November 27, 2007
The Clinton campaign unveiled its plan to fight the HIV/AIDS epidemic in the U.S. and around the world. The comprehensive approach addresses the multiple challenges that HIV/AIDS has presented for over 25 years and includes investments for increased research, prevention and education, and access to treatment and other services. Hillarys plan would especially help groups in the U.S. that have seen HIV infection rates rise over the past several years, including African Americans and gay men, and address the continued risk in Latino communities and among women. In addition, Clinton has pledged to increase funding for the global HIV/AIDS fight to at least $50 billion by 2013.
"In many ways, our fight against HIV/AIDS is at a crossroads. While we have made progress in education and developing medicine that keeps those living with HIV/AIDS healthier, we need to be vigilant in ensuring that people are getting the information and care they need, said Clinton. I believe with leadership and smart investments we can significantly reduce the number of new infections, develop treatments that turn HIV/AIDS into a chronic but manageable condition, and expand toward an eventual vaccine."
On the domestic front, Clinton proposes doubling the HIV/AIDS research budget within the National Institutes of Health (NIH) to $5.2 billion annually, including the U.S. contribution towards finding a vaccine. Clinton's American Health Choices Plan will ensure that all Americans living with HIV/AIDS have access to care. Hillary will end the Bush administration's abstinence-only prevention policy, and instead, fund evidence-based HIV/AIDS prevention programs including, but not limited to, abstinence education as part of a comprehensive prevention message.
Hillary will address the disproportionate burden of HIV/AIDS among minority communities. African Americans account for almost 50% of new infections and Hillary will partner with stakeholders in the community to reverse this trend immediately. She is also concerned about the high rates of infection in the Latino community and will take action to improve prevention among Hispanics. Hillary will increase funding for the Minority AIDS Initiative and support the prevention and treatment efforts of minority-run community based organizations. Her plan also increases federal funding for substance abuse treatment, which often leads to high-risk behavior that can lead to infection. By taking steps to crack down on substance abuse and help users seek treatment, the chance that people will contract HIV can be greatly reduced.
Hillary is taking a bold stand to fight HIV/AIDS globally as well. She has committed to providing at least $50 billion over five years to combat HIV/AIDS around the world. This commitment will establish the U.S. as a leader in galvanizing the global community around meeting the Millennium Development Goal of halting and beginning to reverse the spread of HIV and other diseases by 2015. She will lead the world in achieving universal access to treatment by doubling the number of people that the U.S. supports with treatment. The Clinton plan will increase the number of health workers in training or in place in Africa by at least one million over a decade and ensure access to medications for all.
Today, Hillary Clinton unveiled her plan to combat HIV/AIDS globally through U.S. leadership and effective investments in research, prevention, and treatment. There are 33 million people living with HIV/AIDS around the world. Every day, about 6,800 people become newly infected and 5,700 die because of AIDS. Here in the U.S., while we have made tremendous strides in combating HIV/AIDS, about 40,000 people are newly diagnosed with HIV each year - an estimate which is expected to increase. More than 16,000 Americans die from AIDS annually and AIDS is the leading cause of death among African-American women aged 25-34.
AIDS has had a devastating impact on the continent of Africa, where more than two-thirds of all people with HIV/AIDS live, more than three-quarters of AIDS-related deaths occur and where the epidemic has orphaned 11 million children.
With a coordinated and comprehensive effort, Hillary knows we can significantly reduce the number of new infections annually and help provide coordinated care and treatment to the more than one million Americans currently living with HIV/AIDS in the U.S. and the millions living with HIV/AIDS around the world. As President, Hillary will:
Fight HIV/AIDS in the U.S. by:
Fight HIV/AIDS Globally by:
This plan builds on Hillary's long history of working to address the HIV/AIDS epidemic. As Senator, Hillary has introduced legislation to expand access to treatment for low-income individuals living with HIV; pushed to make scientific, evidence-based prevention programs more available to youth; sought to increase coordination in combating global AIDS; championed legislation to provide universal basic education that would help prevent the spread of AIDS, and consistently supported increased funding for federal efforts against the epidemic both in the U.S. and around the world.
