WASHINGTON – Harold Phillips, director of the White House Office of National AIDS Policy (ONAP), said Monday that Congress must increase funding to end the HIV/AIDS epidemic, including for programs designed around the lives and needs of Americans who are living with the disease.

“We have the support of the Biden Harris administration, and we have the support at HHS, but without Congressional funding we can’t get there,” said Phillips, who delivered his remarks during the AIDS United annual AIDSWatch conference in Washington, D.C.

Phillips echoed remarks by other speakers in calling for Congress to increase appropriations funding for the U.S. Department of Health and Human Services (HHS) Ryan White HIV/AIDS Program, but he also emphasized the importance of “making space for people living with HIV in other aspects of the budget.”

Consistent with the Biden-Harris administration’s focus on employing a whole-of-government approach, Phillips said stakeholders must understand that while “HIV is, yes, a public health threat,” the disease is also “the result of systemic and structural racism,” an intersectional problem requiring more than narrowly focused biomedical or public health responses.

Therefore, he said, these conversations about matters like HIV’s impact on Black lives, or considerations for aging folks who are living with the disease, must be held at places like the White House Gender Policy Council, the National Economic Council, and the U.S. Department of Labor.

“When we talk about ending HIV as a public health threat,” Phillips said, “we also want to end HIV such that it’s not the defining characteristic for people living with HIV and that they can have access to housing, access to employment, good mental health and substance abuse treatment.”

Under Phillips’s leadership, data on these considerations for those living with HIV/AIDS will be measured for the first time with ONAP’s rollout of new quality of life indicators in the National HIV/AIDS Strategy Federal Implementation Plan.

“There’s an indicator in there that’s self-reported quality of life,” Phillips said, which asks respondents to consider, “how do I feel?” This is important, he added, because people living with HIV may have positive lab results but still feel poorly.

Phillips advised those AIDSWatch participants who are slated to meet with members of Congress and their staffs after hosting a rally on the grounds of the U.S. Capitol Tuesday morning to “build a common bond” with lawmakers by emphasizing the human impact of the appropriations funding for which they are advocating.

An AIDS United spokesperson told the Washington Blade by email Monday that 187 Congressional meetings have been scheduled for Tuesday.

Phillips also noted that while “conversations need to happen in Washington, there’s also conversations that need to happen on the state and local level,” where “we’re finding a level of hate and stigma and discrimination that’s on course to try to either stop our progress or take us backwards.”

Speaking before Phillips, Equality Federation Public Health Policy Strategist Mike Webb stressed the importance of policies under consideration by state and local lawmakers. “Our access to PrEP shouldn’t be based on patchwork of laws by the states,” they said, and HIV-related legislative proposals in many cases would “add criminalizing aspects.”

Laws already on the books that “criminalize the transmission of, or perceived exposure to, HIV and other infectious diseases,” the Movement Advancement Project writes, “create a strong disincentive for being tested for HIV, and result in adverse public health outcomes.”

Phillips and the Biden administration have made modernizing or repealing those laws a top priority.

SAN DIEGO COUNTY – Following a visit to the San Ysidro Port of Entry, Governor Gavin Newsom released his administration’s Master Plan for Tackling the Fentanyl and Opioid Crisis on Monday. 

Recognizing the opioid and fentanyl crisis as a multifaceted public health and public safety issue, Governor Newsom’s Master Plan provides a comprehensive approach to save lives. The Master Plan builds on the Governor’s $1 billion investment to tackle this crisis — including an expansion of California National Guard-supported operations that last year led to a 594% increase in seized fentanyl.

The Master Plan outlines aggressive steps to support overdose prevention efforts, hold the opioid pharmaceutical industry accountable, crack down on drug trafficking, and raise awareness about the dangers of opioids, including fentanyl. 

“Over 150 people die every day in our nation from overdoses and poisonings related to synthetic opioids like fentanyl. Enough. With this Master Plan, California is doubling down to combat this crisis and save lives. Our comprehensive approach will expand enforcement efforts to crack down on transnational criminal organizations trafficking this poison into our communities — while prioritizing harm reduction strategies to reduce overdoses and compassionately help those struggling with substance use and addiction,” the Governor said.

