WHITE HOUSE FACT SHEET ON PROGRESS OF HIV/AIDS STRAGEGY

FROM:  THE WHITE HOUSE 

FACT SHEET: Progress in Four Years of the National HIV/AIDS Strategy

On July 15, 2010, President Obama released the first comprehensive National HIV/AIDS Strategy, which envisions that “the United States will become a place where new HIV infections are rare and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.”

The goals of the Strategy are to reduce new HIV infections; increase access to care and improve health outcomes for people living with HIV; and reduce HIV-related disparities and health inequities.  Achieving these goals requires partnerships and coordination among Federal agencies, state and local governments, community-based organizations, and health care settings.

To further the implementation of the Strategy, last year, President Obama signed an Executive Order establishing the HIV Care Continuum Initiative, which outlines the pathway to accelerate and optimize health outcomes for those living with HIV.  This update outlines just some of the major accomplishments and progress made over the last four years towards achieving the Strategy’s goals and highlights new action steps taken today. 

New actions to support the National HIV/AIDS Strategy: 

• Today, to support the goals of the Strategy, the Department of Health and Human Services (HHS) announced the availability of $11 million in funding to enhance Community Health Centers’ HIV efforts in communities highly impacted by HIV, especially among racial and ethnic minorities.  This initiative, funded through the Affordable Care Act and the Secretary’s Minority AIDS Initiative Fund, aims to build sustainable partnerships between public health and health centers to help achieve the goals of the Strategy.
• Additionally today, the Department of Justice (DOJ) released a Best Practices Guide to Reform HIV-specific Criminal Laws to Align with Scientifically Supported Factors. As noted in the National HIV/AIDS Strategy, many states have criminal laws that have not keep pace with our current understanding of best public health practices for preventing and treating HIV and that, instead, may make people less willing to get tested, disclose their status, and undermine the public health goals of promoting HIV screening and treatment. This guide is intended to share best practices for aligning criminal law with the public health goal of reducing HIV-related stigma.

Implementing the National HIV/AIDS Strategy:

Reducing new HIV infections over the last four years: Ensuring that individuals know their HIV status is a critical step to reducing HIV infections.  People who don't know they are infected miss an opportunity to access the life-sustaining care and treatment that can now lead to normal life-expectancy. Undiagnosed individuals can also unknowingly pass the virus on to others. 

• HIV testing: Screening all persons between 15 and 65 years of age is now a grade “A” recommendation of the independent United States Preventive Services Task Force. This means that, as of April 2014, new health plans under the Affordable Care Act must offer HIV screening without cost sharing.
• The number of people who know their HIV status increased:  The overall number of people with HIV who know their HIV status increased to 84.2% in 2010, approaching the Strategy goal of 90% by 2015.  Serostatus awareness was 90% or higher among persons 45 year or older and among injection drug users. 

• Reduction in new HIV infections in some sub-populations:  Black women saw a 21% reduction in new HIV infections from 2008 to 2010.  In 2010, there was a 22% reduction in new HIV infections among injection drug users. However, there has been a 12% increase in new HIV infections among men who have sex with men (MSM) and 22% increase among young MSM aged 13 to 24. The Administration is committed to enhancing outreach to young, black, gay males.
• Reduced transmission of HIV: One of the most successful scientific advances in HIV prevention, treatment as prevention, shows that people living with HIV who have a suppressed viral load due to effective HIV treatment, reduce their HIV transmission risk by up to 96%.
• Pre-exposure prophylaxis (PrEP): In May 2014, the Centers for Disease Control and Prevention (CDC) released clinical practice guidelines on HIV risk and eligibility for PrEP use.
• Research for an effective vaccine and cure: An effective vaccine remains a critical component of any long-term strategy.  In 2014, the President announced that the National Institutes of Health (NIH) is redirecting $100 million for development of new therapies toward a cure and will continue to strive to be on the forefront of new discoveries.  

Increasing access to care and improving health outcomes over the last four years: To end the epidemic, in addition to providing prevention strategies, access to health insurance coverage and other key supports are essential. 

• Making coverage affordable: The Affordable Care Act has expanded access to affordable health insurance coverage for millions of Americans, including thousands living with HIV.  Thanks to the Affordable Care Act, people can no longer be denied coverage based on pre-existing conditions, including HIV.  The Administration will continue to focus on the Ryan White HIV/AIDS Program and Affordable Care Act coordination.

