Secretary Sebelius Asks HHS to Sustain NHAS Momentum

Dr. Ronald Valdiserri.

Secretary of Health and Human Services Kathleen Sebelius recently sent an important communication to the Department's leadership regarding HHS-wide efforts to implement the National HIV/AIDS Strategy (NHAS). The message, sent in late January, reiterated that the implementation of the NHAS is a priority for HHS. Secretary Sebelius reminded the heads of her operating divisions and staff divisions that even prior to the release of the NHAS, the HHS Strategic Plan FY2010-2015 had committed the Department to "prevent(ing) the spread of HIV infection…increase(ing) efforts to make people aware of their status…and enable(ing) them to access HIV care and treatment using innovative, culturally appropriate means."

Secretary Sebelius praised the Department's long-standing efforts in support of HIV prevention, care, treatment, and research, but signaled the need for enhanced intra-departmental coordination and collaboration in order to achieve the ambitious goals of the NHAS. Specifically, she identified four actions that HHS leadership should undertake in order to advance the implementation of the NHAS across HHS:

• Actively Support the "12 Cities Project" -- Secretary Sebelius called upon all of the Department's agencies and offices to actively support the "12 Cities Project" which is a Department-wide effort to accelerate comprehensive HIV/AIDS planning and more closely integrate HIV prevention with care and treatment by coordinating cross-agency response in the 12 U.S. jurisdictions hit hardest by HIV/AIDS. Specifically, she asked the leadership to inform their staff, grantees, and other stakeholders about the strategic importance of the initiative and direct them to actively work across agency and program lines to facilitate better coordination of Federally funded HIV/AIDS programs at the local level in each of those communities. She also urged coordination of Federal technical assistance activities to these 12 jurisdictions so that HHS can set a constructive example of the cross-program integration of HIV/AIDS prevention, care, and treatment, that it is seeking to foster at the local level.
• Streamline Grant Administration -- As an important step in responding to the Strategy's call to simplify grant administration activities and grantee reporting requirements, the Secretary asked the operating and staff divisions to collaborate in identifying a set of common metrics that can be used across HHS-funded HIV/AIDS activities to measure program outcomes in the 12 Cities Project, noting that using common program measurements will help to promote efficiency and reduce grantee burden.
• Enhance Coordination and Collaboration -- Secretary Sebelius also emphasized the importance of ensuring that all HHS funding announcements for Federal HIV/AIDS dollars adhere to and are consistent with the goals of the NHAS. To help promote this consistency, she asked that all HIV/AIDS funding announcements undergo a technical review in the Office of the Assistant Secretary for Health (OASH) prior to finalization and publication.
• Ensure NHAS Priorities are HHS Priorities -- Lastly, Secretary Sebelius asked that all operating divisions and staff offices review their current uses of HIV/AIDS resources and realign those existing resources, as appropriate, from lower to higher priority activities. Without a doubt, asking decision makers to re-evaluate how resources are deployed is a complicated and sensitive issue. Nevertheless, this level of scrutiny is both necessary and appropriate, so that we can assure legislators, the American public, vulnerable communities, and other key stakeholders that we are doing the best job possible with the resources available to us.

Don't forget, the NHAS Federal Implementation Plan asks us to consider the following three questions as we evaluate the implementation of the National HIV/AIDS Strategy (see page 31, Evaluating the National HIV/AIDS Strategy):

• Are we doing the right things?
• Are we doing them right?
• Are we doing them on a large enough scale?

As we prepare for the public release later this month of the HHS Operational Plan to implement the National HIV/AIDS Strategy, we would do well to follow Secretary Sebelius' example of asking ourselves, our colleagues, and the communities we serve these same three questions—remembering that the answers, while not easy to come-up with, will move us closer to achieving the vision of the NHAS:

The United States will become a place where new HIV infections are rare and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.

Ronald Valdiserri, M.D., M.P.H. is the Deputy Assistant Secretary for Health, Infectious Diseases, U.S. Department of Health and Human Services.