New AIDS Strategy a Decade-Long Journey
This week, a decade-long journey for advocates of HIV/AIDS policy in the United States concluded and a new chapter in American history begins.
Nine years ago, at the United Nations General Assembly Special Session on HIV/AIDS, the United States voted along with all other nations impacted by HIV/AIDS to develop national plans for addressing the epidemic in their countries. Those of us who have been advocates for such a policy and those of us who served on federal advisory committees urged and requested that such a plan be developed, but none was forthcoming until this week. While plans are only truly useful once successfully implemented, it is a significant accomplishment and newsworthy that the United States now has a plan in place to guide its efforts in combating HIV/AIDS.
Interestingly, while the U.S. did not have a plan of its own, it did lead the world in supporting prevention, treatment, and care strategies for HIV/AIDS through the President’s Emergency Plan for AIDS Relief (PEPFAR), and it provided billions of dollars of life saving support to the 15 nations hardest hit by AIDS. PEPFAR required that those receiving U.S. aid develop the very kinds of national plans that we in America never had. Meanwhile, U.S. agency-specific goals for HIV prevention at the Centers for Disease Control and Prevention (CDC) were not met due to year after year of flat funding. Nearly 50 percent of Americans in need of HIV care did not receive services, and one quarter of Americans infected with the HIV virus did not know it—all because a comprehensive, federal-wide, multi-sectoral national plan did not exist.
In the 2008 presidential election, candidates in both parties committed to developing such a plan if elected, and President Barack Obama has now delivered on that promise by releasing a national plan for HIV/AIDS. For those of us living with HIV and AIDS, and for all of us affected by HIV/AIDS, this is the start of a new chapter in American history and in our lives. Yet for those who have died waiting for this day, and for those who became infected because strategies were not wide enough, strong enough, coordinated enough, or funded enough to help them, this day comes too late. However, with more than 56,000 new infections estimated each year in this country and with a growing list this year of over 2,000 Americans in nearly a dozen states waiting to get the treatments they need to stay alive, this strategy has come just in time.
President Obama’s national plan is comprehensive and an excellent guide. Its goals of reducing new infections, of increasing access to care and improving health outcomes for people who are infected, and of reducing health disparities between Americans based on race, gender, age and sexual orientation are just what this nation needs to save Americans’ lives and prove that we are committed to our own people with the same determination we have been committed to others around the world.
While the journey toward creating a national plan has ended, the work of ensuring funding and successful implementation is just beginning. Funding is of particular concern for the plan’s success. We know all too well that the CDC’s previous goal of reducing infections by 50 percent between 2000 and 2005 failed miserably because of flat funding. The 2009 professional judgment budget estimate for HIV prevention requires an additional $4.8 billion above current funding levels over the next five years to meet the goal of reducing new infections by 25 percent by 2015. Such dramatic increases in funding for the U.S. epidemic are essential or this plan will fail. So, advocates and Congress still have much to do.
Despite the legitimate concerns many have about finding the resources needed to put this plan put into action, the creation and release of a national strategy for HIV/AIDS in the U.S. is a remarkable and needed achievement. For Americans who may be infected in this decade, for those in our country needing treatment and care today and in the future, and for our citizens gripped by the stigma of HIV/AIDS, this is a long awaited and wise change in policy and direction. We turn our attention now to finding the fuel to use the plan to truly create positive change for HIV/AIDS in America.
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Zack Cooper
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