The Partnership to End HIV, STDs, and Hepatitis Testimony for HHS Listening Session on the National HIV/AIDS and Viral Hepatitis Strategies

The Partnership to End HIV, STDs, and Hepatitis Testimony for the U.S. Department of Health & Human Services Office of HIV/AIDS and Infectious Disease Policy (OHAIDP) Listening Session on the National HIV/AIDS and Viral Hepatitis Strategies

February 22, 2019

My name is Emily McCloskey, Director of Policy & Legislative Affairs at NASTAD. I am here on behalf of The Partnership to End HIV, STDs, and Hepatitis, a coalition of five of the nation’s leading organizations focused on ending the HIV, STD, and viral hepatitis epidemics in the United States. The Partnership is comprised of AIDS United, NASTAD, the National Coalition of STD Directors, NMAC, and The AIDS Institute.

I want to thank Secretary Azar, Assistant Secretary Giroir, Dr. Beckham, and other leaders at HHS for the opportunity to share ideas and recommendations for updates to the National HIV/AIDS Strategy (NHAS) and the National Viral Hepatitis Action Plan (Action Plan).

We already know the numbers. We also know that science demonstrates we can successfully cure or treat those living with these diseases while also preventing new cases and increase the quality of life for the individual and the health of our nation. But to do so, our health care delivery system needs to diagnose, enroll and retain all those living with one of more of these diseases into care and treatment. In order to realize the goal of ending these epidemics, Congress and the Administration must ensure federal programs are adequately funded to expand access to HIV, STD, and viral hepatitis prevention and treatment efforts. Ending these epidemics will require a robust and integrated health care system as well as broader access to comprehensive health care coverage free from discrimination. Now more than ever, investment in public health programs is critical for reaching the goals of the NHAS and the Action Plan.

Addressing the record levels of new sexually transmitted diseases (STDs) is an essential part of any strategy to end the HIV epidemic, as we know STDs are driving many new HIV cases and elevate the risk for transmitting the virus. Among the many facets of this approach would be enhanced coordination between the Office of HIV/AIDS and Infectious Disease Policy (OHAIDP), CDC’s Divisions of STD Prevention and HIV/AIDS Prevention, and other offices.

We also know that the elimination of viral hepatitis in the U.S. is within our reach, but not without increased investments in comprehensive hepatitis prevention, education, screening, linkage to care, and surveillance programs. New cases of viral hepatitis continue to increase despite the existence of a highly effective preventative vaccine for hepatitis B and well tolerated cure for hepatitis C. The recent increase in cases has also shifted the population most impacted by the disease. While the disease had been focused largely in the Baby Boomer population, new cases are largely affecting younger populations and require a shift in efforts to educate, screen, and link this population to care. The opioid crisis must also be addressed in order to end viral hepatitis.

The current level of funding is woefully inadequate for the CDC to conduct the work necessary to put an end to the ongoing epidemic. This results in states often only being able to hire one less-than-full-time employee to coordinate hepatitis efforts in the entire state. The country lacks a coordinated hepatitis surveillance system, and many state health and local departments are unable to fund HCV surveillance activities. The lack of funding impacts communities’ ability to access hepatitis information, identify and avert outbreaks, provide education and screenings for individuals, and link those individuals to care.

Finally, we believe these plans must be updated to include a specific review of the intersection of the opioid crisis, and its ties to injection drug use and infectious diseases. The opioid crisis directly threatens the nation’s ability to eliminate HIV, viral hepatitis, and STDs. All plans should also adequately address disproportionately burdened populations, communities, and geographic areas.

We have a unique opportunity to end these epidemics in our lifetimes, but to reach this goal, there must be new resources allocated for that purpose. While we support ensuring resources are going to areas and activities that will have the greatest impact, we also know that simply redistributing existing resources will undermine currently successful programs and risk the progress already made in this effort. The Administration recently announced the End the HIV Epidemic by 2030 plan with the addition of significant new funding to increase access to treatment and PrEP in the areas with the highest number of HIV infections. Our partnership has been advocating to end the HIV epidemic and we look forward to learning more details of the plan, including the total budget allocations and program specifics.

Congress and the federal government, working with the states, community-based organizations, advocates and other stakeholders, are essential to ending HIV at home, stemming the tide of STDs, and eliminating viral hepatitis in the U.S. within our lifetimes.

We appreciate the opportunity to share our recommendations and look forward to working with you to update the NHAS and the Action Plan. It is our sincere desire that we can work together to advance our shared vision of ending these epidemics and protecting the health of our nation.

AIDS United (AU), NASTAD, the National Coalition of STD Directors (NCSD), NMAC, and The AIDS Institute (TAI) are national non-partisan, non-profit organizations focused on ending HIV in the U.S. They have been working in partnership to identify and share resources to sustain successes and progress we have made in HIV and STD prevention, care and treatment in the United States.