Office of National AIDS Policy Blog
- Posted byon July 28, 2011 at 4:43 PM EDT
Today, I was honored to participate in a special White House event to commemorate the first official World Hepatitis Day. This event was one of many held across the United States and around the world for communities to join together and focus attention on the global health threat of viral hepatitis and promote actions to confront it.
Worldwide, one in twelve persons are estimated to be living with viral hepatitis and about one million people around the world die every year because of viral hepatitis. Many people infected with viral hepatitis are unaware of their status, and as a result, may unknowingly transmit the infection to others. Without knowing their status, these patients also face the possibility of developing otherwise preventable debilitating or fatal liver disease. Last year, in recognition of this “silent epidemic,” the World Health Assembly resolved that July 28 should be designated as World Hepatitis Day, providing an opportunity to increase awareness and understanding of viral hepatitis and recognize it as a major global health problem. The theme for this first official World Hepatitis Dayis “This is hepatitis... Know it. Confront it. Hepatitis affects everyone, everywhere.”
In the United States, an estimated 3.5-5.3 million persons are living with hepatitis B or hepatitis C virus. Viral hepatitis impacts Americans of all backgrounds but affects some U.S. populations more than others. Half of all hepatitis B infected persons in the U.S. are Asian Americans and Pacific Islanders; African-Americans are twice as likely to be infected with hepatitis C when compared with the general population. To actively address these disparities and to accelerate our efforts to fight viral hepatitis, the U.S. Department of Health and Human Services (HHS) developed an Action Plan for the Prevention, Care and Treatment of Viral Hepatitis. The plan outlines actions to increase viral hepatitis awareness and knowledge among health care providers and communities, and steps that will improve access to quality prevention, care, and treatment services for viral hepatitis. Improved coordination across HHS, along with the active engagement of other governmental and nongovernmental partners—including informed communities—will be crucial to our success.
Today’s World Hepatitis Day Event was hosted by the White House Office of National AIDS Policy with active support from the HHS Office of the Assistant Secretary for Health. Dr. Howard K. Koh, the Assistant Secretary for Health, emphasized that marking this day in such a special way provides an opportunity to reaffirm our collective commitment to focus more attention on this pressing public health issue. Dr. Koh was among the dignitaries who provided opening remarks at the event and read a World Hepatitis Day proclamation on behalf of President Obama. I was pleased to then hear from several members of Congress, including Representatives Bill Cassidy, Judy Chu, Michael Honda, Hank Johnson, and Barbara Lee, who have been leaders in raising hepatitis awareness. I moderated a panel that highlighted opportunities across the federal government to implement the HHS Action Plan for Viral Hepatitis. This discussion was followed by a session led by health care providers and patients living with viral hepatitis who shared their individual experiences with fighting viral hepatitis. Mr. Jeffrey Crowley, Director of the White House Office of National AIDS Policy, provided a closing statement to the audience, which included government leaders, policy makers, community advocates, patients, and health professionals.
Ronald Valdiserri, M.D., M.P.H. is the Deputy Assistant Secretary for Health, Infectious Diseases, U.S. Department of Health and Human Services
- Posted byon July 13, 2011 at 11:09 AM EDT
It’s been one year since we launched the first comprehensive National HIV/AIDS Strategy and today we are releasing an implementation update to keep you up to speed on the latest work. We plan to release a more comprehensive progress report after the conclusion of the calendar year, but as we mark this critical first year, we wanted to provide some reflections on key first-year achievements.
The Strategy details President Obama’s three goals: 1) reduce the number of new HIV infections, 2) increase access to care and improve health outcomes for people living with HIV, and 3) reduce HIV-related health disparities. Our mission is for the United States to 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. As you will see from the report, agencies throughout government are stepping up to the plate and stakeholders from all sectors are taking action.