As President, Hillary Clinton will continue her commitment to providing care and support for people living with HIV, as well as stopping the spread of the virus by:
Federal efforts to tackle HIV/AIDS are diffuse and uncoordinated today, failing to maximize coordination among agencies providing treatment, support and care, and limiting our efforts to engage in effective prevention. Hillary will tie all of the federal efforts together into a single comprehensive national strategy. She will bring together federal agencies, such as the Centers for Disease Control and Prevention, the Health Resources and Services Administration, and the Centers for Medicare and Medicaid Services, state and local governments, community-based organizations, providers, academic experts, and Americans living with HIV, among others, to devise a plan to better coordinate the overall response to this epidemic in the U.S., with the goals of significantly reducing the number of new infections, particularly among populations with increases in infection rates, improving the health of people living with HIV, and reducing disparities in care. This plan will include measurable goals, targets, and timelines for increasing evidence-based prevention and expanding effective treatment interventions, so that we can monitor and evaluate our efforts, expand what is working, and correct what is not. This single, comprehensive strategy will allow for better cooperation and more efficient and effective allocation of resources, so that we can stop and reverse the increases in HIV infection among vulnerable populations.
Hillary has proposed the American Health Choices Plan, which ensures that every American will have access to affordable, quality health insurance. Under her plan, insurers will not be able to deny coverage based on preexisting conditions, such as HIV infection. Safety net care options, like Medicaid, will be strengthened, while individuals will be able to choose from an array of plans with benefits at least as good as the typical plan offered to Members of Congress, which includes mental health parity. Health care will be made affordable through the provision of a premium affordability tax credit, which will be designed to ensure that health care premiums never exceed a reasonable portion of a persons income. With the American Health Choices Plan, individuals with HIV/AIDS will have access to chronic care management, helping ensure that their providers are coordinating care for the best outcomes.
Hillary believes we should never stop working to achieve the end goal of a cure for AIDS, and recent setbacks in vaccine trials do not mitigate the need to develop a vaccine to combat this disease. During the 1990s, new drugs helped people with HIV and AIDS live longer, healthier lives. In addition to increasing access to these drugs, the federal government must also research new treatments to simplify regimens, increase adherence, and address issues of drug resistance. We must also focus on funding for prevention - whether it is through efforts to fund microbicide research, or efforts to evaluate the best behavioral health strategies for preventing HIV and AIDS. In order to achieve these goals, Hillary would increase our investments in HIV/AIDS research at the National Institutes of Health to $5.2 billion annually, and ensure that researchers in all areas have the resources necessary to continue and expand their valuable efforts.
Hillary will extend Medicaid eligibility to low-income Americans living with HIV by the end of her first year in office. Today, too many low-income Americans with HIV have to wait until they become sick in order to receive health care through Medicaid. Delaying care in this manner hurts those who could have avoided illness through preventive care and treatment, and increases the costs associated with their care over the long-term. Hillary will change the Medicaid rules so that early treatment and intervention is guaranteed. This proposal builds on Hillarys record as the lead Democratic sponsor of the Early Treatment for HIV/AIDS Act, and helps to strengthen the affordable options available for those living with HIV as part of her Americas Health Choices Plan.
As President, Hillary will work to give individuals the tools needed to protect themselves against HIV by supporting proven strategies and targeting those efforts to the populations most vulnerable to HIV infection. Hillary supports giving young people age-appropriate information about HIV/AIDS and how to protect themselves against the disease, including by delaying sexual activity. But she rejects the Bush Administration approach of investing exclusively in abstinence-only sex education. She supports federal funding for needle exchange programs. And she will work to target culturally competent prevention efforts towards vulnerable populations that account for a disproportionate number of new infections. In addition, she will ensure that women, who account for more than one-quarter of all new HIV/AIDS infections in the U.S., have the knowledge and tools necessary to protect themselves against HIV.
Hillary will work to halt and reverse the recent increase in infection rates among gay men, young people, and people of color. In addition, Hillary will seek to address the factors that contribute to high risk behavior, such as the use of drugs like crystal meth, which is impacting both rural and urban areas, and the use of which is on the rise in the gay community. Hillary was a proud co-sponsor of the Combat Meth Act of 2005, which was signed into law on March 9, 2006. This law tightens restrictions on how pseudoephedrine is sold to ensure that it is not being trafficked, and provides resources for prevention, education, and treatment. As President, Hillary will work to see that this law is implemented effectively.
