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O F F I C E O F T H E A S S I S T A N T S E C R E T A R Y F O R H E A L T H

ENDING THE HIV EPIDEMICAn Update to the President’s Advisory

Council on HIV / AIDS

A D M I R A L B R E T T P. G I R O I R , M . D .A ss i s t a n t S e c re t a r y fo r He a l t h a n d S e n i o r Adv i so r

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“We will eradicate the AIDS epidemic in America by the end of this decade”

- President Donald J. Trump

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ENDING THE HIV EPIDEMIC: A PLAN FOR AMERICA

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ACHIEVING THE GOALS

DIAGNOSEAll people with HIV as early as possible after infection

TREATPeople with HIV rapidly and effectively to reach sustained viral suppression

PREVENTNew HIV transmissions by using proven interventions, including pre-exposure prophylaxis (PrEP) and syringe services programs (SSPs)

RESPONDQuickly to potential HIV outbreaks to get needed prevention and treatment services to people who need them

4O F F I C E O F T H E

A S S I S T A N T S E C R E T A R Y F O R H E A L T H

VISITED JURISDICTIONS AND STATES88% OF THE PHASE 1 JURISDICTIONS AND 100% OF PHASE 1 STATES HAVE BEEN VISITED

Phase I Jurisdictions

Visited Phase 1 Jurisdictions

Other Outreach

Visited Phase 1 States

ACCESS IN COMMUNITY

MINIMIZE STIGMA COORDINATION

OF CARE

CBOs and FAITH-BASED

SOCIAL DETERMINANTS

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THE INITIATIVE IS ONGOING: $33M IN FY19 ACTIVITIES

JUMP-START SITES

$1.5M MINORITY HIV/AIDS FUNDS AWARDED TO EACH SITE:

DeKalb County, GA

Baltimore City, MD

East Baton Rouge, LA

Cherokee Nation, OK

ACCELERATING STATEAND LOCAL HIV PLANNING AWARDS

32 STATE AND LOCAL HEALTH DEPARTMENTS

$12M to all 57 geographic areas

“By, For, and Of Each Community”

NASTAD (CDC HIV PREVENTION FUNDS)

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$1.5 million per year from 2019 to 2023

Technical assistance for community plans

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PREVENTION THROUGH ACTIVE COMMUNITY ENGAGEMENTUSPHS Commissioned Corps officers will assist the EHE program:

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Serve as public health educators and coordinators on EHE strategies, interventions, and messaging

Engage through public forums and community centers, increasing effectiveness and national reach

Serve as force multipliers and partners with federal, state and especially local stakeholders

Region PACE Personnel

4CDR John OguntomiladeLT Neelam Gazarian

6CDR Luz RiveraLCDR Rodrigo Chavez

9CDR Michelle Sandoval-RosarioLCDR Jose Ortiz

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PREVENTION AND TREATMENT TOOLKITS

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TREATMENTPREVENTION

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May 2019Agreement between the Trump administration and Gilead Sciences, Inc., for the company to donate PrEP medications for up to 200,000 uninsured individuals each year for up to 11 years.

December 2019The READY, SET, PrEP program officially launched and opened for enrollment.

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WHO’S ELIGIBLE FOR READY, SET, PrEP?

To receive PrEP through the Ready, Set, PrEP program, an individual must:

Test negative for HIV

Have a valid prescription for PrEP

Not have prescription drug coverage

For individuals enrolled in the program, there is no cost for medications.

The costs of clinic visits and lab tests may depend on a person’s income and where they receive the services.

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PARTNERS: READY, SET, PrEP

Beginning March 2020:

Partners will donate their services to distribute PrEP at no-cost to qualified patients in over 22,000 U.S. pharmacy locations including the District of Columbia, Puerto Rico, and the U.S. Virgin Islands and through mail order.

Partners will also provide patient counseling and take steps to promote patient adherence to the regimen.

