Important Happenings in HIV/Health Policy

Important Happenings in HIV/Health Policy

Week ending: January 25, 2018
By: Sable K. Nelson & Matthew Rose

HHS Requests Community Feedback on National HIV/AIDS Strategy (NHAS) and the National Viral Hepatitis Action Plan (NVHAP)

The U.S. Department of Health & Human Services Office of HIV/AIDS and Infectious Disease Policy (OHAIDP) will soon host two listening sessions to continue gathering public input for updates to the National HIV/AIDS Strategy (NHAS) and the National Viral Hepatitis Action Plan (NVHAP). Both national plans currently expire in 2020.

Save the Dates for the In-Person Listening Session on Friday, February 22, 2019: 
In-person Listening Session at HHS from 11:00 a.m.–1:00 p.m. (ET) in Room 800 of the Hubert H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC, 20201. RSVP by Thursday, February 14 by sending your name, title, and organization to HepHIVStrategies@hhs.gov.

Share Your Comments in Writing

In addition, we will soon publish a Request for Information (RFI) in the Federal Register to solicit written comments, recommendations, and ideas for updating both the NHAS and the NVHAP. As soon as the RFI is published, NMAC will provide a link to it as well as information about its deadline for input.

All the input gathered from the listening sessions and responses to the RFI will be shared with our federal partners, who collectively will use that information to update the vision, goals, and strategies for both plans, as well as each agency’s actions for implementing them.

Modeling Study Shows Two Common STDs Threaten Advances in HIV

Despite tremendous advancements that have been made toward the goal of ending the HIV epidemic in the US, a modeling study recently published in Sexually Transmitted Diseases, Researchers reported that 10 percent of all new HIV cases among men-who-have-sex-with-men in the US are caused by gonorrhea and chlamydia infections. Gonorrhea and chlamydia are the two most common reportable infections in the US. This model supports research showing these STDs increase the body’s risk to transmit and receive HIV. The increase of gonorrhea and chlamydia threatens the decrease of over 13 percent in new HIV cases over the last eight years – as the result of sustained federal investment in HIV prevention and the advent of biomedical advances like PrEP. For more information, READ → http://www.ncsddc.org/wp-content/uploads/2019/01/2019_Jones_Proportion_of_Incident_HIV_Cases_among_Men_Who.98127.pdf

Drug-Pricing Policies Find New Momentum As ‘A 2020 Thing’

Emboldened by midterm election results and interest in possible presidential runs, Democrats are advancing a slew of new and old legislative proposals. It’s not yet clear, though, which if any could go the distance. For more information, LISTEN → https://khn.org/news/drug-pricing-policies-find-new-momentum-as-a-2020-thing/

Podcast: KHN’s ‘What The Health?’ ‘Medicare-For-All’? More? Some?

“Medicare-for-all” has become the rallying cry for Democrats in the new Congress. But there is a long list of other ways to increase insurance coverage. Meanwhile, the Trump administration continues to chip away at the Medicaid program for the poor, and new rules could mean higher costs for individual health insurance in 2020. Alice Ollstein of Politico, Stephanie Armour of The Wall Street Journal and Paige Winfield Cunningham of The Washington Post join KHN’s Julie Rovner to discuss these issues and, for “extra credit,” provide their favorite health policy stories of the week. For more information, LISTEN → https://khn.org/news/podcast-khns-what-the-health-medicare-for-all-more-some/

What You Can Do

TAKE ACTION: It is very important that our elected officials hear from us to protect federal funding for HIV prevention and care. Speak truth to power by sharing your personal stories with your elected officials. It is vitally important to meet to your federal elected officials when they are at home. If we don’t support and advocate for HIV funding and programs, who will?  Our movement cannot afford to stand on the sidelines. Your U.S. Senators and U.S. Representatives need to hear from you.

What NMAC is Doing About It

  • NMAC remains vigilant in its advocacy to protect FY20 government funding and the existence of the social safety net. And we  will start looking for increases to our existing programs.
  • NMAC is planning for the new year and meeting our new members of Congress. We are very excited to talk to the new House about our priorities.
  • NMAC is working in coalition to defend the right of people living with HIV to serve in the US military.

Reflection on Personal Experience at the 2018 Biomedical HIV Prevention Summit-Los Angeles, CA

By Michelle Rollins, 50+ Strong and Healthy Scholar

I walked away from the 2018 Biomedical HIV Prevention Summit on December 2-4, 2018 in Los Angeles, California having learned so much.