The Newsom Administration has invested over $1 billion to crack down on opioid trafficking and enforce the law, combat overdoses, support those with opioid use disorder, and raise awareness about the dangers of opioids. The Master Plan provides a comprehensive framework to deepen the impact of these investments — including through a new CalRx effort where California will seek to manufacture its own opioid overdose reversal drug Naloxone.

California will further save lives through an additional $96 million in funding in the Governor’s 2023-24 proposed budget: 

• $79 million for the Naloxone Distribution Project to meet increased demand and provide more Naloxone to communities than ever before; 
• $10 million for grants for education, testing, recovery, and support services; 
• $4 million to make fentanyl test strips more widely available; and 
• $3.5 million in Prop 98 funding to provide overdose medication to all middle and high schools.

These new investments, coupled with the extensive abatement, enforcement, and treatment efforts outlined in the Master Plan will save lives and make California safer. 

The U.S. has faced an evolving crisis of opioid addiction, overdose, and death for over two decades, driven by Big Pharma’s irresponsible marketing of prescription opioids – bringing the United States to today’s fentanyl crisis.

Millions of Americans suffer from opioid use disorder and more than 71,000 Americans died in 2022 alone from fentanyl-linked overdoses and drug poisonings. According to the Drug Enforcement Administration, a vast majority of fentanyl in the U.S. comes via ports of entry at the border –  through trafficking by organized crime rings, not by migrants. 

California has worked aggressively to tackle the opioid crisis. In the current fiscal year alone, the California Health and Human Services agency is investing $450 million in treatment, abatement, and prevention efforts.

The 2022 Budget Act Governor Newsom signed into law included $30 million to expand the California Military Department’s existing drug interdiction efforts to thwart drug-trafficking transnational criminal organizations throughout the state, with a particular focus on assisting federal, state, local, and tribal law enforcement agencies in combatting fentanyl. To support the Governor’s initiative to reduce deadly fentanyl in communities, the California National Guard has hired, trained, and embedded 144 new members. 

View the Master Plan (here).

WASHINGTON – The $6.8 trillion budget unveiled by President Joe Biden on Thursday includes increased investment in existing programs to fight HIV/AIDS, along with new initiatives to expand access to HIV prevention medications and eliminate hepatitis C.

U.S. House Republicans are expected to kill the proposal, which is nevertheless seen as a possible blueprint for the major themes to come in Biden’s expected reelection campaign.

Major focus areas of the plan include deficit reduction, raised taxes for the wealthy, and increased spending on the military and other endeavors to compete with China.

The HIV + Hepatitis Policy Institute praised the budget in a press release Thursday, writing that it will “significantly increase the federal resources necessary to end both HIV and hepatitis C.”

The group’s president, Carl Schmid, said Biden “recognizes the historic role the federal government must play, and the investments needed to end infectious diseases.”

First, the plan would bolster funding for the Trump-era Ending the HIV Epidemic in the United States initiative by $313 million, bringing the total to $850 million. Second, it would debut a “ten-year $9.7 billion nationwide PrEP delivery program” and a “historic initiative to eliminate hepatitis C.”

PrEP, or preexposure prophylaxis, is a medication regimen that reduces the risk of contracting HIV. According to the HIV + Hepatitis Policy Institute, only 30 percent of patients who could benefit from the drug are taking it.

The new hepatitis C program “seeks to provide outreach, testing, and curative medications to the estimated 2.4 million people living with hepatitis C, many of whom are unaware of their infection.”

NEW YORK – The Trevor Project’s research team released a new study on the mental health and suicide risk of Black transgender and nonbinary youth Tuesday. Based on a survey of nearly 34,000 LGBTQ youth across the nation, the findings show that one in four Black trans and nonbinary young people reported a suicide attempt in the past year — more than double the rate compared to their Black cisgender LGBQ peers.

