When the World Health Organization established the first World AIDS Day on December 1, 1988, treatment options for people living with HIV were practically nonexistent, and AIDS was almost invariably fatal. Hope was in short supply, and there seemed to be little reason for optimism. I am grateful that the world is a very different place for the 25th annual World AIDS Day.
Thanks to tremendous advances in our understanding of the disease and how to treat it, millions of individuals, both in the U.S. and around the globe, are now truly living with HIV.
As we observe World AIDS Day 2013 under the Federal theme of Shared Responsibility: Strengthening Results for an AIDS-Free Generation, we reflect on U.S. led initiatives that have helped bring about this dramatic change. We rededicate ourselves to working with our partners across the nation and around the globe to fortify and intensify our efforts in HIV prevention, testing, care and treatment, and research.
The President’s Emergency Plan for AIDS Relief (PEPFAR) is marking its 10th anniversary of leadership in the global response to HIV. PEPFAR now directly supports life-saving antiretroviral treatment for millions of men, women, and children worldwide. Together with the Global Fund to Fight AIDS, Tuberculosis and Malaria and partner nations, we are working toward an AIDS-free generation around the world.
Here in the U.S., guided by the National HIV/AIDS Strategy, (NHAS), agencies and offices across the Department of Health and Human Services are working to strengthen HIV prevention, care and treatment efforts. As President Obama directed earlier this year when he established the HIV Care Continuum Initiative, we are accelerating efforts to increase HIV testing as well as improve access to and retention in HIV care. That way, we can better address drop-offs along the continuum of HIV care, from diagnosis to receiving optimal treatment. Fewer than half of the people living with HIV are getting the medical care they need, and only about 25 percent have achieved control over their HIV infection with medication. Such control both benefits their health and reduces the likelihood of HIV transmission.
So, we still have much to do.
The Affordable Care Act provides critical support to help us reach these goals. The health care law makes it illegal (already for children, and in 2014 for adults) for insurance companies to deny anyone coverage because they have HIV; eliminates lifetime benefit caps and starting in 2014, annual dollar limits; and generally requires health insurance plans to cover HIV testing and other preventive services such as domestic violence and STI screening and counseling, without any additional out-of-pocket costs to the patient. It also authorizes states to expand Medicaid eligibility, which would extend coverage to more people living with HIV.
The Ryan White HIV/AIDS Program remains a vital element of our national response to HIV, supporting critical efforts to engage and retain clients in care and demonstrating improved health outcomes for those clients across the HIV care continuum. Similarly, other HHS programs—including CDC’s HIV prevention activities, NIH’s HIV research, FDA’s regulation of HIV medicines, tests and devices, and many other activities—all remain essential parts of our response to HIV. We are grateful to the dedicated HHS personnel working to advance these efforts and all of our non-federal partners for their innovation, persistence, and passion.
Finally, I am pleased to note an improved tool in our response: an updated, more user-friendly Common Patient Assistance Program Application (CPAPA). The form allows uninsured low-income people living with HIV who do not qualify for insurance or other assistance to fill out a single form to apply for life-saving HIV drugs from multiple patient-assistance programs. This simplified process is the result of a public-private partnership involving HHS, pharmaceutical companies, the National Alliance of State and Territorial AIDS Directors , and community stakeholders.
As we observe this 25th World AIDS Day, hope and optimism are thankfully no longer in short supply. Please join us in this global observance by learning more about HIV/AIDS in your community and how you can be part of the movement to create an AIDS-free generation and help to bring an end to this global health crisis.
You can find ways to get involved by visiting CDC’s Let’s Stop HIV Together website or learning about AIDS.gov’s Facing AIDS campaign, which invites you to help reduce HIV-related stigma and promote HIV testing by putting a face to AIDS.
We can all make a difference. Here at HHS we are commemorating World AIDS Day through multiple activities, including offering HIV testing to employees and supporting staff who are volunteering with local HIV service providers.