Introduction:
As a HIV 50+ Strong and Healthy Scholar, I was impressed with the many interesting topics covered. I learned that through prejudicial thoughts and actions, governments, communities, health care providers, employers, family members and colleagues often contribute to HIV stigma. I learned that ending the HIV epidemic in black and brown communities will take big, bold, innovative, policy initiatives along with authentic engagement. U = U and PrEP are valuable tools all persons can use effectively and an ambitious, effective public awareness campaign is needed. Presenters shared the importance of promoting U=U and PrEP among black women, who present a perfect opportunity to break down obstacles to increasing awareness and reducing stigma. Campaigns like this can be successful if they are strategic and tailored to the context, values, language, and resources available to target audiences. I also learned that stigma leads to several other health-related problems amongst persons diagnosed with HIV/AIDS such as: loneliness, isolation, low self-esteem, identity crises and a lack of interest.

This year’s subject matter is particularly important for the citizens of Garden Valley district, where I serve, because our strategy includes crafting easy to understand language in our messages as we speak to the community about advancing innovation, (PrEP), and ending the HIV epidemic in African American and LatinX communities. We believe wording and content of the message depends on what it is supposed to achieve.

Advancing Innovation:
There is a lot at stake! Ending HIV/AIDS is a big-time accomplishment right up there with ending polio, and all other life threating diseases.

I learned how it is important to recognize and address clear patterns of healthcare disparities among African American women. In fact, our greatest challenge is reducing the deep disparity in health status of minorities and especially African American women and make PreP readily available. I learned we are not reaching those in need of another option ending the HIV epidemic in black and Latino communities and ultimately the US will take multifaceted innovative and intentional approaches.

The Garden Valley Neighborhood House mission is to support and promote the advancement of health innovation and technologies in the greater Cleveland, Ohio area by advising, educating, and training community activists in the establishment and legitimate aspects of the healthcare sector. Our view is that health promotion messages should focus on what can be gained by changing behavior, while detection behavior messages should focus on what could be lost if they don’t go through with the screening. I presented on the innovative activities of the Garden Valley Neighborhood House in the Community Corner at the Summit.

Ending the HIV Epidemic:
Incorporating U=U and PrEP into our conversation and communities daily will help break barriers, save lives this will increase awareness and will help to reduce stigma. I learned that People Living with HIV/AIDS not only face personal medical problems but, also social problems associated with the disease such as stigma and discriminatory attitudes. Public stigma and discrimination have harmful effects on the lives of people with HIV/AIDS. I also learned overall education and contact has a positive effect on reducing stigma for adults living with HIV/AIDS. However, contact has a better effect than education at reducing stigma for adults. I learned face-to-face contact is more effective than contact by video.

I learned getting people to change patterns of human behavior is no easy task. What I already knew but has practical application is, in natural world there are basically two kinds of change: evolutionary and disruptive.

Conclusion:
Evolutionary change is gentler form of change, typically less destructive but it takes a very long time. Disruptive change is fast, and sometimes necessary but can be extremely destructive or constructive. Do efforts to engage African American women in U=U and PrEP pursue evolutionary change or disruptive change? Perhaps, we need a combination of both. If things continue on their current path, African American women will be digging ourselves out of a ditch.

As a community advocate, HIV 50+ Strong and Healthy Scholar and 2018 Biomedical HIV Prevention Summit attendee, I learned part of my task is to make determinations how to approach changing a group of people’s behaviors in order to save lives. I firmly believe through education about PrEP and increasing awareness in communities at most at risk is the key.
In my lifetime there have been seven deadly diseases cured. As a nation, we work tirelessly to remedy major epidemics and illnesses. With determined effort and advancing innovation we can end the HIV epidemic.

HIV  Biomedical Conference Reflections

By 50+ Strong & Healthy Program Scholar Paul Grace-Neal

I was honored to attend the Conference in December 2018 in Sunny Los Angeles, California.  The Spirit and excitement was the attendees was very high. I witnessed a lot of people’s hope in thriving while living with HIV.  This is significant to me because when I came out as a lesbian in the early 99’s, I attended countless funerals of folks who were newly diagnosed.  Their diagnoses became their swan song. Diagnostic protocols and treatment were crude and harsh and folks had not be introduced to symptoms and prevention so the diagnosis was often too late.  Today, with the flux in clinical research and early intervention, people can thrive and not just survive.

