New U.S. AIDS policy targets prevention

WASHINGTON (Reuters) - A new domestic AIDS policy rolled out by the White House on Tuesday asks states and federal agencies to find ways to cut new infections by 25 percent, get more patients treated quickly and educate Americans about the deadly and incurable virus.

A red ribbon hangs in advance of World AIDS Day on the front of the White House in Washington, November 29, 2009. REUTERS/Jonathan Ernst

As an immediate down payment, Health and Human Services Secretary Kathleen Sebelius announced $30 million to develop better prevention methods using a combination of approaches.

“We need to ensure every HIV-positive American gets the care they need,” President Barack Obama told a White House gathering of AIDS experts and activists.

“We need to make sure all our efforts are coordinated within the federal government and across state and local governments.”

The plan directs government agencies to work together more closely to focus spending where it is most needed and identify where new spending would do the most good -- for instance, among hard-hit communities of blacks, Hispanics, drug users and gay and bisexual men.

It urges the Food and Drug Administration to make review of new HIV tests a priority and says HIV patients need housing and other support in addition to medical care.

Many activists who have been in on the planning of the new strategy for the past 15 months praised it.

“I think this strategy points us in several very important directions in terms of informing and improving the domestic response to HIV,” Chris Collins, public policy director at The Foundation for AIDS Research or AMFAR, said in a telephone interview.

“It doesn’t speak to the need for more resources and that is one of the two critical issues.”

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Michael Weinstein of the AIDS Healthcare Foundation was cynical. “This will be another report that will gather dust on the shelves of the Library of Congress,” Weinstein said after hearing Obama speak.

He said the $30 million being offered to expand testing added up to “9 cents per man, woman and child” in the United States. “It took 15 months to figure out what we already knew, and we are going to fight a war without any weapons,” he said.

But Sebelius said cash over and above the $19 billion the United States spends a year on domestic HIV prevention, care, and research is not available.

There is “no question that there is not a big pot of new money,” Sebelius told Reuters in an interview. “We can’t expect this to be solved by a huge infusion of new resources.”

Government departments have 150 days to come up with their plans for following the new plan, said Jeff Crowley, director of the White House Office of National AIDS Policy.

"It is not intended to be a comprehensive list of all the things we need to do to fight HIV," he said. The plan is availablehere.

Obama and Sebelius said healthcare reform will help get more patients with HIV into treatment, by preventing insurance companies from denying them coverage because of a pre-existing condition and by forming new insurance pools.

More than 1.1 million people in the United States are infected with the human immunodeficiency virus that causes AIDS, according to the Centers for Disease Control and Prevention, with 56,000 new infections every year.

AIDS, transmitted during sex, in blood and on needles and in breast milk, gradually wears down the immune system and can take years to cause symptoms.

Many studies have shown that blacks, gay and bisexual men and Hispanics are the most affected groups but only 79 percent of those infected know it.

The plan aims to get that number up to 90 percent by 2015 and says people should not only be tested to learn whether they have the virus, but should be able to get care quickly, including tests to monitor the infection so they can decide if and when to start taking drugs that can control it.

While not a cure, these drug cocktails can keep patients healthy and can reduce the risk that they will infect other people. They generate billion a year for makers such as Gilead Sciences Inc, Bristol-Myers and Abbott Labs.

Julie Scofield, executive director of the National Alliance of State & Territorial AIDS Directors, said she would welcome better coordination on the federal level.

“Right now state health departments and community-based organizations really have so many disparate requirements and rules and reporting that it really ties them up in knots more than it should,” Scofield said in a telephone interview.

In the end, Obama said, the plan calls for the United States to root out inequities and injustice.

“When a person living with HIV/AIDS in viewed as having done something wrong, when she is viewed as being morally compromised, how can we expect her to get tested?” he asked.

Editing by Mohammad Zargham