Office of National AIDS Policy Blog

  • Implementing the National HIV/AIDS Strategy at the Community Level

    Now that the National HIV/AIDS Strategy has been released and the lead Federal agencies are working on preparing their report to the President before the December 9th due date, the ONAP team has switched focus on assessing the implementation of the National HIV/AIDS strategy at all levels.  Of course, at the Federal level Secretary Sebelius and her very capable team are primarily responsible for bring all of this together.  Working with our Federal partners ONAP is taking a cross sectional look at how the implementation process is moving along, especially at the community level.

    Shortly after the release of the strategy I had an opportunity to travel to southern Arizona where I met with several community based organizations, local county health officials and service providers as well as individual living with HIV/AIDS.  Border Health has been issue that I have been particularly interested in.   I was struck by two things; first, the level of enthusiasm and commitment by many individuals at the local level with respect to the strategy.  Several of the individuals that I talked to have been working in the HIV/AIDS field for many years.  They have waited a long time to get clear, direct and committed guidance on how to fight this epidemic from the highest level of our government, and were anxious to get started.

    "We just completed our five year plan, here" said Wendell Hicks, executive director of the Southern Arizona AIDS Foundation, an organizations whose mission is to provide compassionate medical care to people with HIV and, and to help prevent the spread of HIV through education and testing.  He continued; "with the strategy, we will now go back and see where we can realign our goals and objectives to match those of the strategy."  In a follow up conversation, several Southern Arizona Health leaders committed to developing a local strategy using the national strategy as a template.  I am looking forward to returning to Southern Arizona in a year's time to see what they have come up with.

    I was also struck by the enthusiasm of many of the "promotoras" (Spanish for field health services navigators or outreach workers) that go out and engage the community to get tested and seek or stay in care.  Their enthusiasm for the work they do and the gratitude for the guidance that the strategy provides was contagious.  One young "promotora," a volunteer mother of two, whose son is HIV positive, commented that she had been encouraging individuals in her community to talk about HIV and get tested for over ten years.  She was happy that the strategy reinforced and supported her work.

    I had a similar experience in Philadelphia, Pa. where The Black AIDS Institute, the National Black Leadership Commission on AIDS, BABASH and other local organizations hosted a discussion to discuss elements of the strategy.  There, several community leaders were encouraged that the strategy addressed many of the issues that impacted their local communities.  Several leaders, especially local health officials committed to going back to their own strategic plans and fine tune them so that they better align with the national strategy.  I committed to support their efforts and arranged for copies of the my presentation and the strategy to be available for the next meeting.  In total the group expects to conduct 11 such gathering nationwide.

    We will continue to engage the local community and encourage them to read the strategy and to explore ways to implement it in their local setting.  We anticipate that the reports due back from the various lead Federal agencies, especially HHS will provide the community greater specificity.  Moving forward, we will soon (September 23, 1pm) host a meeting here in the White House with Federal, state and local stakeholders in the Latino Community to explore how they are implementing the strategy in their communities.   Separately, we are working with Faith leaders to develop a tool kit that they may use to highlight the goals and measures of the strategy during upcoming World AIDS Day (December 1) events. 

    I am encouraged that as more and more community leaders read, study and learn of the goals and measures of the strategy they will begin to explore ways of implementing it in their organizations.

    James Albino is a Senior Program Manager in the Office of National AIDS Policy (ONAP)

  • National HIV/AIDS and Aging Awareness Day

    Tomorrow, September 18, 2010, marks the 3rd annual National HIV/AIDS and Aging Awareness Day.  This special day provides us all with the opportunity to focus on the many challenges related to HIV prevention, testing, and treatment facing our aging population.  “Aging is a part of life; HIV doesn’t have to be,” the theme for this years National HIV/AIDS and Aging Awareness Day, reminds us that there is more we can do to make older Americans aware of HIV prevention and testing.  With 15% of all new HIV/AIDS cases occurring among people aged 50 and older, it’s clear that we can and must do more to inform individuals and service providers about the importance of educating older Americans. 