Key Findings:

• One in four (25%) Black transgender and nonbinary young people reported a suicide attempt in the past year — more than double the rate of suicide attempts compared to Black cisgender LGBQ young people (12%).
• Black transgender and nonbinary young people reported higher rates of all indicators of poor mental health compared to their Black cisgender LGBQ peers.
• Black transgender and nonbinary young people experience higher rates of victimization, attempts from others to change their sexual orientation or gender identity, and housing instability compared to Black cisgender LGBQ young people.
• Black transgender and nonbinary young people with high social support from their family had 47% lower odds of reporting a suicide attempt in the past year.

ATLANTA – The Centers for Disease Control and Prevention (CDC) released its Youth Risk Behavior Survey Data Summary & Trends Report: 2011-2021, in which the CDC disclosed alarming data that documented that rates of violence and worsening cases poor mental health, continued to rise among female and LGBQ+ adolescents.

The data found poor mental health and suicidal thoughts and behaviors are increasing for nearly all groups of youth and experiences of violence, including sexual violence, are not declining and in some cases are increasing.

Overall, young people are experiencing a level of trauma and distress that requires action.

There are also differences among groups of students.

• Female students and LGBQ+ students are experiencing alarming rates of violence, poor mental health, and suicidal thoughts and behaviors.
• The rates of experiencing bullying, sexual violence, poor mental health, and suicidal thoughts and behaviors indicate a need for urgent intervention.
• Some differences between students across racial and ethnic groups have lessened, but there are still concerning disparities.

Note: Because the 2021 national YRBS did not have a question assessing gender identity, this report does not highlight data specifically on students who identify as transgender.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat https://t.co/aLLohASutY. @988Lifeline

— CDC (@CDCgov) February 13, 2023

Top Findings on Mental Health & Suicide Risk from the report:

• 45% of LGBQ+ students seriously considered attempting suicide in the past year, compared to 15% of straight students
• 22% of LGBQ+ students attempted suicide in the past year, compared to 6% of straight students
• 37% of LGBQ+ students made a suicide plan in the past year, compared to 12% of straight students
• Nearly 70% of LGBQ+ students experienced persistent feelings of sadness or hopelessness, compared to 35% of straight students
• 52% of LGBQ+ students experienced poor mental health during the past 30 days, compared to 22% of straight students

The YRBS report represents a nationally representative sample of more than 17,000 students in grades 9–12 attending public (including charter schools), Catholic, and other non-public schools in the 50 states and the District of Columbia. Collected in fall 2021, these data also represent the first YRBS data collected since the start of the COVID-19 pandemic. 

Statement from Dr. Ronita Nath, Vice President of Research at The Trevor Project:

“These alarming data further emphasize why The Trevor Project exists and what we already knew to be true: queer students face disproportionate rates of victimization, and this directly contributes to their higher rates of poor mental health and suicide risk. Queer students are not inherently prone to these challenges because of their identities. 

“At a time when schools are increasingly being turned into political battlegrounds in the ‘Culture War,’ we must remember that real, young lives are at stake. Our schools must be safe places where all students can learn and find support, not a consistent source of bullying and discrimination. 

“Our governments and school officials must respond to this public health crisis with comprehensive suicide prevention strategies tailored to meet the unique needs of students who are LGBTQ and/or are people of color. What they should not be doing is censoring curriculums, banning inclusive books, and discouraging students from confiding in teachers and counselors about their identities.” 

According to the CDC report, data show that school environments, which are influenced by how teachers manage classrooms, programs to support positive youth development, and policies and practices that support LGBTQ+ students, can have a strong and lifelong effect on areas where youth are struggling now, including mental health.

Other findings included:

• Risky sexual behaviors are decreasing, but so are important protective behaviors like condom use, HIV testing, and STD testing.
• Substance use is generally decreasing, but still too high.

The CDC also noted that the data show that many of the same behaviors and experiences that were moving in the wrong direction before the pandemic, like poor mental health, continued to worsen, and highlight the challenges young people continue to face.

Read the full report here: (Link)

NEW HAVEN, CT. — In a visit to one of America’s most prestigious institutions of higher learning, Adm. Rachel Levine answered questions and offered insight about two of the most controversial healthcare issues of this decade, Long Covid and gender-affirming care.

