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New Federal Actions Aim to Improve Outcomes Along the HIV Care Continuum: World AIDS Day Update

Dr. Valdiserri

Dr. Ronald Valdiserri

Dr. Howard Koh

Dr. Howard Koh

One of the recurring themes of the World AIDS Day observance held earlier this month was the vital role of partnerships in our domestic and global response to HIV/AIDS. Collaborations between researchers, funders, pharmaceutical companies, people at risk for and living with HIV, community leaders, service providers, and other key partners create tools for HIV prevention, diagnosis and treatment. Furthermore, collaborative efforts of Federal, state, and local governments; healthcare providers; community-based organizations; and affected communities deploy these tools to improve public health.

Partnerships were key in producing more than 150 activities and events across Federal programs, agencies, and departments for 2013’s observance of the 25th anniversary of World AIDS Day. This culminated in a broad range of domestic and international partners joining with President Obama at the White House on December 2, 2013, to commemorate World AIDS Day. During that event, the President remarked, “As President, I’ve told you that in this fight, you’ll have a partner in me. And I said that if the United States wanted to be the global leader in combating this disease, then we needed to act like it—by doing our part and by leading the world to do more together. And that’s what we’ve done, in partnership with so many of you.”

Celebrating Advances in the Response to HIV/AIDS

As a result of these and many other partnerships, we are able to celebrate some important accomplishments highlighted by the President, Secretary of State Kerry and Secretary of Health and Human Services Sebelius during the World AIDS Day observance held at the White House on December 2nd:

  • Earlier this year, the millionth baby was born HIV-free thanks to life-saving PEPFAR-funded programs to prevent mother-to-child transmission of HIV. New pediatric HIV infections around the world have dropped by nearly 50% since PEPFAR began.
  • PEPFAR has exceeded the President’s 2011 World AIDS Day target to put 6 million people on lifesaving treatment. As of September 30, 2013, PEPFAR is supporting treatment for 6.7 million people. This signifies an almost four-fold increase (from 1.7 million [2008] to 6.7 million [2013]) since the start of the Obama Administration.
  • The number of people living with undiagnosed HIV infections in the U.S. has declined from one in five to one in six.
  • In the United States, the waiting list for the AIDS Drug Assistance Program (ADAP) has dropped from 9,000 to zero in just two years.

Even in the face of these significant accomplishments, UNAIDS reports that in 2012 more than 2 million new HIV infections and 1.6 million AIDS-related deaths occurred globally. Although a decline from previous years, these numbers also reflect a grim reality: far too many people continue to become HIV-infected and die from the effects of the disease. While in the U.S., we have recently seen a welcome decline in the number of people living with undiagnosed HIV infection, we also know that only one in four people living with HIV in this country are successfully navigating the HIV care continuum, realizing the full benefits of treatment and achieving a sustained undetectable viral load.

Recommendations of the HIV Care Continuum Working Group

As part of the World AIDS Day observance, the White House released a report, Improving Outcomes: Accelerating Progress Along the HIV Care Continuum. The report features the first recommendations and action steps developed in response to the President’s July executive order establishing the HIV Care Continuum Initiative. The initiative will guide our next steps of implementing the National HIV/AIDS Strategy with the goal of accelerating all of our Federal efforts to help people who are infected be diagnosed, linked to care, and treated for HIV. I (Dr. Koh) had the honor to co-chair, along with Dr. Grant Colfax, Director of the White House’s Office of National AIDS Policy, the Federal working group [PDF 37KB] that developed these five recommendations and 21 specific Federal actions. Spanning domains from service delivery and research to the use of data and stigma reduction, these recommendations complement work already underway to reduce new HIV infections and improve the health of people living with HIV across the nation. These recommendations and actions are, as HHS Secretary Kathleen Sebelius observed at the White House event, “another example of the Federal government breaking down silos and working together to implement that National HIV/AIDS Strategy.”

One of the specific actions detailed in the report received a significant boost when the President announced during the event that NIH would be redirecting $100 million to expand support for research directed toward a cure for HIV.

All of the recommended action steps will require intensive collaboration on the part of government, academia, national and community-based organizations, professional societies, industry, people living with HIV, and other key stakeholders to share their knowledge and expertise.

Through continued collaboration among and contributions from all sectors of society; tailoring of local responses using evidence-based approaches concentrated on the populations most affected; and combating HIV-related stigma, together we will bring about an end to HIV both here and around the world.

Watch the video Exit Disclaimer of the White House event commemorating World AIDS Day.