I was honored to witness countless folks share their testimonies of being undetectable.  U=U. People of all ages from their 30’s to well above 50 could finally live and excel with minimal complications, less pills, and a longer life expectancy.   I was honored to celebrate with everyone. I struggle with the implications of this campaign however. I think it generates a false sense of security as the health care industry attempts to irradiate other STI’s such as syphilis which recently has reemerged to pandemic proportions.

During the conference, I had an awesome privilege of engaging participants on two panels, Trans As Trade, which explored how Trans men are often discounted and erased in research and the LGBT community.   It is frustrating that in research and marketing, information is often categorized with cisgender women simply due to similar research results. If Trans women and gay men are at high risk and Trans men intimately engage with these populations,  shouldn’t we be as equally at risk for acquiring HIV and other STIs? I also shared on a panel with my fraternity members on considerations for receiving medical care as Trans. I shared as a nurse who works at an organization who provides care to PLWHIV and as a Trans man who is medically transitioning and has experienced negative situations while admitted in the hospital after surgery.

PrEP offers a lot of hope for all HIV negative folks including Trans men but if research and marketing discount them, doctors are less likely to see Trans men as high risk and will not be willing to prescribe it.  This puts Trans men at a higher risk of acquiring HIV. This thought pattern and lack of funding for research is disheartening and further erased and stigmatizes Trans men at exponential proportions.

I was honored at the opportunity to participate and serve at this conference.  However, I simply wish there was a greater push for Trans men to be validated, respected, and involved in furthering HIV treatment and eradication.

I look forward to be part of other conferences of NMAC.  I love the high energy and compassion you bring to provide a safe place for HIV individuals to be heard and HIV negative individuals to learn.

Important Happenings in HIV/Health Policy

Important Happenings in HIV/Health Policy

Week ending: January 11, 2018
By: Sable K. Nelson & Matthew Rose

TAKE ACTION: Trump Administration Proposes Changes to Medicare Part D Prescription Drug Benefit that Could Hurt PLWH

Centers for Medicare and Medicaid Services have proposed new rules that could have unprecedented access restrictions to lifesaving HIV drugs under Medicare Part D. If finalized, this rule would jeopardize our nation’s efforts to provide treatment to Medicare beneficiaries living with HIV, one of the largest providers of HIV care services. The new proposed rule would change the “protected class status” of anti-retrovirals under Medicare Part D, which allows PLWH to have direct access to the best treatments as prescribed by their doctor. Over the last 15 years, this policy has saved and improved millions of lives and brought us closer than ever to our shared goal of ending the HIV epidemic in the United States. AIDS United has led the charge, providing a way to edit and submit your own comments, check out: https://www.aidsunited.org/Take-Action/My-Status-My-Medicare!.aspx. Comments must be received no later than 5 p.m. on January 25, 2019 in response to a rule proposed by the Centers for Medicare and Medicaid Services. For additional information about the proposed regulation, check out this webinar presented by the HIV Health Care Access Working Group: https://www.youtube.com/watch?v=RXZy0yTaOZw&feature=youtu.be

READ: Report Impact of Trump Administration Judiciary on the LGBT Community

Lambda Legal issued a report entitled “The Promise of a Fair and Independent Judiciary is Under Siege.” This document examines the impact of the Trump Administration on the judiciary with an LGBT lens. The Trump Administration has worked tirelessly to confirm ideologically driven judges in order to further their ultraconservative policy objectives in the courts. To achieve this aim, the administration has worked closely in tandem with outgoing Senate Judiciary Committee Chairman Chuck Grassley, Senate Majority Leader Mitch McConnell, and advisors from a powerful, but shrouded, network of right-wing organizations. For more information, READ https://www.lambdalegal.org/publications/trumps-judicial-assault-on-lgbt-rights

US Senator and US Representatives Introduce Legislation to Reduce Prescription Drug Plans