Long Covid is the mysterious phenomenon in which patients endure debilitating, long-term effects from being infected by the coronavirus and gender-affirming care, treatments for transgender youth that are being targeted by lawmakers nationwide.

“Long Covid is real,” said Levine, the assistant secretary for health at the Department of Health and Human Services, and the highest-ranking transgender official in the Biden administration. “We heard from patients who have suffered heart issues, lung issues, issues of fatigue and brain fog, after their Covid-19 infection. And we heard from providers at Yale who are forming a multidisciplinary clinic in order to evaluate and treat these patients.” 

In a public session held Monday at the Yale Law School, four of these “long haulers” shared their challenges with the admiral: Shortness of breath, pulmonary disorders, lifestyle and work limitations and disabilities that are hidden to most observers. “Hearing the patients tell their stories is so meaningful,” she said, calling it a privilege to better understand the challenges they face. “That helps us drive policy as well as research,” Levine said. 

“I was very active,” said Hannah Hurtenbach of Wethersfield, Conn., a 30-year-old registered nurse who was diagnosed with post-Covid cardiomyopathy, cognitive brain fog and pulmonary issues. “I loved hiking and being outside. I was constantly on the move and now I barely leave my couch. I barely leave my house and I can’t really handle even a part time job now when I used to work full time. So that has been really difficult at age 30 to be facing those sorts of issues that I never really anticipated feeling.”

Hurtenbach told the Los Angeles Blade she appreciated Adm. Levine’s visit. “Sharing my experience today with the admiral was probably one of the more highlight moments of this experience,” she said. “Knowing that the federal government is taking action, is paying attention, and listening to these stories means more to me than anything else, and especially knowing that what I’ve gone through over the last couple of years can be led and used into the future research and help others just like myself.”

A woman named Christine told the Blade that even though she is so impacted by Long Covid that she needs assistance to walk and has to pause as she speaks because of her shortness of breath, she felt attending this event was worth all the struggle to get there. “I’m so glad I came. I learned a lot from hearing from the others,” she said, who like her are trying to recover from Long Covid.

Levine told the Blade that so far, she herself has not contracted Covid, and that she is double-vaccinated and double-boosted. With the president announcing the end of emergency Covid declarations on May 11, she said the administration is pushing Congress to approve extra funding for Long Covid and other related needs. But how can she expect to get that through a House of Representatives full of anti-vaxxers, anti-maskers and Covid-deniers, including in GOP leadership?

“Long Covid is real and we hear you,” she said. “We plan to engage Congress to talk about the funding that we need. And we’ll continue to work. We do have to get past misinformation in this country, but we are here to give the correct information about Covid-19 and Long Covid, and we’ll continue to engage Congress on that.”

Hurtenbach expressed disappointment in those colleagues in healthcare who came out publicly in opposing vaccines and mask mandates. “I just wish they had paid better attention in school and learned more of the science,” the nurse said. “I wish they would trust the science that they are supposed to be promoting for their patients as well.” 

Following Monday morning’s public meeting, Levine held a private session with Long Covid patients and Yale doctors, researchers, counselors, physical therapists and other providers. Then in the afternoon, the admiral spoke at another event, held at Yale Medical School: “A Conversation on LGBTQI+ Health & Gender-Affirming Care.” Although it was closed to press, Yale Asst. Professor of Medicine Diane Bruessow attended the event and shared with the Blade what Levine told those gathered, which is that she remains positive and optimistic. 

“I think over time, things will change, and things will get better,” said Levine, adding the caveats, “I don’t know if they will get better everywhere in the United States. I also don’t know if it’s going to be quick. I think the next two years will be really, really hard.” Especially with more than 270 anti-trans pieces of legislation moving their way through state legislatures.

“But I am going to stay positive. I’m going to think that over time, things will improve,” Levine said, pledging that both she and the Biden administration would do everything they can to help families with trans kids. “I think the tide will turn.”

Adm. Rachel Levine: ‘Long Covid Is Real’:

WASHINGTON – David Lauterstein, co-founder of the popular clothing brand Nasty Pig with his husband, Frederick Kearne, spoke with the Washington Blade by phone on Thursday about his company’s work with the Biden administration on public health initiatives targeting the LGBTQ community.