Providing federal funding for needle exchange programs will help increase referrals and entry into treatment programs and reduce overall HIV incidence, but there is much more we can do to address the connections between substance use and HIV infection. Hillary will expand available treatment services and provide additional federal assistance for such services by increasing funding for SAMHSA, the Substance Abuse and Mental Health Services Administration. In a 2006 SAMHSA study more than 23 million Americans were identified as needing specialty treatment for substance or alcohol abuse, yet only about 10% of them accessed such services. A major barrier to receiving such services is the cost of treatment.
As many as half of all people living with HIV/AIDS will need housing assistance at some point in their illness. For many of those, short-term assistance with rent, mortgage or utility costs alone will provide the necessary support to remain healthy and in stable housing. But for others, more intensive supportive services are needed. Hillary will increase funding for the Housing Opportunities for People with AIDS (HOPWA) program to serve about 90,000 households. In addition, Hillary recognizes the importance of supportive services for individuals living with HIV and their families. With stable housing and supportive services, individuals are more likely to be able to access comprehensive health care and adhere to HIV/AIDS treatments, improving their medical outcomes and reducing health care costs.
The Ryan White CARE Act is an important mechanism through which to deliver treatment and supportive services to individuals living with HIV and AIDS. As President, Hillary will support increasing Ryan White funding, especially in underserved areas and areas where the epidemic is growing, and working to make sure the increases are coordinated with other federal programs. She will also work to increase flexibility of funding to be used for supportive services - such as nutrition assistance and case management - that increase treatment adherence and improve the health and well-being of Americans living with AIDS.
Hillary will increase funding for the Minority AIDS Initiative, and work to ensure that it helps to foster and support the prevention and treatment efforts of minority-run community based organizations. This effort is particularly important in the African American community, as African Americans in the U.S. account for approximately 13% of the population, yet make up almost half of the new HIV/AIDS diagnoses. Hillary will work to end the disproportionate impact of AIDS on this community and seek to halt the growth of HIV in other minority communities as well. In addition, she will seek to increase cooperation with the clergy and other religious leaders in the black and Hispanic communities, to determine how churches can play a role in reducing the number of new infections. Finally, she will work to reduce and eliminate racial and ethnic disparities throughout our entire health care system, to ensure that African Americans and Latinos living with HIV and AIDS have access to quality care and treatment.
As First Lady, Hillary Clinton saw the impact of HIV and AIDS in her travels around the globe. As Senator from New York, she has worked to secure funding and improve coordination for global AIDS programs. As President, she will continue our efforts to secure universal access for treatment, prevention, and care by focusing on the following:
Hillary has a long record of advocating for funding for both U.S. and multilateral efforts to fight HIV/AIDS around the world. While we have made important progress on funding over the past decade, Hillary believes that we must go beyond the Presidents request to flat-line global HIV/AIDS funding over the next 5 years. She is currently fighting in the Senate to reauthorize and improve PEPFAR - the Presidents Emergency Plan For AIDS Relief. And as President, Hillary will commit at least $50 billion for global HIV/AIDS efforts by 2013. This investment will allow the U.S. to increase our commitment to the Global Fund to Fight AIDS, Tuberculosis and Malaria, which leverages additional donor commitments to support coordinated national approaches to fighting disease. It will establish the U.S. as a leader in galvanizing the global community around meeting the Millennium Development Goal of halting and beginning to reverse the spread of HIV and other diseases by 2015.
With increased funding, Hillary Clinton will expand access to treatment in developing countries. The U.S. will take the lead in ensuring that we reach universal access to medications by doubling the number of people that the U.S. supports with treatment over the next several years. Hillary will also invest in building the health infrastructure of developing countries that is critical to achieving effective treatment and prevention of HIV/AIDS and other diseases. This will include working with international partners to increase the number of health workers in place or in training in Africa by at least one million over the next several years, improve the self-sufficiency of local health networks, and reduce global disparities in care.
