Policy Updates: Hill Happenings and Administration Activities

By Mike Weir February 11, 2019

Administration Activities

Federal Ending the Epidemic Plan

The President outlined a plan during his State of the Union to end the HIV epidemic. The Department of Health and Human Services (HHS) released documents detailing the plan, Ending the HIV Epidemic: A Plan for Americawhich aims to reduce new HIV infections by 75% in the next five years and by 90% in the next ten years. NASTAD will continue to engage with administration officials on the implementation of this plan. NASTAD will ensure a role for health departments and that the plan focuses on populations most impacted by HIV.

While no dollar figures have been released, we have been told that a “significant” amount of “new” resources will be included in the President’s budget proposal for FY2020. The President’s budget request will be released in mid-March. 

To achieve this goal, HHS will:

  • Focus on four key strategies: Diagnose, Treat, Protect, and Respond.
    • “Diagnose all individuals with HIV as early as possible after infection.”
    • “Treat the infection rapidly and effectively after diagnosis, achieving sustained viral suppression.”
    • “Protect individuals at risk for HIV using proven prevention approaches.” 
    • “Respond rapidly to detect and respond to growing HIV clusters and prevent new HIV infections.” 
  • Provide new targeted resources to 48 counties, Washington, D.C., and San Juan, Puerto Rico. These areas accounted for more than 50% of new HIV diagnoses in 2016 and 2017.
  • Provide new targeted resources to seven states (Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma, South Carolina) that have a substantial rural HIV burden.
  • Lead Federal Agencies: HHS, Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and Indian Health Service (IHS).

As outlined by HHS, the plan will fund three major areas:

  • “Increasing investments in geographic hotspots through our existing, effective programs, such as the Ryan White HIV/AIDS Program, as well as a new program through community health centers that will provide medicine to protect persons at highest risk from getting HIV.”
  • “Using data to identify where HIV is spreading most rapidly and guide decision-making to address prevention, care and treatment needs at the local level.”
  • “Providing funds for the creation of a local HIV HealthForce in these targeted areas to expand HIV prevention and treatment.”

In a JAMAarticle, HHS officials Dr. Anthony FauciDr. Robert RedfieldDr. George SigounasRADM Michael Weahkee, and ADM Brett Giroir discuss the plan and say, “The President’s budget will ask Republicans and Democrats to make the needed commitment to support a concrete plan to achieve this goal.”

NASTAD released this statement and is working with the HIV community on a further response. NASTAD will continue to provide updates as additional plan details are released.  

National Black HIV/AIDS Awareness Day

National Black HIV/AIDS Awareness Day (NBHAAD) was February 7.The Centers for Disease Control and Prevention (CDC) has provided free tools in the NBHAAD Resource Center to help supportawareness activities and testing events. 

National HIV/AIDS Strategy and National Viral Hepatitis Action Plan Update

The Health and Human Services (HHS) Office of HIV/AIDS and Infectious Disease Policy (OHAIDP) is hosting listening sessions as it begins to update the National HIV/AIDS Strategy (NHAS) and National Viral Hepatitis Action Plan (NVHAP). NASTAD will provide comments.

  • Friday, February 22, 2019: In-person Listening Session at HHS from 11:00 a.m.–1:00 PM EST in Room 800 of the Hubert H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC, 20201. RSVP by Thursday, February 14 by sending your name, title, and organization to HepHIVStrategies@hhs.gov.

OHAIDP previously held listening sessions during the 2018 National Ryan White Conference on HIV Care and Treatment, 2018 National HIV and Hepatitis Technical Assistance Meeting convened by NASTAD, and at the 2018 U.S. Conference on AIDS.

Hill Happenings

Congressional Hearings

The House Labor, Health and Human Services, Education, and Related Agencies  (LHHS) Subcommittee held a hearing focusing on actions the Administration has taken to weaken the Affordable Care Act (ACA). Topics discussed included decreased ACA outreach, advertisement, and enrollment activities and the promotion of short-term limited duration and association health plans.

Resources

NASTAD will host a webinar on Wednesday, February 13 from 3:00 – 4:00 PM EST to provide an overview of the Trauma-Informed Approaches Toolkit.

The updated Common Patient Assistance Program Application (CPAPA) was released along with an instructive companion document

Greater Than AIDS released a new campaign, Let’s Talk About HIV Treatment, with videos featuring young people sharing their journeys from diagnosis to getting into care and treatment to maintaining viral suppression.

Job and Project Opportunities

Assistant Director, Bureau of HIV/STD Field Services– New York

The New York AIDS Institute is hiring for an Assistant Director in their Bureau of HIV/STD Field Services. This posting closes on February 19.

Deputy Medical Director– Tennessee

The Tennessee Department of Health is hiring for a Ryan White Part B Director.

HIV/STD Prevention Program Manager– Maine 

The Maine Department of Health and Human Services is hiring for the HIV/STD Prevention Program Manager position within their Center for Disease Control and Prevention. This posting closes on February 15. 

