Happy Anniversary for America's AIDS Strategy?

Illustration for article titled Happy Anniversary for America's AIDS Strategy?

This week marks the first anniversary of the release of the White House's National HIV/AIDS Strategy, and the Obama administration is eager to talk about how they've spent that time.


"Our mission is for the United States to become a place where new HIV infections are rare," Jeffrey Crowley, director of the White House Office of National AIDS Policy, said in a statement on Wednesday. "And when they do occur, every person … will have unfettered access to high quality, life-extending care, free from stigma and discrimination." With three basic goals in mind — reducing the number of HIV infections, increasing access to care, and reducing HIV-related health disparities — the national strategy largely involves redirecting the $19 billion spent annually on domestic AIDS to the populations most vulnerable to infection.

The strategy also has a clear, hard target: seeing a 25 percent drop in HIV infections by 2015. Crowley says that the administration has made strides toward putting it into practice, and he's showing their work in a newly released implementation update (pdf). The report outlines ways in which government has made its HIV/AIDS-fighting efforts more effective, such as:

* Heightened coordination and communication between federal agencies — the departments of Health and Human Services, Housing and Urban Development, Justice, Labor and Veterans Affairs and the Social Security Administration — so that existing HIV/AIDS programs and resources around research, employment and housing discrimination, and treatment are used toward collective progress.

For example, the strategy's 12 Cities Project (pdf) integrates all of these efforts to focus on areas, including D.C., New York City and Los Angeles, that bear the highest AIDS burden. While the initial phase of the project focused on data collection and planning, with an emphasis on identifying gaps in coverage and services, officials are now working to actually direct resources to the hardest-hit areas.

* A $30 million HIV-prevention fund in the Affordable Care Act. This funding source is paired with the new Enhanced Community HIV Prevention Planning initiative, which allows states and local jurisdictions to better track and monitor community infection rates. Additionally, the Office of National AIDS Policy is putting this money toward programs targeting high-risk populations, including gay and bisexual men and black women and men.

* Various policy changes based, again, on targeting populations with the highest HIV/AIDS needs. The Centers for Disease Control and Prevention and HUD have updated their funding formulas, which are now based on living HIV/AIDS cases, as opposed to their former allocation strategy of looking at cumulative AIDS cases or historical precedents. This new funding formula, which will result in shifting resources away from less-impacted locations to different ones with greater needs, will be phased in over three years.

But the White House wasn't the only organization to commemorate the one-year anniversary of the National HIV/AIDS Strategy's launch. Various advocacy groups had their own thoughts about how it's going so far, and while some were impressed by the progress, others were less convinced that the government has put in enough work.


Daniel C. Montoya, deputy executive director for the National AIDS Minority Council, had an optimistic take. "We have already seen improved transparency, inter-agency coordination, collaboration and accountability, as well as efforts to target resources to communities and regions most heavily impacted by HIV/AIDS," he said in a statement. "While not perfect, initiatives like the Centers for Disease Control and Prevention's Enhanced Comprehensive HIV Prevention Planning and Implementation and Health and Human Services' 12 Cities Project are promising programs aimed at identifying ways to effectively allocate funds and identify gaps in infrastructure and services."

On the other hand, the AIDS Healthcare Foundation used the anniversary as an occasion to launch a national campaign, bluntly entitled: What Has the President Done About AIDS? AHF President Michael Weinstein's answer: Not much.


"After two-and-a-half years in office, President Obama has little to show on AIDS domestically or globally," Weinstein said, criticizing the administration for allotting so much time on the strategy instead of prioritizing the funding shortage of the drug assistance program for people living with HIV/AIDS. "Today, more than 8,600 Americans in 13 states are on waiting lists, denied access to lifesaving AIDS drugs from hard-hit state AIDS Drug Assistance Programs. … As wait lists grew to the highest numbers ever seen, instead of addressing the crisis at hand, President Obama squandered fifteen months drafting a national AIDS strategy."

Crowley, meanwhile, says that the White House has more efforts under way — from defining additional, concrete metrics for measuring progress to building support and partnerships at the state and local level — in order to really change the course of the epidemic. "Ultimately, for the strategy to be truly successful, we need you," he said. "The strategy isn't about what government can do alone. We know that businesses, the faith community and all sectors have a role to play."


Cynthia Gordy is The Root's Washington editor.