Tomorrow is World AIDS Day and as I reflect on the past year, I realize that collectively, many developments over the past year are very important in our fight to eradicate HIV here at home and abroad. At AIDS 2012, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH), said “We have a historic opportunity — with science on our side — to make the achievement of an AIDS-free generation a reality,” and he is right. We are in the midst of implementing the Affordable Care Act (ACA), which will increase access to and quality of care for people living with HIV. Pre-exposure prophylaxis and the first over-the-counter HIV test were both approved by the Food and Drug Administration (FDA). Just last week the United States Preventative Services Task Force (USPSTF) issued a draft recommendation in strong support of routine HIV testing for all adolescents and adults ages 15 through 65, pregnant women, and others at increased risk for HIV younger than 15 and older than 65 by assigning it a Grade “A”. This is a monumental shift in the USPSTF’s previous recommendation of testing only for people who are “at risk” for HIV and pregnant women. Under the ACA, this recommendation will require that HIV tests for all be reimbursed by private insurers.
Though we are turning the tide in the HIV epidemic, we still face many challenges. Congress is currently convened in a lame duck session to address the “fiscal cliff,” which is created by a number of laws designed to force deficit reduction. If ignored, these laws will trigger tax increases, deep federal spending cuts and could send the country back into a recession. The “Bush-era tax cuts” will be allowed to expire on December 31, 2012 and “sequestration” will occur on January 2, 2013, unless Congress acts to change current laws.
NASTAD conducted an analysis on the impacts of sequestration on HIV/AIDS and viral hepatitis programs. Congressional and White House officials, including President Obama, have announced that sequestration will most likely be avoided. However, HIV/AIDS and viral hepatitis programs could still face cuts under the various deficit-reduction proposals. Cutting discretionary programs, the category that most health department funding falls under, has been included in some deficit reduction proposals.
Additionally, some proposals include Medicare and Medicaid reform. Given that Medicaid is the largest source of payment for HIV care and treatment, these reform proposals could be very damaging to people living with HIV by increasing reliance on AIDS Drug Assistance Programs (ADAPs) and other safety net programs. In addition, tax credits and subsidies available through the Affordable Care Act (ACA) could be at risk for cuts.
NASTAD is working with the broader HIV/AIDS community to advocate against further cuts to our programs, but it is important to contact your legislators and the White House to encourage a balanced approach to deficit reduction. While the fiscal cliff must be avoided, it cannot be done by cutting HIV/AIDS and viral hepatitis programs. To find your Representative, click here. A list of Senators can be found here and you can write the White House here.
On World AIDS Day, let’s stand up for HIV/AIDS safety-net programs and ensure that we do all we can to fight this epidemic with the tools that we have now and those that are on the horizon. We have come so far in this fight and cannot afford to slide backwards. Let’s do our best to achieve an AIDS-free generation.
How are you standing up for an AIDS-free generation? Tell us how by leaving a comment below.