It was May 2019, which, in COVID-19 pandemic times, seems a lifetime ago. We were crammed into the beautiful living room of a former ambassador’s Los Angeles residence, waiting our turn to shake hands with former vice president Joe Biden. For my immigrant Armenian parents, this was their first major political event. And for the newly announced candidate for president, the political season was just getting started. As our turn finally approached, I thanked Joe Biden for his leadership on HIV/AIDS. Yet before I could finish the compliment, Joe turned to my parents and gushingly exaggerated my public health work. “Folks, the work your son is doing. … It is really saving lives all around the world,” Joe asserted. It was the kind of affirmation that any young gay person dreams of, and somehow Joe knew exactly what my parents needed to hear.
Vice President Biden’s decades-long commitment to HIV/AIDS dates back to 1987. As a senator, Biden was an early and strong supporter of U.S. domestic programs to address the AIDS crisis. He cosponsored and voted to create the Ryan White CARE Act in 1990, as well as subsequent reauthorizations in 1996, 2000, and 2006. Vice President Biden has also been a staunch supporter of U.S. global-health assistance, particularly the President’s Emergency Plan for AIDS Relief (PEPFAR), the principal U.S. international prevention and treatment program established in 2003. As a Senate Foreign Relations Committee (SFRC) ranking member, he worked with Chairman Dick Lugar, House members like my former boss, Rep. Barbara Lee, and the Bush administration to establish the PEPFAR program in 2003. As chairman in 2008, then-Sen. Biden led the reauthorization of PEPFAR, working with legislators on both sides of the aisle to enact an unprecedented measure that has enjoyed strong bipartisan support until today.
The vice president’s prioritization of HIV/AIDS programs continued after his Senate career. The Obama-Biden administration delivered major advances in prevention and treatment efforts for people living with HIV. The Affordable Care Act (ACA) assisted Americans living with HIV by eliminating preexisting conditions and provided them with much-needed health insurance. In addition, the Obama-Biden administration eliminated the entry ban for tourists and immigrants living with HIV; ensured HIV testing would be covered under the ACA; implemented a comprehensive National HIV/AIDS Strategy; and directed federal agencies to examine the intersection of HIV with violence against women and gender-related health disparities. The programs under ACA had an important impact on addressing HIV prevention and treatment in communities of color.
Working for HIV/AIDS Caucus Co-Chair Rep. Barbara Lee, I coordinated closely with the Obama-Biden administration in hosting the return of the International AIDS Conference, AIDS 2012, to U.S. soil. It was a proud moment, made possible by the repeal of the discriminatory HIV travel ban in 2008. The administration also announced a dramatic expansion of HIV treatment targets under PEPFAR and unveiled the Blueprint For An ‘AIDS-Free Generation,’ to scale up combination prevention, engage civil society, and prioritize interventions to reach underserved populations. Indeed, Vice President Biden’s touch on every major piece of HIV legislation over two decades makes him the biggest ally the HIV/AIDS community has ever had in a presidential candidate.
Despite mortality and HIV incidence reductions achieved over the past decade, the stakes have never been higher for public health and global security. Across the world, people living with HIV are facing the brunt of a new pandemic that is spreading unconsciously, challenging health systems from Nashville to Nairobi. While there are significant differences in the two pandemics, we see many parallels between HIV and COVID-19, and the impact is already being felt in our communities. Many of the same systemic health and social inequities that put certain minorities at increased risk of getting HIV are also pronounced for COVID-19.
Outside the U.S., COVID-19 has not only impacted our efforts to fight HIV, but is contributing to related challenges like food insecurity and poverty. At AIDS 2020, the World Health Organization (WHO) released new information detailing severe disruptions of HIV-medicine supplies, including stockouts, in 73 countries. UNAIDS, which admitted global targets would not be met by the end of the year, warned of an additional 500,000 deaths in sub-Saharan Africa alone through 2021. And recent data from the Global Fund to Fight AIDS, Tuberculosis, and Malaria shows that 80% of countries are experiencing HIV health service delivery disruptions.
COVID-19 shows us that governments and governors can’t simply wish away data or ignore public health. We must strategically prioritize HIV as part of a new development agenda that focuses on results, resilience, and rights. We need international cooperation and strong governance for global health that preserves key attributes of the AIDS response. We need a reinvigorated global agenda to accelerate an end to AIDS, while ensuring health systems are able to prevent and respond to emerging infections such as COVID-19. And we need an Office of AIDS Policy director back in the White House to coordinate the U.S. response.
As a presidential candidate, Vice President Biden has announced he will re-commit to ending the HIV/AIDS epidemic by 2025. His campaign has released a plan that calls for protecting and expanding health care coverage in the U.S., nondiscrimination protections for the LGBTQ+ community, full funding of the Ryan White HIV program, decriminalization of HIV exposure and transmission, and expanded access to pre-exposure prophylaxis (PrEP), among other things. And in a response to the AIDS United candidates’ survey, posted earlier in July, Vice President Biden pledged to rally other nations to end pandemics and work with countries to strengthen health care systems. To do it all, a Biden administration will need the support and advocacy of the HIV community and all Americans.
In his 2019 World AIDS Day statement, Vice President Biden said, “The fight against HIV has taught us to be big-hearted.” Now more than ever, we need a big-hearted president. The kind of person who is empathetic, kind, and compassionate—the Vice President Biden my parents met last May. I know a President Biden will restore moral leadership and international cooperation to tackle the grave challenges we face in the coming months. In the U.S. and around the world, Vice President Joe Biden is our strongest ally to finish the fight and realize the end of AIDS. He has stood with us. And now, we stand with him.