Director, Ryan White Part B Program– Tennessee 

The Tennessee Department of Health is hiring for a Ryan White Part B Director.

Cook County Health System Executive Director of HIV Services– Cook County

The Cook County Health System (CCH) is hiring an Executive Director of HIV Services.

Disease Intervention Specialist– Alaska

The Alaska Department of Health and Social Services is hiring for a Disease Investigation Specialist I within their Division of Public Health, Section of Epidemiology, HIV/STD Program.

Upcoming Meetings

2019 National HIV Prevention Conference

The 2019 National HIV Prevention Conference (NHPC) will be held March 18-21, 2019 in Atlanta, Georgia. Registration is open.

2019 HIV Diagnostics Conference

The 2019 HIV Diagnostics Conference will be held in Atlanta on March 25-28, 2019. The conference will address advances in diagnostic testing, and strategies for using test technologies in public health programs and clinical practice. NASTAD encourages health department HIV, HCV, and STI testing program managers and other staff consider submitting a late breaker abstract.  Particularly encouraged are abstracts that address strategies to integrate HIV and HCV testing and linkage, and best practices to streamline time to test result receipt and linkage to care in clinical and non-clinical settings.

HIV, HCV and Syphilis Diagnostic Testing Workshop

The Association for Public Health Laboratories (APHL) will be hosting an HIV, HCV and Syphilis Diagnostic Testing workshopin conjunction with the 2019 HIV Diagnostics Conference. The workshop will be held Monday March 25, 2019 from 8am-3pm. The conference will kick off at 4pm. The educational workshop will feature short presentations highlighting the current technology and algorithms for each pathogen followed by facilitated and small-group discussions centered around case studies and real-world examples. The objectives of the workshop are two-fold: (1) to educate attendees about the technologies and challenges in diagnostic testing and (2) to encourage peer-to-peer discussions and fostering collaborations beyond the workshop. Program staff are welcome to attend.  If you will be attending the conference and would be interested in participating in the workshop, please contact APHL’s Dr. Anne Gaynor.

AIDSWatch 2019

AIDSWatch will take place April 1-2, 2019 in Washington, DC. AIDSWatch is the nation's largest annual constituent-based national HIV advocacy event, bringing together hundreds of people living with HIV and their allies to meet with Members of Congress and to educate them about the important issues at stake for people living with and affected by HIV in the United States. Please forward this information to your networks and encourage their participation in AIDSWatch 2019. 

News Bulletin

Trump Pledges To End HIV Transmission By 2030. Doable, But Daunting.

Noting that science has “brought a once-distant dream within reach,” President Donald Trump on Tuesday night pledged to eliminate HIV transmission within 10 years.

“We have made incredible strides, incredible,” Trump said in the annual State of the Union address. “Together, we will defeat AIDS in America and beyond.” It’s a goal long sought by public health advocates. But even given the vital gains made in drug therapies and understanding of the disease over nearly 40 years, it is not an easy undertaking. “The reason we have an AIDS epidemic is not just for a lack of the medication,” said Dr. Kenneth Mayer, medical research director at the Boston LGBT health center Fenway Institute. “There are a lot of social, structural, individual behavioral factors that may impact why people become infected, may impact if people who are infected engage in care and may impact or affect people who are at high risk of HIV.”

How realistic is Trump’s pledge to end HIV in the U.S.?

“In his State of the Union address, President Trump promised that his administration would try to end the transmission of HIV/AIDS in the U.S. William Brangham learns more from Jon Cohen of Science Magazine and Carlos del Rio of Emory University School of Medicine about the attainability of this goal, the practical and political challenges and what could help.”

Trump can’t eliminate HIV without protecting Obamacare

“While Trump boldly promised an end to the epidemic, I hope he understands how deeply intertwined the promise of our HIV treatment and prevention tools are with access to equitable and affordable care. If his administration continues to limit vital access to health insurance and medical care, I fear that my patients and others living with or at high risk of acquiring HIV will suffer irreparably and the epidemic will march on.”

Trump’s AIDS turnaround greeted with skepticism by some advocates

“The administration appears to have taken a turn after last year’s appointments of Health and Human Services Secretary Alex Azar and Robert Redfield, director of the Centers for Disease Control and Prevention, and a leading AIDS researcher in the U.S.  Redfield has led the administration’s efforts on the issue, working with officials at the Department of Health and Human Services, the National Institutes of Health, the Health Resources and Services Administration and the Indian Health Services.”

To Halt HIV, Advocates Push For PrEP Outreach To Black Women

“No matter what comes of the Trump administration's plans, public health researchers and grassroots advocates are already tackling the problem. McKinley-Beach works with a group of black women in Atlanta, where some neighborhoods have high HIV rates, raising awareness among women that PrEP is for them too. Nationally, groups like the Black AIDS Institute and the Black Women's Health Imperative, have started campaigns to reach women. And they're using different tactics than those that work to reach gay men.”