The Nasty Pig team received an invitation to the White House on Jan. 12, ahead of the company’s planned participation in Mid Atlantic Leather, the fetish event held annually in D.C. over Martin Luther King Jr. weekend.

After meeting with officials, including White House National Mpox Response Deputy Coordinator Demetre Daskalakis and Harold Phillips, policy director of the White House Office of National AIDS Policy, Lauterstein and Kearne decided to scrap their Nasty Pig booth at MAL in favor of administering a popup mpox and sexual health clinic in partnership with federal and D.C. public health teams.

During those conversations at the White House, “We found out that there was a big need for second shots,” Lauterstein told the Blade on Thursday.

“We learned we have queer siblings in smaller towns and cities where asking for a vaccine is outing yourself — there are queer people who have to put their health at risk because they can’t go to Walgreens and ask for an mpox vaccine,” he said.

Lauterstein told himself, “I don’t give a fuck if we help [just] one person” with the popup clinic, which turned out to be a resounding success. “After day one, the D.C. Department of Health had to call for backup” to meet the demand, Lauterstein said.

From the time he founded Nasty Pig in 1994 amid the AIDS crisis, “we wanted to be a voice of sexual positivity at a time when our community had adopted so much of the stigma placed unfairly upon us, when back then the prevailing wisdom was to blend in and be heteronormative because we were seen as the spreaders of death,” Lauterstein said.

At the White House, a visit that was “one of the most humbling and profound experiences of my life,” Lauterstein said he was stuck by the diversity of the teams working on behalf of the mpox response and other public health initiatives.

“Talk about ‘walking the walk,'” he said.

The administration’s decision to partner with Nasty Pig and hire health officials like Daskalakis who have experience administering programs that are tailored to the needs of LGBTQ people and grounded in, for example, a realistic and judgment-free understanding of the sexual behaviors of gay and bisexual men, is revelatory, Lauterstein said.

“It’s such an evolution of public health and the magnitude of it isn’t lost on me due to our history,” he said, adding that “if we could have had these conversations in 1981 [as the AIDS crisis emerged], the amount of suffering and pain that could have been spared our community would have been tremendous.”

“The fact that we have an administration that understands we don’t need to be lectured to but rather spoken with about how we solve these problems together is a huge shift,” Lauterstein said [emphasis added.]

Lauterstein and Daskalakis developed a friendship during the early days of the COVID-19 pandemic, during which time Daskalakis was a decorated public health official in New York.

They discussed the unmet need for recommendations tailored to the LGBTQ community, and Daskalakis’s guidelines for how to have safe sex during the pandemic reached a broad audience thanks to Lauterstein’s network of devoted Nasty Pig fans and large social media following.

“I recognized the power of our relationship when [Daskalakis] was promoted to the [Centers for Disease Control and Prevention] and then quickly snapped up by the White House to lead the mpox coordinated response,” Lauterstein said. “They couldn’t have asked for a better guy.”

Following months of aggressive public outreach and vaccination campaigns coordinated by the federal government with state, local and community partners, the U.S. Department of Health and Human Services allowed the mpox public health emergency to expire on Tuesday.

SACRAMENTO – Assemblymember Brian Maienschein introduced legislation this week to help California take action to stop drug traffickers from contributing to the fentanyl epidemic.

Fentanyl overdoses have spiked across the nation in recent years. In California, over 5,700 fentanyl-related deaths were reported in 2021 alone. According to the California Department of Public Health, fentanyl is up to 50 times stronger than heroin and 100 times stronger than morphine. An alarming increase in counterfeit pills and other illicit substances being sold on the drug trafficking market have been laced with a fatal amount of fentanyl, leading to thousands of deaths and serious injuries.

Assembly Bill 367 will provide stronger criminal penalties for individuals who sell or otherwise furnish controlled substances, such as fentanyl, that result in great bodily injury or death.

“Fentanyl has had devastating effects in San Diego County and throughout the state, and the data shows us that action to address this epidemic is critically overdue,” said Assemblymember Maienschein. “My bill would help California hold drug dealers accountable for the destruction and trauma they cause by knowingly distributing this deadly substance.”

