Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
FY2024 Appropriations
On March 8, President Biden signed into law the first of two spending packages for Fiscal Year 2024 (FY2024). The minibus packaged six out of twelve bills that fund federal agencies and programs, including housing, energy, agriculture, science, transportation, and the Food and Drug Administration. The remaining bills in the second spending package, which include health programs funded through the Labor, Health and Human Services, Education, and Related Agencies (LHHS) bill, are due on March 22.
The passage of the appropriations minibus marks the end of a months-long delay due to partisan disagreements on spending levels and policy priorities. In fact, on March 11, the White House will release the President’s Budget Request to Congress for Fiscal Year 2025 (FY2025), which traditionally kicks off the upcoming fiscal year’s spending negotiations. However, there remain lingering disagreements on the final minibus of FY2024 that must be reconciled by March 22 before Congress can pivot to FY2025.
NASTAD will continue to monitor the congressional appropriations process and advocate for the highest possible funding for HIV, hepatitis, and drug user health programs.
Administration Activities
President Biden Delivers Final State of the Union Address
On March 7, President Biden delivered the final State of the Union Address (SOTU) for the Biden-Harris Administration’s 4-year term. Notably, President Biden highlighted efforts to reduce high drug prices and lower healthcare costs, and called for more Congressional action to reduce consumer costs. In particular, President Biden touted the Inflation Reduction Act of 2022 (H.R.5376), a landmark bipartisan bill which empowers the Centers for Medicare and Medicaid Services (CMS) to negotiate directly with pharmaceutical companies in order to reduce the price of certain drugs covered by Medicare Part D. During the SOTU, President Biden called on Congress to expand the number of drugs that are eligible for price negotiation and called for an extension of caps on out-of-pocket drug costs. Additionally, President Biden highlighted efforts to address the overdose crisis, but emphasized supply-chain interventions such as strengthening penalties for fentanyl trafficking instead of public health approaches to drug-related mortality.
HHS Assistant Secretary for Health ADM Levine Hosts Roundtable on Congenital Syphilis
On February 28, Department of Health and Human Services (HHS) Assistant Secretary for Health (ASH) ADM Rachel L. Levine and members of the National Syphilis and Congenital Syphilis Syndemic Federal Task Force met with leaders from national provider organizations to discuss actions to address the syphilis epidemic. The ASH emphasized the reemergence of syphilis as a public health concern, especially for pregnant women and infants with perinatally acquired syphilis, and underscored the role of health providers in expanding screening, testing, and treatment for syphilis whenever indicated. The provider roundtable was prompted by record-high rates of syphilis and a shortage of Bicillin L-A, the preferred treatment for syphilis and the only antibiotic indicated for pregnant women with syphilis.
Resources
The AIDS Institute: Unchecked: Copay Accumulator Adjustment Policies in 2024
On February 29, The AIDS Institute released a new report analyzing the use of copay accumulator adjustment policies in 2024 marketplace health insurance plans sold to individuals and families. Click here to access state-level fact sheets.
Conference on Retroviruses and Opportunistic Infections (CROI) 2024:
- HIV diagnoses continue to fall in US states with high PrEP coverage, while others are left behind
- “The number of new HIV diagnoses has continued to drop steeply between 2012 and 2021 in US states with the highest coverage of PrEP (regular medication to prevent HIV), according to research presented by Dr Patrick Sullivan at the Conference on Retroviruses and Opportunistic Infections (CROI 2024) yesterday. An eightfold difference in annual changes to HIV diagnosis rates was seen between states with high PrEP coverage based on how many people need it, when compared to those states with the lowest PrEP coverage. Access to PrEP through drug assistance programmes and state-level Medicaid expansion remains a crucial, central factor.”
- People need pathways from PEP to PrEP – and back again
- “Services providing post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) need to build stronger connections between these two ways of preventing HIV infection, so as to help people who’ve used one method to access the other, according to experts at the Conference on Retroviruses and Opportunistic Infections (CROI 2024).
- Sexually transmitted infections in San Francisco have fallen since doxyPEP roll-out
- “Taking the antibiotic doxycycline after sex appears to have lowered the incidence of sexually transmitted infections (STIs) in San Francisco, according to researchers who presented some of the earliest real-world data yesterday at the Conference on Retroviruses and Opportunistic Infections (CROI 2024).”
Treatment Action Group: Tuberculosis Treatment Pipeline Report
“TAG is pleased to share the final installment of its flagship Pipeline Report series for 2023, which details the latest developments in tuberculosis (TB) treatment research. The only centralized resource of its kind, the TB Treatment Pipeline Report is for researchers, clinicians, drug sponsors, research funders, civil society, and TB-affected communities looking to better understand the state of the TB treatment pipeline and key issues to consider as the outputs of TB treatment research are being translated into policies.”
