Both the resignation of seven members of the President’s Advisory Council on HIV/AIDS (PACHA) and the possible passage of the Senate version of the ACA repeal/replace bill give cause for concern for advocates of HIV/AIDS prevention and research. Here are three reasons the U.S. is going backwards:
- Medicaid Cuts in the ACA Repeal/Replace Effort – Arguably the biggest threat to treatment of AIDS/HIV patients in the coming years is the plan to roll back the expansion of Medicaid that was a signature element of the ACA. While the Senate is still grinding out their version of the repeal/replace bill – and several moderate senators have strong misgivings about the impact on Medicaid patients in their states – if repeal is successful many millions of patients including those needing anti-retroviral drugs would be left without coverage.
- Budget Cuts at the CDC – Donald Trump’s proposed 2018 budget includes significant cuts to public health measures. Specifically Trump’s budget outline calls for over $186 million less in funding for HIV/AIDS prevention and testing. In its own overview of the budget cuts, the CDC acknowledges the impact of these cuts: “At the FY 2018 requested amount, CDC will reduce activities around testing,
support services for persons living with HIV, and prevention services. In addition, CDC’s ability to implement innovative demonstration projects or research examining strategies related to high impact prevention and new
tools supporting HIV prevention will be reduced.”
- Priority – Since taking office in January, President Trump has been largely silent on HIV/AIDS research, education, and prevention. The PACHA board members cited both his silence and lack of strategy in their decision to resign from the board: “The Trump Administration has no strategy to address the on-going HIV/AIDS epidemic, seeks zero input from experts to formulate HIV policy, and—most concerning—pushes legislation that will harm people living with HIV and halt or reverse important gains made in the fight against this disease.”
Since PACHA was created by the Clinton administration almost 20 years ago it has provided valuable insight and guidance from academics and public health activists as previous administrations have worked to address HIV/AIDS treatment and prevention.
1.1 million people live with HIV in the U.S. right now and, according to the CDC, one person out of seven of those afflicted are unaware they carry the virus. As with many public health issues, the cost of prevention and education is a fraction of what we as a country will spend if HIV/AIDS rates increase.