    Increased prevention is one element of the call-to-action the National HIV/AIDS and Aging Awareness Day provides, but we must also focus on treatment and care. Research indicates that by 2015, half of the people living with HIV in the U.S. will be over age 50. As people live longer with HIV, we must continue to learn more about how to manage the longterm effects of HIV and how this intersects with the aging process and other common health conditions. Aging services providers and HIV care providers must work together to ensure that the special needs of these men and women can be effectively addressed in an integrated and collaborative fashion. 

    Please join the Administration on Aging and our network of community-based aging services providers in heeding the call-to-action of the National HIV/AIDS and Aging Awareness Day and join us in raising awareness across the country of the prevention, testing and treatment needs of our aging population. 

    Kathy Greenlee is the Assistant Secretary for Aging in the Department of Health and Human Sevices

  • Institute of Medicine Issues Report on HIV Screening and Access to Care

    Last fall, the Office of National AIDS Policy (ONAP) commissioned the Institute of Medicine (IOM), the health arm of the independent National Academy of Sciences, to study certain questions related to HIV testing policy and access to care.  They organized a 15-member committee, the Committee on HIV Screening and Access to Care which consisted of subject matter experts that planned a series of workshops and are developing three reports.  Today, the IOM released the first of these reports.  HIV Screening and Access to Care: Exploring Barriers and Facilitators to Expanded HIV Testing is available at the IOM’s website at www.IOM.edu.  This report was produced in response to ONAP’s charge to examine the extent to which Federal and State laws and policies and health insurance policies pose a barrier to expanded HIV testing.  Forthcoming reports will examine: 1) the capacity of the health care system to administer a greater number of HIV tests and to accommodate new HIV diagnoses; and , 2)Federal and State policies that inhibit entry into clinical care or the provision of continuous and sustained clinical care for people with HIV/AIDS.

    The National HIV/AIDS Strategy for the United States, released by the Obama Administration in July of this year, calls for expanded HIV testing and screening to increase knowledge of HIV serostatus as a critical component of the nation’s response to HIV/AIDS.  This report provides important and timely information for policymakers at all levels that are grappling with complex and challenging policy questions about how to effectively expand access to HIV testing and screening in a manner that is most effective at identifying people living with HIV who are unaware of their HIV status.  We anticipate that this report will serve as a valuable resource as we work to support implementation of the Strategy.

    I encourage you to read the IOM’s report and I would like to acknowledge and thank the important work of the staff of the IOM and the Committee on HIV Screening and Access to Care.

    Jeffrey S. Crowley is the Director of the Office of National AIDS Policy

  • Continuing Our Commitment to Prioritizing HIV/AIDS

    Today, the Obama Administration is taking new action to prioritize support for Federal HIV/AIDS prevention and care programs.  We are sending to the Congress an amendment to the President’s FY 2011 budget request to increase HIV/AIDS funding by $65 million.  This is comprised of a requested $35 million increase for HIV prevention in order to continue exciting new HIV prevention activities described below to support the National HIV/AIDS Strategy and a $30 million increase for State AIDS drug assistance programs to respond to the ongoing crisis States are facing in operating these essential programs.  These resources come on top of proposed increases for HIV prevention and care at the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) that were included in the original budget submission.  Ultimately, the Congress will enact a budget that will establish Federal funding levels for the fiscal year that begins on October 1st.

    Last month, the Obama Administration released the National HIV/AIDS Strategy.  This was the product of a robust dialogue with the HIV community and other members of the public and identifies a small set of priority action steps for moving the Nation forward in responding to the domestic HIV epidemic.  On the evening of July 13th, the President hosted a reception for the HIV community at the White House where he spoke about the Strategy and his commitment to fighting HIV/AIDS.  He said the following,

    Now, I know that this strategy comes at a difficult time for Americans living with HIV/AIDS, because we’ve got cash-strapped States who are being forced to cut back on essentials, including assistance for AIDS drugs.  I know the need is great.  And that’s why we’ve increased Federal assistance each year that I’ve been in office, providing an emergency supplement this year to help people get the drugs they need, even as we pursue a national strategy that focuses on three central goals.

    We recognize that times are tough and there are significant challenges faced by people living with HIV/AIDS and other Americans that must be addressed.  The Federal government cannot tackle these problems alone, but we can do our part. 