Last year, San Diego Mayor Todd Gloria signed an executive order calling for bold action by state and federal lawmakers to help the region and the state address the fentanyl emergency. Assemblymember Maienschein has partnered with Mayor Gloria on AB 367 to take the necessary steps to address this crisis in San Diego County and throughout California.

“The nationwide proliferation of illicitly manufactured fentanyl is a deadly crisis that claimed more than 800 lives in San Diego County in 2021 alone – and the death toll continues to climb,” said San Diego Mayor Todd Gloria. “We need action at every level of government, and Assemblymember Brian Maienschein is stepping up with bold legislation that I’m proud to sponsor. AB 367 will crack down on predatory dealers of a dangerous poison that’s complicating our efforts to address homelessness and fueling a crisis of addiction, mental illness, and overdose across our region and the nation.”

The fentanyl epidemic has claimed too many lives across CA, including over 800 San Diegans in 2021 alone. This year, I am partnering with @MayorToddGloria on #AB367 to provide stronger penalties & hold drug dealers accountable. pic.twitter.com/AsQSHNkEVw

— Brian Maienschein (@BMaienschein) February 2, 2023

AB 367 is also supported by San Diego County District Attorney Summer Stephan who has championed fentanyl overdose awareness and action throughout the region, as well as the San Diego Police Department.

“This bill gives a measure of dignity to the suffering of the thousands who were inflicted with great bodily injury or death due to drug dealers selling fentanyl,” said San Diego County District Attorney Summer Stephan. “This proposed law allows our prosecutors to hold those who are causing this devastation accountable for their actions. Current state law treats a seller of drugs who does not result in injury the same as a fentanyl seller that results in the person becoming paralyzed or dying and that is not justice. I fully support this bill and thank Assemblymember Maienschein for helping us fight to save lives.”

“Law enforcement needs help from the legislature in updating our laws to meet the needs of our communities,” said San Diego Police Chief David Nisleit. “We must ensure that when crimes are being committed, including the predatory actions of fentanyl dealers who have little regard for whether their actions lead to loss of life, there are real consequences so we can stem the tide of rising drug-induced deaths. Combatting the drug overdose crisis from all levels is what it will take to save lives. Thank you to Assemblymember Brian Maienschein for enhancing our ability to hold criminals accountable with AB 367.”

AB 367 will be heard in policy committees later this spring and will move on to the Assembly floor this summer.

WEST HOLLYWOOD – Based on a Trevor Project survey of nearly 34,000 LGBTQ youth across the U.S., findings show that an overwhelming majority report being dissatisfied with their bodies – and rates are even higher among transgender and nonbinary youth.

The brief also found that LGBTQ youth who reported body dissatisfaction had significantly higher odds of reporting a suicide attempt in the past year.

Key Findings:

• Nearly nine in ten (87%) LGBTQ youth reported being dissatisfied with their body. 
• Rates of body dissatisfaction were higher among transgender and nonbinary youth (90%) compared to cisgender youth (80%).
• LGBTQ youth with body dissatisfaction reported higher rates of depression symptoms, anxiety symptoms, self-harming behaviors, and considering suicide compared to LGBTQ youth with body satisfaction.
• LGBTQ youth with body dissatisfaction had twice the odds of reporting a suicide attempt in the past year compared to LGBTQ youth with body satisfaction. 

“These findings underscore that an overwhelming majority of LGBTQ youth struggle with body dissatisfaction, something that can severely impact their mental health and contribute to higher odds of attempting suicide,” said Dr. Myeshia Price, Director of Research Science at The Trevor Project.

“As LGBTQ youth across the U.S. consume media and messages related to health and physical fitness – especially during this time of year, in relation to new year’s resolutions – we must do a better job of centering body acceptance and healthy lifestyles rather than encouraging young people to achieve a certain physical appearance. We encourage all youth-serving professionals, including educators, physicians, and health care providers, to discuss how body image may be impacting the LGBTQ youth they support.”