On Thursday, Jan. 10, Sen. Bernie Sanders (I-Vt.) and Reps. Elijah Cummings (D-Md.), Ro Khanna (D-Calif.), Peter Welch (D-Vt.), Joe Neguse (D-Co.), and other cosponsors in the House and Senate held a press conference to announce a legislative package of three bills that would drastically reduce prescription drug prices in the United States. These bills seek to provide policy solutions to address particular challenges in the current health insurance market such as giving HHS the authority to invalidate manufacturers’ exclusivity rights if their prices are deemed excessively high; allowing HHS to negotiate prices for prescription drugs under Medicare Part D; and permitting Americans to buy drugs from other countries, like Canada. For more information, WATCH https://www.sanders.senate.gov/newsroom/video-audio/sanders-cummings-and-colleagues-announce-legislation-to-lower-drug-prices. For a good summary of how drug prices are set in the United States, LISTEN to a recent “Today, Explained” podcast regarding prescription drug prices: https://art19.com/shows/today-explained/episodes/cec4cf6e-55d0-4606-87ec-8ee2ad54b117

UPDATE: How the Government Shutdown Affects Health Programs

As the partial government shutdown stretches into unprecedented territory, several questions have been raised regarding the health and well-being of both the impacted government workers as well as the persons who benefit from government programs. For example, the USDA announced funding for SNAP (food stamps) will remain for February 2019 (for more information, READ https://www.cbpp.org/research/food-assistance/usda-to-fund-snap-for-february-2019-but-millions-face-cuts-if-shutdown) but it’s unclear what will happen after February if the government does not re-open. Similarly, health care benefits are not expected to be interrupted for those affected by the current partial federal government shutdown (for more information, READ https://www.npr.org/sections/health-shots/2019/01/11/683770812/most-federal-workers-health-coverage-to-continue-during-shutdown-even-if-pay-sto). However, some people living with HIV have already begun encountering obstacles and financial impediments for accessing essential HIV treatment, including labs and prescription medications.

What You Can Do

TAKE ACTION: It is very important that our elected officials hear from us to protect federal funding for HIV prevention and care. Speak truth to power by sharing your personal stories with your elected officials. It is vitally important to meet to your federal elected officials when they are at home. If we don’t support and advocate for HIV funding and programs, who will?  Our movement cannot afford to stand on the sidelines. Your U.S. Senators and U.S. Representatives need to hear from you.

What NMAC is Doing About It

  • NMAC remains vigilant in its advocacy to protect FY19 government funding and the existence of the social safety net.
  • NMAC is planning for the new year and meeting our new members of congress we are very excited to talk to the new House about our priors. We spent last Thursday stopping by members’ offices to welcome them to Hill.
  • NMAC is working in coalition to defend the right of people living with HIV to serve in the US military.

The Summit from a 50+ Perspective

50+ Strong & Healthy Program Scholar Zeke Garcia attended NMAC’s 2018 Biomedical HIV Prevention Summit. He contributed this report on his experience.

Since the provenance of HIV’s existence in my life, I have fought the good fight to end this epidemic. The foundation of this work is providing an integrated, comprehensive approach to treatment support. I am dedicated and driven to maintain, encourage, and support prevention and HIV infection treatment engagement. While at the recent HIV Prevention Summit in Las Angeles I experienced discussions, debates, questions, and concerns that promote fact based information, understanding, respect, and compassion for PLWH. My initial takeaway was the discussion on PrEP and the Trans community and data limitations, lack of physicians and healthcare along with the need for cultural components including interpersonal HIV, PrEP, PEP, and TASP strategies of prevention, streamlined for Trans enrollment in biomedical services led by human capital, visibility, and transparency. PrEP offers a new paradigm of choices, decisions, actions, and responsibilities.

We have an unprecedented opportunity to be catalysts for real change in the world; not just with our bodies, but with our minds and actions. It invites us to rethink HIV prevention and sex as tools for expanding love, information, and compassion, instead of promoting fear, shame, and stigma, encouraging all to be part of a revolution of community, integrity, and unity by engaging in informed discussion. I believe in the power of information and education to transcend and empower individuals and communities.

As discussed in a session regarding HIV and Incarcerated Populations, those going into custody tend to be at elevated risk of HIV; I believe PrEP within the correctional setting encompassing gender affirming care for Gay,Trans and Cis gender inmates with a history of transactional sex and sexual trauma are key elements of the prevention continuum challenge.

