … by 90% within 10 years,” Giroir said.
“This is a laser-focused program targeting 48 counties of the more 3,000 counties in the United States, plus the District of Columbia and San Juan and seven states where the epidemic is substantially … [affecting] rural communities,” added CDC Director Robert Redfield, MD.
Those seven target states are Oklahoma, Missouri, Kentucky, Arkansas, Alabama, South Carolina, and Mississippi.
As for the target populations, new infections are most common among African American and Latino gay and bisexual men and transgender individuals, “women of color,” and those living in Southern states, Redfield said.
While HIV rates overall have “stabilized” in Indian Country, new infections have shot up 63% among young American Indians and Alaska Native men who have sex with men, said Rear Adm. Michael Weahkee, principal deputy director of the Indian Health Service.
The International AIDS Society called the elimination of HIV in 10 years a “bold goal.”
“Reaching this target is doable with the prevention and treatment tools that exist today, but it will require the full muscle and funding of the U.S. government. This goal can only be achieved by acknowledging and addressing the drivers of HIV – including stigma, discrimination and social inequities that limit access to healthcare,” said Kevin Osborne, executive director of the IAS, in a press statement.
While praising the overall plan, the IAS did highlight inconsistencies between the President’s announcement and “rhetoric that directly attack trans people and the larger LGBTQ community, people who inject drugs, people of color, refugees, sex workers and women’s rights.”
The Democratic National Committee (DNC) was even more critical. “The Trump administration has consistently undermined advancements in HIV/AIDS research, attacked people living with HIV/AIDS, and sabotaged access to quality healthcare at every opportunity,” said a DNC press release.
The committee also cited the HHS proposed rule of eliminating requirements for insurance plans to cover prescription drugs in Medicare’s protected classes which would include HIV/AIDS medications; HHS’s decision to channel monies from the Ryan White program into funding immigrant family separations; recent budget proposals which attempted to cut over $1 billion in funding for global HIV/AIDS funding; and a proposed rule allowing healthcare providers to refuse treatment for LGBTQ individuals if they have a “moral objection.”
The AIDS Institute, on the other hand, welcomed the president’s plan for ending HIV/AIDS.
“While we might have policy differences with the President and his Administration, this initiative, if properly implemented and resourced, can go down in history as one of the most significant achievements of his Presidency,” said Michael Ruppal, the institute’s executive director, in a press release.
“We look forward to learning more details of his plan, including its proposed budget, and will work together with the HIV community and state and local governments on its implementation,” he added.
Source: MedicalNewsToday.com