• Housing for people living with HIV: Since 2010, over 56,000 people with HIV receive housing assistance from the Housing Opportunities for Persons with AIDS (HOPWA) program annually. In keeping with the goals of the Strategy, the President’s Fiscal Year 2015 Budget proposes modernizing HOPWA’s funding formula to better reflect the current state of the epidemic.
• Increasing access to life-saving HIV treatment: Thanks to targeted investments by the Administration, waiting list for the AIDS Drug Assistance Program (ADAP) have been nearly eliminated from a high of over 9,000 in 2011.
• Commitment to ensuring access to care for people living with HIV: Together, the Affordable Care Act and the Ryan White HIV/AIDS Program are improving and expanding access to care for people living with HIV/AIDS.  Federal leaders have taken steps to ensure this collaboration, including providing guidance to Ryan White grantees to help them effectively interact with new coverage provided under the Affordable Care Act, and strengthening Ryan White data and information to improve program management.  

Reducing health disparities over the last four years: Gay and bisexual men, transgender women, and Black and Latinos continue to bear significant disproportionate burden of new HIV infections and poorer health outcomes. Black gay youth aged 13 to 24 have been identified in the National HIV/AIDS Strategy as a principal group facing HIV/AIDS-related health disparities. 

• Improving care continuum outcomes among people of color: In 2012, HHS funded a $44 million Care and Prevention in the United States (CAPUS) demonstration project to reduce HIV and AIDS-related morbidity and mortality among racial and ethnic minorities in eight cities.  This project focuses efforts on improving outcomes along the HIV care continuum.
• Addressing the concerns of the communities most affected:  In June 2014, Office of National AIDS Policy (ONAP) held listening sessions in areas most impacted by the epidemic in the southern United States (Jackson, Columbia, and Atlanta).  Additionally, ONAP convened a meeting at the White House focusing on HIV and the southern United States, and will host another meeting to address HIV and gay men, particularly young black MSM, in fall 2014. 
• Reducing stigma and discrimination: In May 2014, CDC launched the latest communication campaign under its Act Against AIDS initiative: “Start Talking. Stop HIV.” aiming to eliminate stigma and discrimination and promote open communication between gay and bisexual men about a range of HIV prevention strategies. Additionally, DOJ launched ADA.gov/AIDS, a portal for individuals to directly report cases of HIV-related discrimination.
• Integrating behavioral health for people at high risk: The Substance Abuse and Mental Health Services Administration (SAMHSA) piloted a number of the Minority AIDS Initiative Continuum of Care programs focused on integrating HIV medical care into behavioral health programs designed for racial and ethnic minority populations also at high risk for behavioral health disorders and HIV. 

Achieving a more coordinated national response over the last four years: The National HIV/AIDS Strategy recognizes that a core principle of reaching its identified quantitative targets requires Federal agencies to coordinate efforts, along with coordinating across State and local government and the private sector.

• Intersection of violence against women and girls, HIV/AIDS, and gender-related health disparities: In 2012, President Obama signed a memorandum forming a Federal working group and directing agencies to coordinate efforts on these key issues.  Federal agencies and community partners are investing time and resources to provide co-screening for HIV and intimate partner violence as well as learn more about the benefits of trauma informed care. 
• Implementing common core indicators: In 2012, HHS approved a set of seven common core indicators to monitor HHS-funded prevention, treatment, and care services in an effort to standardize data collection and grantee reporting requirements, thereby reducing burdens and increasing efficiency.
• Public-private partnerships to facilitate access to HIV treatment: In 2012, a convening of funders by HHS and the MAC AIDS Fund led to the development ofHarborPath, an online portal for health care providers to help connect uninsured individuals with HIV to access medications and/or medication assistance programs through a streamlined common application.
• Investing in future research:  NIH expanded their investment in research to address gaps and opportunities in the HIV Care Continuum, including investigations of the effectiveness of methods to identify HIV-infected people earlier and to link them to care; community-level interventions to expand HIV testing and treatment; interventions to improve HIV outcomes among substance users; and evaluation of innovative network approaches for HIV testing and referral for persons in the correctional system. 

Toward the Goals of the National HIV/AIDS Strategy:

The Administration, led by Office of National AIDS Policy and HHS Office of HIV/AIDS and Infectious Disease Policy, in partnership with other Federal agencies, state and local governments, communities and people living with HIV, have made tremendous progress in addressing HIV/AIDS in the United States over the last four years. Together, we are committed to accelerating our efforts to reach the Strategy’s goals and, eventually, attain an AIDS-free generation. Smart investments and collaborations will provide opportunities to scale up effective efforts so that every community affected by HIV can contribute to achieving the goals of the Strategy.

