July 14, 2010
San Francisco, Calif. -- On July 13, President Barack Obama released the nation's first published strategy for further containing its now 29 year long HIV/AIDS epidemic. Project Inform, which has served as a member of the community-based committee that called for the development of the Strategy, thanked the President for assuring its completion and hailed the document as "precisely what we hoped for; a bold and focused blueprint that makes it possible to prolong life for hundreds of thousands of HIV-positive Americans and prevent hundreds of thousands more people from acquiring HIV."
During the 2008 campaign, a national coalition of HIV/AIDS service providers and advocates called upon all candidates for the Presidency to develop a National HIV/AIDS Strategy to address serious gaps in progress against HIV/AIDS. Today, an estimated 25 percent of 1.1 million HIV-positive people in the US do not know their HIV status; 25 percent of people who know they are HIV-positive are not receiving care and treatment that would prolong their lives and help prevent new cases of HIV infection; women and people of color have much poorer health outcomes than others living with HIV; and every year for over a decade, 56,300 people have become newly infected with HIV.
As a candidate, the future President Obama quickly pledged that his administration would develop a Strategy, and since his election, the White House has actively solicited advice from advocacy groups, including Project Inform, on what should be contained in the Strategy. In December of 2010, Project Inform and the Community HIV/AIDS Mobilization Project co-hosted a meeting of leading HIV experts who recommended that the Strategy include an initiative called Testing & Linkage to Care Plus (TLC+). TLC+ proposes that by greatly increasing HIV testing nationally and quickly linking newly diagnosed HIV-positive people to primary medical care, social services, prevention counseling, plus treatment, the US could greatly increase the percentage of HIV-positive people adhering to care and treatment, improve their heath outcomes, prevent new infections, and reduce health disparities suffered by women and people of color.
"We are pleased to see that the Strategy sets ambitious and achievable targets for reducing the impact of HIV on the nation, and that key concepts behind TLC+ have been substantially incorporated into the Strategy," said Dana Van Gorder, Project Inform's Executive Director. "We particularly commend the administration for asserting that expanded treatment of HIV-positive people is likely to play a significant role in preventing new infections. While HIV-positive people should begin treatment primarily because it will prolong their lives, we must encourage them to recognize that doing so may also help them in the efforts to avoid transmitting HIV to others."
Van Gorder praised Jeffrey Crowley, the Director of President Obama's Office of National AIDS Policy, for "masterful work balancing the opinions, interests and needs of people with HIV, HIV advocates and the government in the Strategy" and noted the "historic way in which the President warmly welcomed the community to the White House to celebrate the release of this pivotal document."
Project Inform did, however, express concern about the administration's plans to finance access to primary medical care and medications for HIV-positive people. "If correctly implemented, recently adopted health care reform will help us to make greater progress against the epidemic by supporting most, though not all, HIV-positive Americans to access primary medical care and medications. The Strategy correctly embraces this opportunity," said Anne Donnelly, Project Inform's Director of Health Policy. "But reform will not be fully implemented until 2014, and in the meantime, the administration has failed to support adequate funding of one of the most important programs in the fight against HIV, the AIDS Drug Assistance Program (ADAP). It is painfully incongruous with the vital care and prevention goals of the Strategy to allow people with HIV to lose prescription drug coverage in the run up to health care reform legislation."
Last week, the Obama Administration announced the release of $25 million in emergency funding for ADAP, which sends funds to the states to provide medications for low-income people living with HIV/AIDS. It is a lifeline for over 150,000 people around the country and in the U.S. territories. Many state ADAPs are facing financial crises, forcing them to make severe cuts. This results from inadequate federal funding, the poor economy and increased unemployment, and the inability of many states to add sufficient funding to their programs. According to the National Alliance of State and Territorial AIDS Directors (NASTAD), as of July 8, 2010, there are 2,291 people on ADAP waiting lists in twelve states, and that number is growing dramatically each week.
Advocates around the country, including Project Inform, have urged President Obama and Congress to take swift action to address the ADAP crisis by providing an emergency increase of $126 million to help states maintain a minimum level of service to those in need. Two weeks ago, the President's Advisory Commission on HIV/AIDS (PACHA) passed a resolution calling on the Administration to work with Congress to secure this funding and to provide immediate expanded access to Medicaid for low-income people with HIV through passage of the Early Treatment for HIV Act (ETHA).
"While Project Inform appreciates the Administration's attention to the ADAP crisis and we recognize that $25 million will help provide relief to many states, the increase is far short of what is needed to ensure that everyone with HIV has access to lifesaving medications," said Ryan Clary, Project Inform's Director of Public Policy. "Furthermore, it fails to provide a sustainable solution that will assure stable access to treatment until health care reform legislation is fully implemented in 2014. This $25 million in funding is one-time only and will run out at the end of the current Fiscal Year (September 30, 2010). President Obama and Congress must work with HIV/AIDS advocates to create a plan that ensures a bridge to health care reform for those who depend on public programs like ADAP for their health and well-being."