Hillary understands that in order to meet our goals for universal access to treatment, we must make available the life-extending medications we have in the U.S. to resource-poor countries. The World Health Organization estimates that 10 million lives could be saved each year by improving access to medicines already in existence. As President, Hillary will ensure the U.S. lives up to its Doha Declaration commitments and allow countries to access the treatments necessary to address public health crises like HIV/AIDS. She will support trade policies that protect and expand poor countries right to affordable, quality-assured generic drugs for important health needs. As President, she will also work with institutions that receive federal funding to ensure that drugs developed with taxpayer resources are made available off-patent in developing countries.
Hillary wants to maximize the impact of new U.S. funding in prevention efforts at the local level. She believes that effective prevention models should be tailored to the needs of communities, without requirements that limit the ability to provide accurate information and relevant comprehensive services to as many individuals as possible. To that end, she supports striking the current requirement that 33% of prevention funding be spent on abstinence-only programs, to ensure that prevention efforts can be tailored to local needs and populations most at-risk. She also supports using U.S. funding to support proven harm reduction efforts - including needle exchange - to help hard-to-reach populations, and will continue to support new evidence-based prevention methods as additional scientific research helps us understand how to best address this epidemic. Hillary will also work to support efforts to reduce stigma and improve outreach and education around testing. When people get tested, and they discover they are positive, we can help them access treatment, medical care, and information about the virus before they become sick. If people get tested and they are negative, counselors can help them understand how they can avoid infection.
Hillary is the original Senate sponsor of the Education For All Act, which calls for a dramatic increase in US funding and leadership in achieving universal basic education. In addition to reducing poverty and improving child and maternal health, education is a key form of prevention - a "social vaccine"- against the spread of HIV/AIDS. Compared to peers who are out of school, girls enrolled in secondary education are more likely to resist early marriage and remain abstinent, while also being five times more likely to know the basic facts of prevention and three times less likely to contract HIV/AIDS. With strong peer support programs, life skills training, and prevention curricula that address HIV/AIDS, gender-based violence and other health concerns, education can be even more effective in combating HIV/AIDS.
Hillary Clinton wants to work with both donors and recipient governments to ensure that U.S. investments are made as effectively as possible. Donors must work to improve coordination and reduce the burden placed on poor country ministries of multiple, overlapping and sometimes conflicting reporting requirements. Developing countries must work with donors to identify the impact of the epidemic on a localized basis and help target prevention and treatment efforts to vulnerable populations that are often overlooked, including orphans, displaced persons and individuals who have been trafficked. Doing so will allow the U.S., at the country level, to better identify needs, eliminate duplication, and establish monitoring and evaluation systems to better track funding. In addition, Hillary will increase funding for operations research to identify and replicate best practices in prevention, care and treatment. Finally, Hillary will work to improve outreach and coordination with nonprofit organizations, businesses, faith-based groups, people living with HIV and AIDS and other nongovernmental entities to ensure that civil society is engaged and active in efforts to prevent and treat HIV/AIDS.
Worldwide, adult women account for almost half of all new infections, and in certain areas, like sub-Saharan Africa, women account for more than 60% of those living with HIV. As President, Hillary Clinton will work to reduce infections among women, improve their access to care and treatment, and give them the tools needed to protect themselves against infection. She will require our government to develop a comprehensive plan to address the needs of girls and women and integrate these needs into our efforts to address HIV/AIDS. This plan will identify and address factors, such as gender-based violence and economic insecurity, which are linked with increased vulnerability to HIV. It will also work to improve services for women, in order to integrate HIV and AIDS care into existing health service delivery, including sexual and reproductive health services and family planning. In addition to working to ensure that the health needs of women are addressed in our global AIDS policies, Hillary Clinton will also improve access to overall womens health services that help provide treatment, care and education. She would restore U.S. funding for UNFPA, which provides vital reproductive health services to women around the world, and rescind the Global Gag Rule, which prevents U.S. funding from assisting nongovernmental organizations in other countries that provide information about or access to abortion services.
The majority of children living with HIV worldwide die before the age of three. As First Lady and Senator, Hillary worked to increase the number of medications specifically manufactured for children, including those that would treat AIDS. As President, she will work to ensure that the gains we have made in increasing treatment options are extended to children around the world. As she moves to improve needs assessments and expand treatment across the lifespan, she will work to ensure that childrens needs are included in strategies for fighting AIDS, including plans for the care and treatment of orphans and other vulnerable children who have lost their families to the AIDS epidemic.