President’s Plan to End the HIV Epidemic Must Address Drivers, Gaps
David Hardy, MD, Chair of the HIV Medicine Association
Cynthia L. Sears, MD, FIDSA President of the Infectious Diseases Society of America
The President’s goal to end the HIV epidemic in the United States within the next 10 years, announced in his State of the Union Address is laudable and critically important to the strength and well-being of our nation. As associations of clinicians and scientists dedicated to the prevention and treatment of HIV and other infectious diseases, we share President Trump’s stated goal and know that it can be achieved through a strong, comprehensive, committed investment of adequate, sustained resources and science-based policies.
The achievement of ambitious public health goals must always include reassessments of existing policies and priorities.
To succeed, the administration’s plan must include investments that will develop and maintain strong public health and health care systems throughout the United States. Comprehensive, non-discriminatory and affordable health care coverage and an expanded Medicaid program in every state that does not impose work requirements or any other barriers to health care coverage, are essential to ensuring that all Americans can access preventive services, primary care, behavioral health care, and prescription drugs, including the most effective HIV medications. A proposal to end the HIV epidemic across this country must encompass the country, and not trade progress in one targeted location at the expense of another.
Our country must strengthen and sustain our leadership of responses to HIV globally as well, as the president noted, to have lasting impacts. Amid a still growing epidemic of opioid use, U.S. leadership, at home and abroad, must also embrace proven and effective measures -including syringe exchange to reduce infections among individuals with substance use disorders. If new transmissions of HIV are to be ended, no one can be left behind. Laws and policies that marginalize, discriminate against and compromise healthcare access for lesbian, gay, bisexual and transgender individuals must be recognized and reversed. Stigma and discrimination against people living with HIV must be addressed in all forms, including in the states that have HIV-specific criminal laws.
The goal of ending the public health threat of HIV will be better achieved if paired with commitments to address other infectious disease threats, including hepatitis C, sexually transmitted diseases and tuberculosis, at home and around the world. Success in ending HIV transmissions will require meaningful and ongoing funding for necessary education, healthcare workforce development, and biomedical research investments. Targeted interventions, including loan forgiveness, will be required to support a qualified and sufficient HIV health care workforce. We will need to invest further in communities where vulnerabilities and gaps continue, and where modern medical advances, while near, remain out of reach.
Achieving this shared, ambitious and important goal will require essential shifts in the administration’s current policies and priorities. We look forward to learning details of the administration’s budget proposal and future policies, and to providing guidance and support.