House Releases Long-awaited National AIDS Strategy
Tuesday, July 13, President Barack Obama unveiled the
first-ever National HIV/AIDS Strategy for the United
States. The plan, developed over the past year and a
half in consultation with stake-holders across the country,
espouses important goals -- including allocation of
resources to the most heavily affected groups, science-based
approaches, and greater coordination of prevention,
testing, and care -- but advocates decried the absence
of new funding for its implementation.
By Liz Highleyman
unveiled the strategy and its accompanying federal implementation
plan at White House press conference, followed by a reception
for members of the HIV/AIDS community.
have learned what we can do to stop the spread of the disease.
We've learned what we can do to extend the lives of people living
with it," he said. "So the question is not whether we
know what to do, but whether we will do it."
the last 15 months, the White House Office of National AIDS Policy
(ONAP) hosted 14 public community discussions totalling upwards
of 4000 participants and collected more than 1000 comments through
its website. Input came from medical and social science experts,
AIDS care and service providers, and people with HIV and their
advocates from across the country.
represents the work of thousands of individuals whose leadership
and input over the last three years helped it take shape,"
said Judith Auerbach of the San Francisco AIDS Foundation who
helped found the Coalition for a National AIDS Strategy. "Now
it is up to all of us to ensure its full funding and implementation
and hold our government accountable for progress."
National HIV/AIDS Strategy (NHAS) vision statement reads, "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."
three key goals are to reduce the number of new infections, increase
access to care, and reduce HIV-related health disparities. Other
components of the plan include establishing a seamless system
to link newly diagnosed individuals with coordinated care, increasing
the number of healthcare providers, and supporting people with
co-existing problems such as homelessness.
a first step, the White House issued a memorandum asking federal
agencies -- including Health and Human Services, the Centers for
Disease Control and Prevention (CDC), the Department of Labor,
Housing and Urban Development, Veterans Affairs, and the Social
Security Administration -- to develop plans to implement the strategy
within 150 days.
Resources to Needs
than 1 million people are currently living with HIV -- including
an estimated 20 percent who do not know they are infected -- and
approximately 56,000 are newly infected each year.
NHAS aims to accomplish the following goals:
the number of new HIV infections by 25%;
the rate of HIV transmission by 30%;
the number of infected people who know their status by nearly
the number of people accessing care within 3 months of diagnosis
the proportion of gay/bisexual men, blacks, and Latinos with
undetectable viral load by 20%.
key theme of the strategy is allocating resources where the need
is greatest. While gay and bisexual men make up only a small percentage
of the U.S. population, they account for more than half of all
new HIV infections.
29 years of neglect, gay and bisexual men are finally being given
the attention they deserve," said Jim Pickett of the AIDS
Foundation of Chicago.
black people make up about 13% of the population but account for
nearly half of people living with HIV; Latinos also have a higher
rate of HIV infection compared with whites.
the White House press conference, Health and Human Services Secretary
Kathleen Sebelius noted, "If you're a white, heterosexual
woman like me, your chances of being infected by HIV/AIDS are
very low -- just 1 in 50,000. But if you're a black female who's
an injection drug user, your chances of being infected are more
than 1000 times higher -- closer to 1 in 35."
new strategy embraces a comprehensive approach to linking prevention,
testing, and care -- though not necessarily immediate antiretroviral
therapy. It comes amid a growing
debate about the public health and civil rights implications
of promoting earlier treatment as a means of prevention.
that people with HIV disease are diagnosed early and linked to
lifesaving medical care is central to the president's strategy,"
said Michael Saag, chair of the HIV Medicine Association. "A
renewed focus on patient care is urgently needed to meet the increased
demand for HIV care, which will grow under this effort."
advocates generally applauded the NHAS goals, but many criticized
the lack of any major new funding for implementation. Instead,
resources will be re-allocated from existing programs. Fro example,
Obama pledged $30 million for HIV prevention and education from
funds allocated for the Patient Protection and Affordable Care
Act (the recent healthcare reform legislation).
strategy is a day late and a dollar short," said Michael
Weinstein of the AIDS Healthcare Foundation. "Fifteen months
in the making, and the White House learned what people in the
field have known for years. There is no funding, no 'how to,'
no real leadership."
have also been critical of the growing shortfalls facing AIDS
Drug Assistance Programs (ADAPs). According to the July 9, 2010
edition of the National Alliance of State and Territorial AIDS
Directors (NASTAD) ADAP Watch, there are now 2291 people on waiting
lists in 12 states. The administration this month allocated an
additional $25 million for the program, but activists said the
need is closer to $125 million.
is imperative that this nation has a comprehensive approach to
HIV care and prevention," said Randy Allgaier, a member of
the Coalition for a National AIDS Strategy. "The current
ADAP crisis is a prime example of what is wrong with our current
response to HIV/AIDS; it is fragmented and seems to move from
crisis to crisis rather than to think strategically."
National HIV/AIDS Strategy for the United States and accompanying
materials are available online at www.aids.gov/federal-resources/policies/national-hiv-aids-strategy.
HIV/AIDS Strategy for the United States. July 2010.
House Office of National AIDS Policy. White House Announces National
HIV/AIDS Strategy. Press release. July 13, 2010.
AIDS Healthcare Foundation. AHF to Criticize WH Strategy in Face
of Administration's Ongoing Indifference to Domestic & Global
AIDS Epidemic. Press release. July 12, 2010.
Medicine Association. HIV Care Providers and Researchers Applaud
Release of National HIV/AIDS Strategy. Press release. July 13,
Francisco AIDS Foundation. National HIV/AIDS Strategy Can Lead
to Dramatic Progress in Domestic Response to HIV/AIDS. Press release.
July 13, 2010.
ADAP Watch. July 9, 2010.