    In the current fiscal year, FY2010, Congress appropriated funding of $835 million for the AIDS Drug Assistance Program (ADAP).  In July, due to the serious shortfalls in State ADAPs resulting largely from State cutbacks, HHS Secretary Sebelius took an emergency step by re-allocating $25 million for ADAPs for a total of $860 million.  Our FY 2011 budget request had included increased ADAP funding, but today’s proposed $30 million increase would continue funding in FY 2011 for the emergency supplemental funds announced last month.  If the Congress follows our recommendation, Federal funding for ADAPs would rise to $885 million next year—a $50 million increase from the level appropriated by Congress for this year.  This action, alone, will not resolve the challenges faced by ADAPs.  We need States to continue to prioritize their funding for ADAPs even in these difficult times, and we need our pharmaceutical company partners, businesses, foundations, and community-based organizations to do their part as well.

    On the issue of HIV prevention, Secretary Sebelius announced new investments in HIV prevention when we released the National HIV/AIDS Strategy.  To ensure that these initiatives continue, we are requesting $35 million in additional funds for next year.  In FY 2010, these resources are supporting:

    • Comprehensive HIV prevention ($11.6 million):  This will fund the implementation and evaluation of effective combinations of behavioral and biomedical prevention interventions in the highest prevalence jurisdictions.  These jurisdictions will compete to scale-up effective comprehensive approaches in subsequent years. The funding opportunity announcement (FOA) for this initiative is available on Grants.gov. Be sure to type “CDC-RFA-PS10-10181” as the Funding Opportunity Number to download the FOA.
    • Increased testing and linkage to care ($4.4 million):  Building on CDC’s new Expanded Testing Initiative, these funds will ensure that resources are provided to support targeted testing and linkage services for high prevalence communities, including Black, Latino, injection drug using (IDU), and gay male communities. 
    • Expanded HIV surveillance ($5.5 million):  This will support work with jurisdictions to ensure that all jurisdictions report CD4 cell counts and viral loads to the public health surveillance system, enable jurisdictions to estimate community viral load, and take other steps to improve the surveillance system.
    • Consultation, evaluation, technical support and annual MSM survey ($6.5 million):  These resources will support evaluation and monitoring, assisting with developing and implementing new activities and conducting an annual internet survey for men who have sex with men (MSM) to collect behavioral, HIV testing, and other information.
    • HIV, viral hepatitis, STD prevention and sexual health promotion with Tribal Communities ($1 million):  CDC will partner with the Indian Health Service (IHS) to work with Tribal communities on prevention and health promotion.

    These activities reflect a new direction that we believe will have a greater impact at lowering the number of new HIV infections in the United States. 

    Today’s announcement demonstrates that we are committed to implementing the National HIV/AIDS Strategy and ensuring that necessary investments in prevention and care services for people living with HIV continue.

    Jeffrey S. Crowley is the Director of the Office of National AIDS Policy

  • Bringing the International AIDS Conference to DC in 2012

    I have had the pleasure of participating in the 18th International AIDS Conference in Vienna this past week.  As you may know, last week, President Obama held a reception at the White House to celebrate the work of the HIV/AIDS community as his Administration launched the first comprehensive National HIV/AIDS Strategy.  The positive reaction to the Strategy and the energy of so many advocates, providers, and Federal officials to take the next step to implement the Strategy has been evident throughout the Vienna meeting.  This has been just one part of what has made this conference so exciting and full of hope for me.  In addition to many great oral sessions and poster sessions, the conference has been electrified by several major research breakthroughs with implications for vaccines to prevent HIV as well as microbicides to protect women from becoming infected by their male partners.

    Today also marks the beginning of our collective work to maintain the momentum coming out of Vienna to ensure that at the next conference, in Washington, DC, we all have a solid record of new accomplishments.  From the perspective of the United States government, the DC conference will be an important opportunity to showcase American leadership in working to end AIDS at home and around the world.  I thought you would like to see the message from President Obama welcoming delegates to the Vienna conference to Washington, DC in July 2012.

    Download Video: mp4 (63MB) | mp3 (2MB)

     

    Ending the HIV pandemic is an important challenge of our time and, for the first time in a long time, it feels like something that is within reach.  I hope that we take another step towards this goal in DC two years from now.

