IN THE LOOP

President Trump surprised many when he announced a national plan to end AIDS during his State of the Union address in February. Then in March, he surprised many again when he announced that his administration would no longer defend the Affordable Care Act (ACA) in court—potentially leaving millions of Americans without health coverage.

Ending AIDS in the U.S. is inextricably linked to comprehensive, affordable health coverage. Abandoning the ACA without a solid replacement is a terrible strategy to end AIDS.

The President’s plan calls for “new” funding—some $291 million—for the National Institutes of Health, the Centers for Disease Control and Prevention, Ryan White Programs, Bureau of Indian Affairs and the nation’s network of federally qualified health centers (FQHCs).

The plan targets 48 high impact counties, seven states and two territories (Washington, D.C., and San Juan, Puerto Rico) that account for more than 50 percent of new HIV infections annually. Eight of those high impact counties are in California: Los Angeles, San Francisco, Alameda, Orange, San Diego, San Bernardino, Riverside and Sacramento.

The new money would expand HIV testing, increase linkage to care and treatment, and increase PrEP utilization through the FQHCs. APLA Health operates three FQHCs: Gleicher/Chen Health Center in Baldwin Hills, the Long Beach Health Center, and our newest, Olympic Health Center in mid-Wilshire.

These clinics have been promoting and administering PrEP for several years (but PrEP utilization remains low nationally as well as in Los Angeles and California).

Unfortunately, the President’s “new” money to fight AIDS was paired with very steep cuts to health and human services programs in his 2020 budget. Those programs include Medicaid, Medicare, Supplemental Nutrition Assistance Program, Housing Opportunities for People living with AIDS (HOPWA), and global AIDS to name a few.

President Trump further complicated his Plan to End AIDS by endorsing a court ruling to end the ACA. In response to a federal district court decision in Texas invalidating the constitutionality of the entire ACA, Trump’s Justice Department announced that it would not defend the ACA as the case moves forward toward the Supreme Court. President Trump then said Republicans would be coming up with a much better plan for healthcare in the near future. Senate Majority Leader Mitch McConnell and other Senate Republicans then said there would likely be no new healthcare plan until after the 2020 national elections.

The Trump Plan to End AIDS remains on the table, even though his 2020 budget is considered dead on arrival in the Democratic-controlled House. There also remains broad bipartisan support in Congress for addressing HIV. APLA Health together with advocates from across the country will actively engage with the two branches to develop a bi-partisan plan to bring the AIDS epidemic to an end.

Last month more than 140 organizations released a community consensus statement calling on Governor Newsom and the California Legislature to take immediate action to address the state’s alarming epidemics of HIV, hepatitis C (HCV), and sexually transmitted diseases (STDs). The statement urges California’s top elected officials to convene a statewide task force charged with developing and implementing a strategy to end the HIV, HCV, and STD epidemics.

While California has long been a leader on forward-thinking policies, the state is falling behind in effectively addressing HIV, HCV, and STDs. The public health efforts necessary to effectively address these epidemics are underfunded and not strategically aligned toward an overall statewide strategy. Ending these epidemics will require renewed commitment from elected officials and strategic new investments in effective education, prevention, and treatment programs.

“California has an opportunity to lead the nation and develop the first statewide strategy to simultaneously address HIV, HCV, and STDs,” said Craig E. Thompson, CEO of APLA Health. “Governor Newsom showed decisive leadership in endorsing a statewide initiative to end the HIV and HCV epidemics during his campaign. We are eager to partner with him to fulfill that commitment and urge his administration to address California’s skyrocketing STD rates as part of this effort.”

A coalition of public health and community leaders—End the Epidemics: Californians Mobilizing to End HIV, HCV, and STDs—is requesting $2 million to establish the task force. The task force would be charged with setting targets for ending the HIV, HCV, and STD epidemics and identifying recommended programs, policies, and strategies for achieving these targets.

Senator Scott Wiener (D-San Francisco) and Assemblymember Todd Gloria (D-San Diego) also backed the development of a statewide strategy in a March 8 opinion piece in the Sacramento Bee. “California has the tools, resources, and knowledge to do what it takes to end these epidemics,” they wrote. “Now, Gov. Newsom and the Legislature must act. Together, we can get the job done.”

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In response to an article published by the L.A. Times on March 28 about San Francisco’s efforts to end the HIV epidemic, APLA Health submitted the following letter to the editor:

APLA Health was pleased to see today’s story on San Francisco’s remarkable progress in ending the HIV epidemic. The city proves what elected officials and committed community partners can accomplish with today’s prevention and treatment advances. But the article made no mention of L.A. County or the rest of the state. L.A. accounts for 40% of the state’s epidemic and the County rolled out a plan to end AIDS in 2017. However, support from local officials and new funding to implement the plan have been underwhelming. California reports the largest number of new HIV infections in the country—5,000 each year. Governor Newsom endorsed a statewide initiative to end AIDS during the campaign, but he has yet to follow through. Now, even President Trump’s 2020 budget calls for new funding to end AIDS. It’s time for L.A. County and California officials to do the same.

Los Angeles County has a strategy to end the HIV/AIDS epidemic. You can read it here.

APLA Health provides services to more than 15,000 people, and we want to know their stories. Have you been receiving services from APLA Health? Are you a new patient or client? Have you or a loved one been affected by HIV? Has a staff member gone above and beyond what you were expecting? We want to know the full story. What are we are doing well? How we can serve you better?

Tell us your story!