Being privy to the groundbreaking Undetectable = Untransmittable (U=U) plenary was a highlight for me as an educated HIV Positive Latinx Gay man; I am personally inspired by the campaign. The information of today’s poor historians of HIV is outdated, stigmatizing, and fear based messaging which has quenched opportunities to improve the lives of people living with HIV, dismantle HIV stigma, and prevent new transmissions. I have personally amplified my role as an HIV Educator,  Community Health Worker, and Long Term Survivor of HIV. I actively advocate through sharing science based information within my community. The foundation of the certainty that U=U offers freedom and hope for many people living with HIV and their partners opens up social, sexual, and reproductive choices I never thought would be possible. It is an unprecedented opportunity to transform the lives of people thriving with HIV. As a USCA/NMAC 50 + Scholar I trust that a strong public health awareness of universal access to diagnostics, treatment as prevention will save lives and bring us closer to ending the epidemic.

Zeke Garcia HERRS/PN/CHW
He, Him, His, Él

2018 National Ryan White Conference on HIV Care & Treatment

By Robert Riester, 50+ Strong & Healthy Program Scholar

This biennial conference is presented and funded by the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB), and intended for comprehensive HIV care and treatment providers, Ryan White HIV/AIDS Program recipients and stakeholders, national partners, and people living with HIV. There were 4,000 attendees. (Note that PLWH are listed last).
Before the conference officially begins, HRSA holds business meetings for the Ryan White (RW) programs. As an active Planning Council member, I was invited to attend DMHAP business meeting for RW Part A. The meeting included updates on Policy Clarification Notices (PCNs), notably: 16:02, 18:01 and 15:02 (search hhs.gov website). They urge RW recipients and sub-recipients to collaborate. Among the examples of collaboration mentioned were NMAC’s Building Leaders of Color program including: National Trans Women of Color trainings and National Youth trainings, and CHATT for Planning Councils and Planning Bodies. The biggest news of the meeting was that the RW programs have full appropriation and that FY 2019 grant awards should be made in full before the end of the year.

The standing room only DCHAP “Let’s Talk About HIV & Aging” meeting included an AIDS Education Training Center overview, a RW recipient presentation, a Round Table discussion and Integrated Geriatric Care Models. Education and training of all care providers would be the major takeaway from this meeting. The HIV & Aging norms that have been extensively reported in recent years, due in large part to the efforts of NMAC’s 50+ Strong and Healthy program and Long-term Survivor (LTS) advocacy efforts, were presented with updated data and observations. The Round Table discussion now focused on long-term care, facilities, training of their staff and how LTS on fixed incomes would afford these services. HRSA officials suggested this would be a good talking point when the RW Program comes up for re-authorization (time TBD). Perpetual poverty, psychological age, poly-providers equals polypharmacy, rural/transportation, and dental concerns were also big issues discussed. Due to the overwhelming interest in this meeting, it was offered again as a session the same afternoon.

The Opening Plenary session rapid Takeaways: The release of the 2017 updated RW Data Report; 45+ age demographic is rising; 90.6 percent viral suppression rate for the 50+ age demographic; HRSA recognition of U=U; PrEP recommendation letter for Grade A; Rapid ART Program Initiative; Long acting ARTs and Antibody-Mediated Prevention being researched; Data needs to be leveraged; Strengthen 340-B; Opioid epidemic connection; Update the National AIDS Strategy to 2020; Carl Schmidt and John Wiesman to head Advisory Council to meet in March 2019; and Targeted geographic funding for Washington DC, Birmingham AL, and Atlanta, GA for demographic young African American males, Latinos and MSM who are at highest risk for HIV.

The PLWH Listening session with Dr. Laura Cheever was at capacity and was not limited to PLWH. There were many questions, with few answers other than suggesting re-authorization talking points. There were a couple of sessions on employing PLWH as peer advocates, but still left me with a “them” feeling.

Overall much was learned and attending with my fellow Planning Council members and Grantee staff was an invaluable bonding experience. Collaboration, provider education/training, data sharing and re-authorization talking points were the overarching takeaways for this advocate. Thank you NMAC 50+ Strong & Healthy program, especially Moises, Sable and Joanna for your support!

Important Happenings in HIV/Health Policy

Important Happenings in HIV/Health Policy

Week ending: January 4, 2018
By: Sable K. Nelson & Matthew Rose

NOTE: The new Congress has arrived in DC, with historic numbers of women, people of color, and LGBTQ people. The 116th Congress began on January 3, 2019.