    Gregorio Millett is the Senior Policy Advisor in the Office of National AIDS Policy and he is representing the United States on the Conference Coordinating Committee (CCC) for the AIDS 2012 Conference.
     

  • Taking the National HIV/AIDS Strategy to Vienna

    Last week, we released the National HIV/AIDS Strategy - a comprehensive plan to fight HIV in the United States. On Sunday, June 18, 2010, The Office of National AIDS Policy in conjunction with the Department of Health and Human Services sponsored a session at the International AIDS Conference entitled “A Discussion on the U.S. National HIV/AIDS Strategy”. The purpose of the session was to describe the development of the recently released National HIV/AIDS Strategy to an international audience, as well as to introduce the audience to a few of the individuals responsible for the development and the implementation of the Strategy.

    The session began with remarks by Jeffrey Crowley, Director of the Office of National AIDS Policy (ONAP) and Dr. Howard Koh, Assistant Secretary for the Department of Health and Human Services (HHS). Mr. Crowley addressed ONAP’s year-long effort of community engagement and outreach to Federal agencies to solicit recommendations for the Strategy.  Dr. Koh discussed the interagency process in developing the Strategy and the duties of his office to oversee the Strategy’s implementation.

    This was followed by two panel discussions.  The first panel, chaired by Dr. Ronald Valdiserri of HHS, included a range of Federal officials who discussed the implications of the Strategy to their respective agencies and coordination of effort across the Federal level.  The second panel, chaired by Dr Helene Gayle of CARE USA, included community members who shared their perspectives in the development of the Strategy and the role of community-based organizations and advocates in its implementation.  Notably, the community panel included recently appointed members of the Presidential Advisory Council on HIV/AIDS, as well as members of the Coalition for a National AIDS Strategy.  The Coalition, which began in 1997, coalesced around a single idea: that the United States should have a concise, outcomes-based plan of action to address the domestic HIV epidemic.  The main impetus for the Coalition was the publication of a  document by Christopher Collins in 2007 entitled “Improving Outcomes: Blueprint for a National AIDS Plan for the United States.”

    You can watch the full video below or skip to the sections you're most interested in.  

    Presentation: Developing a National HIV/AIDS Strategy for the United States (00:00 - 11:32)
    Jeffrey Crowley, Director, Office of National AIDS Policy

    Presentation: Implementation of the National HIV/AIDS Strategy (11:32 - 26:06)
    Dr. Howard Koh, Assistant Secretary for Health, Department of Health and Human Services

    Panel Discussion: Federal agency involvement in the National HIV/AIDS Strategy (27:45 - 1:05:55)

    Moderator: Dr. Ronald Valdiserri, Assistant Secretary for Health and Infectious Diseases, Department of Health and Human Services

    Panelists:

    • Dr. Deborah Parham-Hopson, Associate Administrator for HIV/AIDS, HIV/AIDS Bureau, Health Resources and Services Administration (HRSA)
    • Dr. Carl Dieffenbach, Director of the Division of AIDS, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
    • Dr. Kevin Fenton, Director of the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention at the Centers for Disease Control and Prevention (CDC)

    Panel Discussion: Community involvement in the development and implementation of the National HIV/AIDS Strategy (1:07:15 - 1:58:26)

    Moderator:  Dr. Helene Gayle, President and CEO of CARE USA

    Panelists:

    • Chris Collins, Vice President and Director of Public Policy at the Foundation for AIDS Research
    • David Munar, Vice President of the AIDS Foundation of Chicago
    • Naina Khanna, Director of Policy & Community Organizing, Women Organized to Respond to Life-threatening Disease (WORLD), and Coordinator of the U.S. Positive Women's Network (PWN)
    • Dawn Averitt-Bridge, Founder and Chair of The Well Project
    • A. Cornelius Baker, National Policy Advisor for the National Black Gay Men's Advocacy Coalition; Project Director for the NIH/NIAID National HIV Vaccine Research Education Initiative for the Academy for Educational Development (AED) Center on AIDS & Community Health
    • Phill Wilson, President and CEO of the Black AIDS Institute

    Gregorio Millett is a Senior Policy Advisor, Office of National AIDS Policy