Ultimately, for the Strategy to be truly successful, we need you. The Strategy isn’t about what government can do alone. We know that businesses, the faith community, and all sectors have a role to play. The following video above everyday leaders implementing the strategy in their own communities. We hope that you can use this to engage more people in our collective efforts to implement the Strategy and energize key partners to continue their efforts. Go to AIDS.gov to receive more information and take action.
We thank everyone that has worked with us so far, and we look forward to new and productive collaborations over the coming year.
Jeffrey Crowley is the Director of the Office of National AIDS Strategy.
- Posted byon June 27, 2011 at 12:29 PM EDT
Note: Today President Obama issued a statement on National HIV Testing Day
Thirty years ago, at the beginning of the HIV/AIDS epidemic, there was no test for HIV, the virus that causes AIDS. For many, there was only the long and worrisome wait for the signs of infection. Once those signs appeared, no treatment for the virus was available. I personally cared for many, many patients in this era, and I am thankful that those days are over. Today, HIV testing is accurate, widely available, and often free—and treatment can help people living with HIV enjoy long, healthy lives, especially when they get diagnosed early.
The good news is that more people are being tested for HIV than ever before. It is estimated that almost 83 million American adults between 18 and 64 have been tested for HIV, as of 2009. That’s an increase of more than 11 million from 2006 when the Centers for Disease Control and Prevention(CDC) recommended that HIV testing become a routine part of medical care for adults and adolescents.
- Posted byon June 23, 2011 at 1:42 PM EDT
This week, First Lady Michelle Obama is visiting South Africa and Botswana, focusing on youth leadership, education, health and wellness. Today, Mrs. Obama met with organizations dedicated to combating HIV/AIDS in South Africa, including groups that use soccer to convene and educate children about HIV/AIDS. Tomorrow, she will meet with a Teen Club in Botswana that teaches teens about leadership and how to educate others about HIV.
During her meetings with African youth, Mrs. Obama is highlighting the importance of youth leadership in fighting HIV/AIDS. These young men and women grew up watching family members and friends taken by this devastating virus. But today they know there is hope. They have seen dramatic change in recent years – thanks to strong leadership from their Government with support from the American people – where people who were once dying are now living. These youth can be the generation that ends HIV/AIDS.
The United States is proud to be supporting South Africa, Botswana and countries around the world in leading their fight against HIV/AIDS. In South Africa, there are more than one million people on life-saving HIV treatment today, a far cry from the 50,000 people on treatment in all of sub-Saharan Africa in 2003. And Botswana is now closing in on the goal of eliminating mother-to-child HIV transmission.
These successes are being replicated in countries around the world thanks to support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Globally, the United States is supporting more than 3.2 million people on life-saving treatment. In 2010, PEPFAR directly supported 11 million people on care, including 3.8 million orphans and vulnerable children. And PEPFAR-supported programs reached over 600,000 mothers with services to prevent mother-to-child transmission of HIV, leading to more than 114,000 infants being born HIV-free in 2010 alone. For millions of youth around the world, these numbers represent parents, friends and community leaders who are now living with HIV instead of dying from it. As we focus on results, America is also supporting countries so they can lead their fight in the future and continue to save even more lives.
The Obama Administration is more committed than ever to build on the successes of the last decadeand to continue to work with other governments and partners as we all work toward our shared goal of a world without HIV/AIDS. And we hope the millions of lives saved to date will inspire youth in Africa and around the world to continue their fight for an HIV-free future.
Ambassador Eric Goosby is the U.S. Global AIDS Coordinator at the U.S. Department of State.
- Posted byon June 8, 2011 at 9:00 AM EDT
Today, Wednesday, June 8, 2010 is the sixth annual observance of Caribbean-American HIV/AIDS Awareness Day. Caribbean-American HIV/AIDS Awareness Day is designed to raise awareness of HIV/AIDS in Caribbean communities in the United States and its territories. Raising awareness is a necessity because Caribbean communities are at elevated risk for HIV infection.