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READY, SET, PrEP MATERIALS

Fact Sheets- Consumer (English/Spanish)- Healthcare Provider (English/Spanish)- Indian Health Service

Posters (English/Spanish)

Information Card (English/Spanish)

Social Media Toolkit

Sharable Graphics (English/Spanish)

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DATA ANALYSIS AND VISUALIZATION SYSTEM

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PHASE I (2Q FY2020) static version of the dashboard that visualizes jurisdiction-level HIV statistics

PHASE II (Q3 2020)interactive dashboard provides access to data analysis and decision-making

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2020 BUDGETDISCRETIONARY INVESTMENTS, YEAR 1 (+$291 MILLION)

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AGENCY ACTIVITY FY 2020 BUDGET

FY 2020 ENACTED

CDCTest and link persons to treatment; state and local support; surveillanceAugmentation of public health staff in local jurisdictions

$140 M $140 M

HRSARyan White care centers for treatment Community health centers for prevention, emphasizing PrEP

$70 M$50 M

$70 M$50 M

IHS Enhanced support for prevention, diagnosis, and links to treatment $25 M $0

NIH-CFARs Inform HHS and partners on evidence-based practices and effectiveness $6 M $31 M

OASH Project coordination, communication, management, and accountability; Leadership of the Minority AIDS Initiative

Maintains current $

SAMHSA Minority AIDS Program and Substance Abuse Prevention and Treatment Block Grantsfor HIV/AIDS prevention for those with Substance Abuse or Mental Illness

Maintains current $

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EHE UPCOMING FUNDING AWARDSHealth Resources and Services Administration

Ending the HIV Epidemic: A Plan for AmericaRyan White HIV/AIDS Program Parts A and B HRSA 20-078

Technical Assistance Provider HRSA 20-079

Systems Coordination Provider HRSA 20-089

Projected Award Date: Early March 2020

HRSA Bureau of Primary Health Care Supplemental Funding to expand PrEP access in dually funded (BPHC and RWHAP) health centers or health centers with MOU with RWHAP sites in EHE Jurisdictions

195 Applications received

Projected Award Date: Early April 2020

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EHE UPCOMING FUNDING AWARDSCenters for Disease Control and Prevention: CDC-RFA-PS20-2010

Component A: Development and implementation of programs tailored to the four pillars of EHE (diagnose, treat, prevent, and respond)

Component B: Improve ability to estimate HIV incidence in selected jurisdictions to use recency-based assay testing

Component C: Focused funding for STD specialty clinics to increase HIV testing, linkage to care for person with HIV, increase PrEP screening and initiation

Applications Due: March 25, 2020

Proposed Award Start Date: late June 2020

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PRESIDENT’S BUDGET WILL SUPPORT THE HIV INITIATIVE(NEW DISCRETIONARY INVESTMENTS FY 2021)

Activity FY 2021Budget

+/- FY 2020Enacted

CDC

Transition activities from planning to implementationScale up jurisdictional programs to provide additional testing, linkage to treatment, and prevention services, including PrEPAugmentation of public health staff in local jurisdictions

$ 371 M $231 M

HRSACommunity Health Centers - increase access to HIV prevention services, including PrEP, outreach, and care coordination Ryan White HIV/AIDS Program - treat the infection rapidly and effectively after diagnosis, suppress the virus, and prevent transmission

$ 137 M$ 165 M

$87 M$95 M

IHS Enhanced support for prevention, diagnosis, and links to treatment $ 27 M $ 27 M

NIHCenters for AIDS Research (CFARs) - evaluate prevention and treatment across the 57 target jurisdictions and share best practices on HIV prevention and treatment interventions

$16 M $ 10 M

$ 716 M $ 450 M

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* While IHS was not funded, NIH received a $25M boost in HIV/AIDS research funds.

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BRETT P. GIROIR, M.D.

ADM, U.S. Public Health ServiceAssistant Secretary for HealthU.S. Department of Health and Human Services

WWW.HHS.GOV/ASH WWW.USPHS.GOV

@HHS_ASHash@hhs.gov