PRESIDENT OBAMA'S REMARKS DELIVERED ON WORLD AIDS DAY

FROM:  THE WHITE HOUSE 
Remarks by the President on World AIDS Day
South Court Auditorium
Eisenhower Executive Office Building
1:20 P.M. EST

THE PRESIDENT:  Thank you, everybody.  (Applause.)  Everybody, please have a seat.  Well, thank you, Grant, for your outstanding leadership of the Office of National AIDS Policy.  And thanks to all of you for being here.  This is a pretty distinguished crowd, I have to say, and it is wonderful to be here.

I should say, actually, welcome back, because many of you have joined us before as we’ve marked new milestones in our fight against HIV and AIDS.  And I’m honored that you could join us in commemorating World AIDS Day, which was yesterday.  And this is a time for remembering the friends and loved ones that we’ve lost, celebrating the extraordinary progress -- thanks to some people in this room -- that we’ve been able to make, and most importantly, recommitting ourselves to the mission that we share, which is achieving an AIDS-free generation.

I especially want to welcome ministers from our partner countries; members of my administration, including Secretary Sebelius, Secretary John Kerry; Congresswoman Barbara Lee; Mark Dybul from the Global Fund to Fight AIDS, Tuberculosis and Malaria.  And we’ve also got here Francis Collins from the National Institutes of Health; Michel Sidibe from UN-AIDS; Deborah von Zinkernagel, who’s carrying on the great work of Eric Goosby as our Acting Global AIDS Coordinator; and our many friends from the philanthropic world, including Bill Gates.  So thank you all for joining us here today.

Every year, this is a moment to reflect on how far we’ve come since the early days of the AIDS epidemic.  And those of you who lived through it remember all too well the fear and the  stigma, and how hard people with HIV had to fight to be seen, or heard, or to be treated with basic compassion.  And you remember how little we knew about how to prevent AIDS, or how to treat it.  What we did know was the devastation that it inflicted -- striking down vibrant men and women in the prime of their lives and spreading from city to city and country to country seemingly overnight.

Today, that picture is transformed.  Thanks to the courage and love of so many of you in this room and around the world, awareness has soared; research has surged.  Prevention, treatment and care are now saving millions of lives not only in the world’s richest countries but in some of the world‘s poorest countries as well.  And for many, with testing and access to the right treatment, the disease that was once a death sentence now comes with a good chance at a healthy and productive life.  And that's an extraordinary achievement.

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.  We created the first comprehensive National HIV/AIDS Strategy, rooted in a simple vision that every person should get access to life-extending care, regardless of age or gender, race or ethnicity, sexual orientation, gender identity or socio-economic status.

We’ve continued to support the Ryan White CARE Act to help underserved communities, and we lifted the entry ban so that people with HIV are no longer barred from the United States -- which led to the International AIDS Conference being held here last year for the very first time in over 20 years.

This summer, I issued an executive order creating the HIV Care Continuum Initiative to boost our federal efforts to prevent and treat HIV.  Last month, I signed the HIV Organ Policy Equity Act, to finally allow research into organ donations between people with HIV -- a step achieved with bipartisan support.

And thanks to the Affordable Care Act, millions of insured Americans will be able to get tested free of charge.  Americans who were uninsured will now be able to have access to affordable health care coverage, and beginning in January, no American will be again denied health insurance because of their HIV status.

On World AIDS Day two years ago, I announced an additional $35 million for the AIDS Drug Assistance Program, which helps people pay for lifesaving medications.  At one time, the need was so great that over 9,000 people were on the waitlist.  We vowed to get those numbers down.  And I’m proud to announce that, as of last week, we have cleared that waitlist.  We are down to zero.  (Applause.)  And we’re going to keep working to keep it down.

So we’re making progress.  But we’re all here today because we know how much work remains to be done.  Here in the United States, we need to keep focusing on investments to communities that are still being hit hardest, including gay and bisexual men, African Americans and Latinos.  We need to keep up the fight in our cities -- including Washington, D.C., which in recent years has reduced diagnosed infections by nearly half.

And we’re going to keep pursuing scientific breakthroughs.  Today I’m pleased to announce a new initiative at the National Institutes of Health to advance research into an HIV cure.  We’re going to redirect $100 million into this project to develop a new generation of therapies.  Because the United States should be at the forefront of new discoveries into how to put HIV into long-term remission without requiring lifelong therapies -- or, better yet, eliminate it completely.