How The Government Shutdown Affects Health Programs

The partial federal government shutdown continues as Congress holds firm on its refusal to provide funding for the border wall. Medicare and Medicaid are fine, but the food safety component of the Food and Drug Administration and bio-threat surveillance done by the Department of Homeland Security are among the public health functions feeling the pinch. For more information, READ: https://khn.org/news/how-the-government-shutdown-affects-health-programs

Changes Proposed to Medicare Part D Prescription Drug Benefit

On November 26, 2018, the Centers for Medicare and Medicaid Services announced a proposed rule to add unprecedented access restrictions to lifesaving HIV drugs under Medicare Part D that, if finalized, will jeopardize our nation’s efforts to provide treatment to Medicare beneficiaries living with HIV. Comments must be received no later than 5 p.m. on January 25, 2019. For more Information:, https://www.federalregister.gov/documents/2018/11/30/2018-25945/modernizing-part-d-and-medicare-advantage-to-lower-drug-prices-and-reduce-out-of-pocket-expenses. Click here to go directly to the comment submission page.

Kaiser Health News: Medicaid Plans Cover Doctors’ Visits, Hospital Care — And Now Your GED

Emilia Ford became pregnant at 15 and, after her daughter was born, dropped out of high school. As she held down different jobs during the past decade — including housekeeping and working in a relative’s retail store — she always thought about going for her GED to show she met high school academic skills. But the Brookhaven, Pa., woman needed assistance finding tutors and paying for the set of four tests, which cost $20 each. https://khn.org/news/medicaid-plans-cover-doctors-visits-hospital-care-and-now-your-ged/

Florida Rejects Ruling on HIV-AIDS Care Contracts

Outgoing Gov. Rick Scott’s administration has rejected an administrative law judge’s recommendation that the state should rebid Medicaid managed-care contracts in Southeast Florida for the treatment of people with HIV and AIDS. Agency for Health Care Administration Secretary Justin Senior late last month issued a final order in a long-running dispute between the state and Positive Healthcare, a division of the AIDS Healthcare Foundation. Positive Healthcare filed a legal challenge after the agency awarded Medicaid contracts to a competitor, Simply Healthcare Plans. Administrative Law Judge John Newton issued a recommended order in favor of Positive Healthcare, but, under state administrative law, the issue had to go back to the Agency for Health Administration for a final order. For more information, READ → https://www.sun-sentinel.com/news/politics/fl-ne-nsf-medicaid-contracts-hiv-aids-20190104-story.html

They tested positive for HIV. Then the military kicked them out.

Testing positive for HIV was difficult enough. Getting forced out of the military by the Air Force because of the diagnosis proved even harder.So say two U.S. airmen who filed suit on Wednesday against Defense Secretary Jim Mattis in the U.S. District Court for the Eastern District of Virginia, arguing that the Pentagon’s decision last month to discharge them from the military owing to their HIV status violates the Constitution’s equal protection clause and federal law. Read_→https://www.washingtonpost.com/world/national-security/they-tested-positive-for-hiv-then-the-military-kicked-them-out/

What You Can Do

TAKE ACTION: It is very important that our elected officials hear from us to protect federal funding for HIV prevention and care. Speak truth to power by sharing your personal stories with your elected officials. It is vitally important to meet to your federal elected officials when they are at home. If we don’t support and advocate for HIV funding and programs, who will?  Our movement cannot afford to stand on the sidelines. Your U.S. Senators and U.S. Representatives need to hear from you.

What NMAC is Doing About It

  • NMAC remains vigilant in its advocacy to protect FY19 government funding and the existence of the social safety net.
  • NMAC is planning for the new year and meeting our new members of Congress. We are very excited to talk to the new House about our priorities. We spent last Thursday stopping by members offices to welcome them to the Hill.
  • NMAC is working in coalition to defend the right of people living with HIV to serve in the US military.

Important Happenings in HIV/Health Policy

Important Happenings in HIV/Health Policy

Year ending: December 18, 2018
By: Sable K. Nelson & Matthew Rose

Another year in the books and the norm continues of some hot HIV takes in this last month of the year. NMAC wants to give you the highlights of what is happening at this time of year. While this will not be an exhaustive list, it will be a marking of things that we are actively working on at the end of this year. We’ll be back into the new year with highlights and actions to take in the political arena. If you have any questions, do feel free to email us.

Ending the Epidemic

For the first time since the National HIV/AIDS Strategy in 2010, the domestic HIV community has come together to call on the U.S. government to declare an official goal of ending the domestic HIV epidemic by 2025 and urging it to enact legislative and regulatory policies and sufficient appropriations to achieve this goal. The Act Now: End AIDS coalition, with a process managed by AIDS United, solicited input from the larger HIV, public health, and reproductive health communities to develop the policy paper, titled Ending the HIV Epidemic in the United States: A Roadmap for Federal Action. To date, 300 HIV and community organizations from across the U.S. have provided their endorsement.