There are 30 countries in the Caribbean stemming from the 3 most populous (Cuba, Dominican Republic, and Haiti) to the least populous (Saint Barts, Saint Eustatius, and Saba). After sub-Saharan Africa, the Caribbean has the second highest HIV prevalence in the world. HIV prevalence among adults in the Caribbean was approximately 1.1% between 2001 and 2007, although rates vary among countries. Cuba has a low HIV prevalence (0.1%) among adults while the Bahamas has the highest HIV adult prevalence in the region (3.1%). According to CDC, except for sub-Saharan Africa, the Caribbean is the only region where the proportion of women and girls living with HIV (53%) is higher than the proportion of men and boys. Unprotected heterosexual sex is the main HIV transmission mode in the Caribbean. However, transmission categories differ by country. Injection drug users are a primary driver of the HIV epidemic in Puerto Rico, whereas gay and bisexual men and heterosexuals are primarily affected in Cuba and the Dominican Republic (respectively).
CDC recently published surveillance data of HIV among blacks in the United States who are of Caribbean origin. Of an estimated 100,013 black adults and adolescents diagnosed with HIV infection from 2001 to 2007, 11.7% were foreign-born, with most from the Caribbean (54.1%) and Africa (41.5%). Most Caribbean foreign born blacks with HIV in the US are from Haiti (66.9%), 18.2% from Jamaica, 6.3% from Trinidad and Tobago, 3.3% from the Bahamas, 1.4% from Barbados, and 3.8% from other areas of the Caribbean. Males account for the majority (56.6%) of HIV diagnoses among black people born in the Caribbean. Females account for 57.4% of diagnoses among HIV-positive black Americans born in Africa.
Additional information about HIV in the Caribbean is available at UNAIDS, World Health Organization and Pan American Health Organization. Additional information of HIV among Caribbean born individuals in the United States is available on the Centers for Disease Control website. In addition, links to other informational resources are available at the Florida/ Caribbean AIDS Education and Training Center.
Greg Millett is a Senior Scientist and HHS/CDC Liaison to the Office of National AIDS Policy
- Posted byon June 7, 2011 at 3:22 PM EDT
As we reflect on the thirtieth year of the HIV pandemic, our work continues. I wanted to share with you two developments at the White House as we mark this somber, but important milestone.
HHS Announces New Steps to Implement the National HIV/AIDS Strategy
Yesterday, I participated in a call with Health and Human Services Secretary Kathleen Sebelius and key leaders in her Department who announced new actions to support the implementation of the National HIV/AIDS Strategy.
Mary Wakefield, PhD, RN, Administrator of the Health Resources and Services Administration (HRSA)discussed the Administration’s continued commitment to supporting States in responding to the challenge of state waiting lists in the AIDS Drug Assistance Program (ADAP). Funding for ADAP has enjoyed broad bipartisan support. Even in a tough budget climate and at a time when other critical health programs received cuts, the Administration fought for and achieved a $50 million increase in funding for ADAP in FY 2011 compared to the enacted level for FY 2010. This year, the Federal government alone will invest $885 million in the ADAP program. Administrator Wakefield announced that the increased funding will allow a temporary program established last summer with $25 million in emergency funds to continue and HRSA will allocate the remaining increase through both the ADAP formula program and through a targeted, competitive grant process to assist States with waiting lists or other cost containment measures that could impede access to critical medications. While there are challenges in ensuring that individuals have access to life saving medications, HRSA is working closely with states and encouraging pharmaceutical companies to help bridge the gap in this program until state economic conditions improve and the Affordable Care Act alleviates some of the pressure on this program.