Reagan-Udall Foundation for the FDA: Mitigating Risks from Human Xylazine Exposure Meeting Summary Report Published
“The report explores real-world experiences and scientific evidence on emerging data trends, outlines actions needed to address xylazine exposure and the larger overdose crisis, and includes concrete strategies for drug development and clinical research that directly support the mitigation and reduction of risks associated with human exposure to xylazine.”
Job Postings
Public Health Physician (40 hour) – Hartford, CT
The State of Connecticut, Department of Public Health (DPH) is seeking two Public Health Physicians to join our teams within our Infectious Diseases Section. These positions will help lead our critical programs: the Healthcare Associate Infections and Antimicrobial Resistance (HAI-AR) program and the HIV/STD/TB & Hepatitis C surveillance program. Apply by March 27.
Viral Hepatitis Prevention Coordinator – Austin, TX
Under direction of the Prevention Unit, provides highly advanced, senior-level consultative services and technical assistance as the DSHS viral hepatitis prevention coordinator. Oversees implementation and maintenance of viral hepatitis prevention efforts by identifying ways to integrate viral hepatitis prevention, vaccination, testing, and linkage to care into existing public health, clinical care, and community settings. Responsible for developing a DSHS viral hepatitis prevention plan as well as legislatively-mandated plans, including working with branch staff to solicit input from the public, including experts on Hepatitis, on the tenets of the plan. Apply by April 23.
Program Content and Training Specialist, Supporting Harm Reduction Programs (SHaRP) – University of Washington
This position is part of a cooperative agreement award from the Centers for Disease Control and Prevention to provide technical assistance about monitoring and evaluation to syringe services programs (SSPs) as part of the National Harm Reduction Technical Assistance Center. One of the primary projects of this award is to provide technical assistance (TA) to SSPs for monitoring and evaluation activities. The University of Washington is working in collaboration with the CDC, SAMHSA, NASTAD, the National Harm Reduction Coalition, and other TA partners to provide a suite of technical assistance support to individual programs.
Communicable Disease Epidemiologist – Cheyenne, Wyoming
This position will serve as the Communicable Disease AIDS Drug Assistance Program (ADAP) Coordinator, Wyoming TB Controller, and Disease Intervention Specialist (DIS) for the Communicable Disease (CD) Treatment Program. Assist in outbreak response to ensure the safety of Wyoming residents; by interviewing cases for exposure information, updating news outlets on the progress of outbreak control, analyzing exposure data utilizing epidemiological and statistical methods.
Open Positions – New York State
The New York State Department of Health, in partnership with Health Research, Inc, has various job openings, including some within the AIDS Institute. Please visit this link to learn about their current opportunities.
News Bulletin
Bipartisan effort underway to eliminate Hepatitis C in U.S.
“A recent surveillance report from HepVu found the U.S. lacks the necessary funding and resources to combat viral hepatitis. Now, Louisiana and Maryland Senators are working on legislation to fund treatment which could change some American’s lives.
“The issue of viral hepatitis is significant,” said Boatemaa Ntiri-Reid, J.D., M.P.H, Senior Director of Syndemic Approaches at NASTAD.”
Syphilis Is Killing Babies. The U.S. Government Is Failing to Stop the Disease From Spreading.
“Last June, Pfizer, the lone U.S. manufacturer of the injections, notified the Food and Drug Administration of an “impending stock out” that it anticipated would last a year…Across the country, physicians, clinic staff and public health experts say that the shortage is preventing them from reining in a surge of syphilis and that the federal government is downplaying the crisis. State and local public health authorities, which by law are responsible for controlling the spread of infectious diseases, report delays getting medicine to pregnant people with syphilis. This emergency was predictable: There have been shortages of this drug in eight of the last 20 years.”
Statistical Models vs. Front-Line Workers: Who Knows Best How to Spend Opioid Settlement Cash?
“Many of them were excited by the proposal, saying this type of data and statistics-driven approach could reduce personal and political biases and ensure settlement dollars are directed efficiently over the next decade. But some advocates and treatment providers say they don’t need a simulation to tell them where the needs are. They see it daily, when they try — and often fail — to get people medications, housing, and other basic services. They worry allocating $1.5 million for Helios prioritizes Big Tech promises for future success while shortchanging the urgent needs of people on the front lines today.”
How the U.S. is sabotaging its best tools to prevent deaths in the opioid epidemic
“The opioid overdose epidemic has burned through the U.S. for nearly 30 years. Yet for all that time, the country has had tools that are highly effective at preventing overdose deaths: methadone and buprenorphine…But a yearlong investigation by STAT shows that virtually every sector of American society is obstructing the use of medications that could prevent tens of thousands of deaths each year. Increasingly, public health experts and even government officials cast the country’s singular failure to prevent overdose deaths not as an unavoidable tragedy but as a conscious choice.”