PEPFAR

Once again PEPFAR has been reauthorized with strong bipartisan support. For 15 years, PEPFAR helped to share critical resources to help fight the HIV epidemic aboard. In the areas of HIV prevention, treatment, and care, some of the world’s most vulnerable populations have benefited from this program, saving more than 17 million lives. PEPFAR has continued to support a rapid acceleration of HIV prevention by using data to increase program performance, mobilize domestic resources, and support local partners for sustainable implementation.
https://www.vox.com/future-perfect/2018/12/12/18136716/pepfar-hiv-aids-trump-congress

Announcements from the Secretary

Department of Health and Human Services Secretary Alex Azar assured the HIV community on Tuesday that new proposals around Medicare Part D would not cut off critical access to lifesaving medications. The administration had proposed some changes to programs that could significantly hinder access for those living with HIV. In a speech at the 2018 National Ryan White Conference on HIV Care and Treatment in Maryland, Azar said the administration’s recent proposal to allow Medicare Part D plans to negotiate better prices for drugs in “protected class” would not limit access to antiretrovirals used to treat HIV. Public comment about this proposed rule is due at the end of next Monday. Furthermore, the Secretary also announced two co-chairs for the President’s Advisory Council on HIV/AIDS: Carl Schmid and John Wiesman. Schmid serves as deputy executive director of The AIDS Institute. Wiesman is Secretary of Health for Washington state.
https://www.fiercehealthcare.com/regulatory/azar-assures-hiv-patients-protected-class-proposal-won-t-cut-off-access-to-drugs

Administration threats future of HIV research

On December 5, 2018, the Washington Post broke a story about the Trump administration — by and through the Department of Health and Human Services — potentially curtailing an HIV research contract after pressure from anti-abortion activists because the project relies on fetal tissue to generate mice with humanized immune systems, an important animal model for HIV research. Other similar research is also likely to come under threat. (WaPo story: https://www.washingtonpost.com/national/health-science/trump-administration-threatens-future-of-hiv-research-hub/2018/12/04/f2e8e0ec-f7dd-11e8-863c-9e2f864d47e7_story.html?utm_term=.7d9094e88286)

Policy Lead from Partnership of the Nation’s Leading HIV, STD, and Hepatitis Organizations Appointed Co-Chair of the Presidential Advisory Council on HIV/AIDS (PACHA)

Partner Logos - AIDS United, NASTAD, NCSD, NMAC, The AIDS Institute

Washington, D.C. – We applaud Secretary of the Department of Health Human Services Alex Azar’s announcement of new members of the Presidential Advisory Council on HIV/AIDS (PACHA) and the naming of Carl Schmid, Deputy Executive Director of The AIDS Institute, as a co-chair. Mr. Schmid is one of the key policy leads for the HIV, STD, & Hepatitis Policy Partnership, a coalition of five of the nation’s leading organizations focused on ending the HIV, STD, and viral hepatitis epidemics in the United States.

The Partnership is the driving force behind a new policy paper that lays out a clear roadmap for federal action to end HIV and the intersecting epidemics of STDs, hepatitis, and opioids in the United States. The paper is an essential framework for guiding PACHA’s work and meeting the goals of the National HIV/AIDS Strategy.

Secretary Azar made the announcement in a speech at the 2018 National Ryan White Conference on HIV Care and Treatment where he laid out a vision that the U.S. become a nation “where the spread of HIV/AIDS has been effectively halted, because every American with HIV/AIDS is receiving treatment and every American at risk of HIV is engaged in the right prevention strategy.”

In the past, PACHA was an invaluable body that provided a voice for the community to share advice, information, and recommendations with the Administration regarding the nation’s HIV-related programs, policies, and research. Mr. Schmid has been a leader in ensuring domestic HIV programs are fully funded and based on sound public policy for nearly two decades. He is a trusted expert in health care financing systems and is actively engaged in efforts to ensure that the Affordable Care Act meets the needs of people living with or at risk of HIV and hepatitis.

HIV is not a partisan issue and continues to be a public health threat that must have the right leadership and resources necessary to end new infections and ensure access to quality prevention and treatment for everyone who needs it.