Ms. Cindy Mann, Deputy Administrator of the Centers for Medicare and Medicaid Services (CMS) and Director of the Center for Medicaid, CHIP, and Survey and Certificationdiscussed a State Medicaid Director (SMD) letter, issued yesterday, that informs States of various opportunities in Medicaid to improve care coordination and care delivery for people living with HIV, as well as opportunities to use Section 1115 HIV demonstration waivers to expand access to Medicaid for people living with HIV. To facilitate States considering a Section 1115 demonstration waiver, CMS also issued a template and stated that they will work with States to develop streamlined and flexible approaches to meeting legal and policy requirements for these waivers. The commitment to issue this waiver guidance was made in the Federal Implementation Plan for the National HIV/AIDS Strategy and in some states, could provide a mechanism for relieving pressure on ADAP while also providing more coordinated and high-quality care.
Dr. Tom Frieden, Director of the Centers for Disease Control and Prevention (CDC)described CDC’s vision for high-impact HIV prevention. He announced that even in a very difficult budget environment, CDC was increasing its investment in HIV prevention services by $31 million in FY 2011. He also described some of the targeted new prevention investments CDC is making as it realigns its entire HIV prevention portfolio to have a bigger impact. He spoke of the need, articulated in the National HIV/AIDS Strategy, to focus on the geographic, demographic, and programmatic characteristics of the HIV epidemic. In particular, he highlighted the need to better address gay and bisexual men of all races and ethnicities (but especially gay and bisexual men of color), because they reflect the majority of new infections and the only group in the US where infection rates are rising. He discussed the Enhanced Comprehensive HIV Prevention Planning (ECHPP) initiative in the twelve cities and surrounding metropolitan areas that account for nearly half (44%) of the HIV cases in the United States. He described this as a platform for making improvements in planning that will be applied across CDC’s HIV prevention programs. He discussed CDC’s investments in helping state and local jurisdictions track and report CD4 and viral load measurements in order to track community viral load. Research studies have demonstrated that when a community is able to lower the mean viral load across all people living with HIV in that community that this leads to a lowering in HIV incidence. Therefore, tracking community viral load is an important tool for reducing the number of new infections. CDC is doing important work to support states and localities in building their capacity to track community viral load.
Each of these agencies announced significant new initiatives yesterday that move us forward in implementing the National HIV/AIDS Strategy. Their impact, however, is greatest when viewed together. We have a stronger evidence base than ever before and a clearer vision of how to support individuals and communities in lowering their risk of becoming infected with HIV, helping individuals living with HIV to learn their status, and how to bolster the programs that support individuals with HIV in accessing the care and services they need (including access to antiretroviral therapy). Our work continues, but we are making definite forward progress.
Champions of Change
Champions of Change is a weekly White House initiative to highlight Americans who are making an impact in their communities and helping our country rise to meet the many challenges of the 21st century. Last week, we invited a diverse group of people living with HIV to join me; Health and Human Services Assistant Secretary for Health, Dr. Howard Koh; Brian Bond, Deputy Director of Public Engagement and former ONAP staffer and Senior Scientist at CDC, Greg Millett - both people living with HIV; as well as Allison Nichol and David Knight of the Civil Rights Division at the Department of Justice and David Vos, Director of the Office of HIV/AIDS Housing at the Department of Housing and Urban Development for a round table to discuss their experiences as people living with HIV.
For more than two years we’ve been working in close partnership with many members of the HIV community and as we enter our fourth decade fighting HIV/AIDS, we believed it was important to again hear from the collective wisdom of people living with HIV in order to assess our progress and make plans for concerted efforts going forward. Everyone has something to contribute toward ending this pandemic. That’s why we have been working with people living with HIV every step of the way. We felt it was important to meet with HIV positive leaders and hear about the lived experiences of people who may be still facing stigma in their own communities. Many who may still struggle to gain access to services, yet who are working everyday to support their communities as they respond to HIV. The discussion was very powerful and it generated a lot of good ideas.
Check out this introductory post from Brian Bond HERE and learn about these incredible individuals HERE. And check back, as this page will be updated throughout the week with posts by each of these individuals.
Jeffrey S. Crowley is the Director of the Office of National AIDS Policy
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