The Trump administration vowed Wednesday to commit “significant resources” to President Trump’s push to eradicate HIV transmission in the U.S., saying it will provide resources to control the spread of the disease in at-risk populations.
Federal health officials said it’s too early to talk about a budget — that will have to wait for the White House to submit its overall 2020 spending plan to Congress later this year — but said the goal is to reduce transmission by 75 percent within five years, and 90 percent within a decade.
The campaign will focus on 48 counties where the virus is spreading, plus the District of Columbia and San Juan, Puerto Rico. It also will target seven states where rural transmission is prevalent: Oklahoma, Missouri, Kentucky, Arkansas, Alabama, South Carolina and Mississippi.
“There will be significant new resources to support the effort,” said Brett P. Giroir, assistant secretary for health at the Department of Health and Human Services.
Mr. Trump announced the push Tuesday in his State of the Union address, one of several bipartisan rallying cries on public health.
“My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years,” Mr. Trump said. “Together, we will defeat AIDS in America.”
Officials say there have been significant strides against HIV/AIDS since the height of the epidemic in the 1980s and 1990s, though progress in thwarting new cases has plateaued. Roughly 40,000 Americans are newly infected each year.
Carl Schmid, a deputy executive director of the nonprofit advocacy group AIDS Institute, said Mr. Trump’s proposal could be a game-changer, though only if the administration sticks to its funding promises.
“They said it would be a new budget line — ending the HIV epidemic — and it would be substantial new funding,” Mr. Schmid said, citing a briefing his group received from officials.
He said he doesn’t have his own estimate of what the project would cost, but it would be a “lot of money” over multiple years.
HHS officials said the plan will follow a set of core principles, including the swift diagnosis of new cases and rapid treatment.
Mr. Trump said in his speech that “scientific breakthroughs” also can help the U.S. make strides.
Officials want to expand the use of drugs, known as antiretroviral therapy (ART), that reduce the viral load in infected persons to undetectable levels, allowing patients to live longer and avoid transmitting the disease to sex partners.
Also, the administration plans to expand access to “PrEP” drugs that can help at-risk persons avoid infection. It said 1 million Americans could benefit from the drug, yet only 10 percent are using it right now.
“It’s an astounding and shocking figure that so few are getting indicated medication,” Dr. Giroir said.
Mr. Schmid said people on Medicaid or private insurance usually can afford PrEP drugs, but the uninsured have struggled to afford it.
The administration said it will use federally funded health centers to make sure those people are eligible for significant discounts that put it within reach.
“That’s been the missing link. You can take this drug to prevent HIV, but there hasn’t been a payer source for it,” Mr. Schmid said.
Liberal activists complained that the administration’s position siding with a lawsuit that seeks to curtail Obamacare will cut into health efforts to control HIV.
And top Democrats on Capitol Hill reacted coolly to Mr. Trump’s plan.
“The president’s call for ending HIV transmission in America is interesting, but if he is serious about ending the HIV/AIDS crisis, he must end his assault on health care and the dignity of the LGBTQ community,” said House Speaker Nancy Pelosi.
Mr. Schmid said gay men are most at risk of infection, particularly among black and Hispanic populations. They’re followed by white gay men and then black women.
Robert Redfield, director of the Centers for Disease Control and Prevention, said there will be a serious effort to reach all populations and fight the stigma around the disease, particularly among the transgender population and those who may be infected through intravenous drug use.
“Stigma is the enemy of public health,” Dr. Redfield said.
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