The reconvening of PACHA and Mr. Schmid’s appointment represent an important step in ensuring our progress to end HIV and the intersecting epidemics of STDs, hepatitis, and opioids continues. We look forward to continuing to work closely with PACHA and the Administration, and wish Mr. Schmid well in his new role. Mr. Schmid will co-chair PACHA with Washington State Secretary of Health Dr. John Wiesman.

The next PACHA meeting is March 14-15, 2019 in Washington, D.C.

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AIDS United (AU), NASTAD, the National Coalition of STD Directors (NCSD), NMAC, and The AIDS Institute (TAI) are national non-partisan, non-profit organizations focused on ending the HIV, STD, and hepatitis epidemics in the United States by sharing resources to advocate for HIV, STD, and hepatitis programs and appropriations.

Important Happenings in HIV/Health Policy

Week Ending: Nov. 9, 2018
By: Matthew Rose & Sable K. Nelson

NOTE: The U.S. Senate and U.S. House of Representatives returned from recess on Nov. 13th.

Key Take Healthcare Related Takeaways from the 2018 Midterms
Health Care Was the Most Important Issue to Voters, Fueling a Democratic Majority in the House of Representatives

According to national exit polls, voters said health care was the most important issue by a two-to-one margin compared to the second most important issue, immigration, 41 percent to 23 percent, and Democrats won those voters 77 percent to 22 percent. Among the competitive GOP-held districts, Democrats had an 8 point advantage on health care, 52 to 44 percent. When it comes specifically to protecting people with pre-existing conditions, voters preferred Democrats over Republicans by a 24-point margin , 58 percent to 34 percent.

While most of us were focused on selecting elected officials, voters across the country also weighed in on several ballot initiatives in many states that will impact healthcare (including Medicaid expansion). For more information about what happened, please and how it may impact you, READ → https://www.salon.com/2018/11/10/midterm-results-show-health-is-important-to-voters-but-no-magic-bullet_partner/

The Trump-Pence Administration Finalized Dangerous and Unlawful Birth Control Rules Just One Day After the Mid-Term Elections

The day after the mid-term elections, the Trump-Pence Administration ramped up its assault on women’s health. In addition to attacking insurance coverage of abortion and the Title X family planning program, the Administration finalized two rules that would gut the Affordable Care Act’s birth control benefit, which requires health plans to cover all FDA-approved birth control methods for women without out-of-pocket cost. If the final rules go into effect as the Trump-Pence Administration would like them to on January 14, 2019, they will allow virtually any employer or university claiming a religious or moral exemption to deny insurance coverage of birth control to their employees and students. NWLC is suing the Trump-Pence Administration and supporting legal challenges by several states to stop these dangerous rules from going into effect.
READ → https://nwlc.org/blog/the-trump-pence-administration-finalized-dangerous-and-unlawful-birth-control-rules-just-one-day-after-the-mid-term-elections/

LISTEN: KHN’s ‘What The Health?’ Split Decision On Health Care

In the latest episode of KHN’s “What the Health?” Julie Rovner of Kaiser Health News, Margot Sanger-Katz of The New York Times, Rebecca Adams of CQ Roll Call and Joanne Kenen of Politico discuss the Trump administration’s new birth control coverage rules and the potential impact of the midterm election results on health policy. For more information, READ → https://khn.org/news/podcast-khns-what-the-health-split-decision-on-health-care/

Understanding the Various Healthcare Proposals (such as Medicare-For-All and Single-Payer?)

As politicians across the country toss about such health care catchphrases, sometimes interchangeably, many voters say they’re “just confused.” As we prepare for a new Congress, please take a moment to understand the various healthcare proposals. For more information → https://khn.org/news/quick-whats-the-difference-between-medicare-for-all-and-single-payer/

What You Can Do

TAKE ACTION: It is very important that our elected officials hear from us to protect federal HIV funding for HIV prevention and care. Speak truth to power by sharing your personal stories with your elected officials. It is vitally important to meet to your federal elected officials when they are at home. If we don’t support and advocate for HIV funding and programs, who will?  Our movement cannot afford to stand on the sidelines. Your U.S. Senators and U.S. Representatives need to hear from you.

What NMAC is Doing About It

  • NMAC is beginning to meet with the new congress to make sure HIV remains front and center
  • Working on national Ending the Epidemic plans and implementation
  • Engaging with the CDC about molecular surveillance