And of course, this fight extends far beyond our borders.  When I became President, I inherited President Bush’s phenomenal program, PEPFAR, which has helped millions around the world receive lifesaving treatment.  And we haven’t just sustained those efforts, we’ve expanded them -- reaching and serving even more people, especially mothers and children.  Earlier this year, PEPFAR reached a wonderful milestone -- the one millionth baby born without HIV.  (Applause.)   And that alongside the rapid decline in new HIV infections and deaths from AIDS in sub-Saharan Africa.

On my visit to South Africa this year, I visited a clinic run by Bishop Desmond Tutu and had the honor of spending time with some of their extraordinary young patients and counselors and outreach workers and doctors.  Every day, they are doing extraordinary work.  And when you visit this facility, you cannot help but be inspired by what they do each and every day, in part thanks to the support of the United States of America.  They’re saving lives and they’re changing the way their country, and the world, approaches this disease.  And that’s work that we have to continue to advance.

On World AIDS Day two years ago, I set new prevention and treatment targets for PEPFAR, like increasing the number of mothers we reach so that we prevent their children from becoming infected, and helping 6 million people get treatment by the end of 2013.  Today, I’m proud to announce that we’ve not only reached our goal, we’ve exceeded our treatment target.  So we’ve helped 6.7 million people receive lifesaving treatment.  And we’re going to keep at it.  (Applause.)  Which is why, after I leave here today, I’ll be proud to sign the PEPFAR Stewardship and Oversight Act, to keep this program going strong.  (Applause.)  Count on the legislator to applaud legislation.  (Laughter.)

Looking ahead, it’s time for the world to come together to set new goals.  Right now we’re working hard to get a permanent leader in place at PEPFAR, and once we do, one of our first items of business will be convening a meeting early next year, so the United States and our partners worldwide -- including governments, the Global Fund, U.N.-AIDS, and civil society -- can sit around one table and develop joint HIV prevention and treatment goals for the countries where we and the Global Fund do business.  We’ll hold each other accountable, and we’ll continue to work to turn the tide of this epidemic together.

And that includes keeping up our support for the Global Fund.  Its success speaks for itself.  It’s helping over 6 million people in over 140 countries receive antiretroviral therapy.  And now it’s time to replenish the Fund.  The United States will contribute $1 for every $2 pledged by other donors over the next three years, up to $5 billion total from the United States.  And the United Kingdom has made a similar promise.  (Applause.)

So today I want to urge all those who are attending the Global Fund’s replenishment meetings both today and tomorrow to take up this commitment.  Don’t leave our money on the table.  It’s been inspiring to see the countries most affected by this disease vastly increase their own contributions to this fight -- in some cases, providing more than donor countries do.  And that ought to inspire all of us to give more, to do more, so we can save more lives.

After all, none of the progress we’ve made against AIDS could have been achieved by a single government or foundation or corporation working alone.  It’s the result of countless people -- including so many of you -- working together from countries large and small, philanthropies, universities, media, civil society, activists.  More than anything, I think it’s thanks to the courageous people living with HIV around the world who’ve shared their stories; you’ve lent your strength, demanded your dignity be recognized, and led the fight to spare others the anguish of this disease.

We can’t change the past or undo its wrenching pain.  But what we can do -- and what we have to do -- is to chart a different future, guided by our love for those we couldn’t save. That allows us to do everything we can, everything in our power to save those that we can.  And that’s my commitment to you as President.

The United States of America will remain the global leader in the fight against HIV and AIDS.  We will stand with you every step of this journey until we reach the day that we know is possible, when all men and women can protect themselves from infection; a day when all people with HIV have access to the treatments that extend their lives; the day when there are no babies being born with HIV or AIDS, and when we achieve, at long last, what was once hard to imagine -- and that’s an AIDS-free generation.

That’s the world I want for my daughters.  That’s the world that all of us want for our families.  And if we stay focused, if we keep fighting, and if we honor the memory of those that we’ve lost, if we summon the same courage that they displayed, by insisting on whatever it takes, however long it takes, I believe we’re going to win this fight.  And I’m confident that we’ll do so together.

So thank you very much for your extraordinary efforts.  Appreciate it.  God bless you.  Thank you.  Thank you.  (Applause.)  Good work.  (Applause.)