December 1 marks World AIDS Day, and even though we’ve been fighting HIV and AIDS for more than 30 years, it’s fitting that this year’s theme is “The Time to Act is Now.”
The U.S. Department of Health and Human Services is committed to high-quality health care for every American. In August, the United States marked the 25th anniversary of the passage of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, a ground-breaking and historic comprehensive federal response to the devastation caused by AIDS.
Before large-scale federal action, AIDS brought about unique partnerships among those stricken with or at risk for the disease and the health care professionals who cared for them. Eventually, those partnerships expanded to include a wide coalition determined to do right by the people of the United States by passing the CARE Act – now called the Ryan White HIV/AIDS Program.
In directing the program’s administration to the Health Resources and Services Administration (HRSA), the legislation made the agency partner with patients, with their families, with the health care professionals who treat them, and with thousands of people in state and local governments who run or oversee HIV care and treatment programs.
Through the years, the success of the work of HRSA’s HIV and AIDS efforts multiplied as together with others, we:
- Improved the ability to get people living with HIV into care as soon as possible – and today the Ryan White HIV/AIDS Program touches over half of all people living with HIV in the U.S. In addition, our primary care programs, including community health centers, have reported a 53% increase since 2010 in the patients they serve living with HIV;
- Increased testing efforts – in 2014, health centers provided HIV testing to nearly 1.2 million patients – a 48% increase since 2010;
- Succeeded in stopping transmission of the virus from the majority of mothers to newborns; and
- Worked to make sure that treatment followed the epidemic to minority communities, most-at-risk populations and women.
Perhaps most importantly, the Ryan White HIV/AIDS Program helped improve the overall quality of HIV care and pioneered new approaches, some of which became new standards for care. In addition, the program contributed to the foundation in the global fight for HIV/AIDS – the historic launch of the U.S. Government’s President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003. PEPFAR built upon the expertise of domestic programs to help people throughout Africa, Asia and the Caribbean, as they struggled with high rates of HIV transmission and limited access to treatment.
In the decade that followed PEPFAR’s passage, we have – together with partners on the ground in the affected nations – helped stand up public health systems that bring prevention, care and treatment to millions of people in need.
For example, in Malawi, through the Nursing Education Partnership Initiative (NEPI), more than 600 recent nursing graduates have trained in PEPFAR-supported, model hospital wards, where they participate in the initiation of HIV treatment, work directly with women who are HIV-positive, and adapt nursing practices to optimize the day-to-day care of HIV patients.
Through the Medical Education Partnership Initiative (MEPI), a network of over 40 medical schools in Africa and around the world lead the development of evidence-based health workforce education reform in Sub-Saharan Africa. Over the past five years, MEPI has trained more than 5,000 medical faculty to bring best practices and HIV knowledge to curriculum development, pedagogy, and medical research.
And as has been the case in tracking and dealing with HIV in the United States, PEPFAR responds to changes in the spread of the disease. In Uganda around 2010, for instance, statisticians noted that early successes in reducing the HIV infection rate were slowing. So PEPFAR-supported health care workers modified their strategy to fight HIV. By focusing on the rapid scale-up of care and treatment with targeted prevention interventions, including voluntary medical male circumcision, Uganda has turned a corner on the rise of new infections.
PEFPAR’s new focus on targeted, rapidly-scaled interventions, like the efforts that led to reversing trends in Uganda, aim to move us toward an AIDS-free generation. The emphasis on heavily impacted areas and priority interventions mirrors changes that administrators of the Ryan White HIV/AIDS Program have made in the domestic strategy to fight HIV/AIDS. In the U.S. and abroad, scientists and public health experts are following the impact of the disease and using data to apply the latest science more effectively to combat the virus.
We have a strong foundation, but we need to build quickly to reverse the epidemic. Implementing the vision of the updated National HIV/AIDS Strategy will make the United States – and the world – a place where new HIV infections are rare and where every person has unfettered access to high-quality, life-extending care, a life of health and dignity free from stigma and discrimination.