Read the Trevor Project’s latest research brief, LGBTQ Youth and Body Dissatisfaction:

WASHINGTON – The President’s Emergency Plan for AIDS Relief (PEPFAR) marks its twenty year anniversary today, marking the largest commitment by any nation to address a single disease in the world.

The initiative which was personally led and launched by former President George W. Bush in 2003,  its funding has totaled more than $110 billion to date, including funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), to which the U.S. government is the largest donor.

PEPFAR is credited with saving millions of lives and helping to change the trajectory of the global HIV epidemic.  The White House today released a statement by President Joe Biden marking the 20th Anniversary:

Twenty years ago today, President George W. Bush declared that preventing and treating HIV/AIDS was a foreign policy priority of the United States. At a time when nearly 30 million people were HIV positive, but very few were receiving life-saving medicines, the President’s Emergency Plan for AIDS Relief (PEPFAR) transformed the global AIDS response and laid a marker for America’s commitment to countries that were impacted the hardest by the AIDS epidemic. Helping lead the bipartisan effort in Congress to authorize PEPFAR is among my proudest achievements from my time in the Senate. To this day, PEPFAR remains a powerful example of America’s unmatched ability to drive progress and make life better for people around the world.
 
Since 2003, PEPFAR has saved more than 25 million lives and dramatically improved health outcomes in more than 55 partner countries. AIDS-related deaths have declined by 68 percent since their peak in 2004, and new HIV infections are down 42 percent. PEPFAR investments have ensured that 5.5 million babies have been born HIV-free. And two decades of investment in partner nations’ health systems played a critical role in countries’ ability to respond to other health crises such as COVID-19, Mpox, and Ebola.    
 
Today, PEPFAR continues to support 20.1 million people around the world with HIV/AIDS treatment, and my Administration is committed to continuing to lead the global HIV/AIDS response. We will build on our decades of progress to reach the Sustainable Development Goal of ending AIDS by 2030, work to eliminate the stigma and inequities that keep people from accessing care, and keep the voices of people living with HIV/AIDS at the center of our response.  I look forward to working with Congress on PEPFAR’s reauthorization this year.

PEPFAR is overseen by the U.S. Global AIDS Coordinator, who is appointed by the President, confirmed by the Senate, and reports directly to the Secretary of State, as established through PEPFAR’s authorizing legislation.

PEPFAR’s original authorization established new structures and authorities, consolidating all U.S. bilateral and multilateral activities and funding for global HIV/AIDS. Several U.S. agencies, host country governments, and other organizations are involved in implementation.

Dr. John Nkengasong, the current coordinator was sworn in on June 13, 2022, and holds the rank of Ambassador leading the Office of the Global AIDS Coordinator (OGAC) at the U.S. Department of State.

Twenty years ago this month, President George W. Bush announced #PEPFAR during his State of the Union address. Since then, the U.S. government has invested $100B+ in the global HIV/AIDS response through PEPFAR, saving 25M lives & bringing us closer to #EndAIDS2030. #PEPFAR20 pic.twitter.com/SMAOHWPZ03

— PEPFAR (@PEPFAR) January 11, 2023

Nobel Prize winning scientist Harold Varmus, who served as Director of the National Institutes of Health (NIH) from 1993 to 1999 and currently the Lewis Thomas University Professor of Medicine at Weill Cornell Medicine in New York City, wrote in an article honoring World Aids Day 2013:

[…] “the PEPFAR story must begin with George W. Bush and his wife, Laura, and their interests in AIDS, Africa, and what Bush termed “compassionate conservatism.” According to his 2010 memoir, Decision Points, the two of them developed a serious interest in improving the fate of the people of Africa after reading Alex Haley’s Roots and visiting The Gambia in 1990.³ In 1998, while pondering a run for the U.S. presidency, he discussed Africa with Condoleezza Rice, his future secretary of state; she said that, if elected, working more closely with countries on that continent should be a significant part of his foreign policy. She also told him that HIV/AIDS was a central problem in Africa but that the United States was spending only $500 million per year on global AIDS, with the money spread across six federal agencies, without a clear strategy for curbing the epidemic.”

Key Facts (As provided by Kaiser Health & Family Foundation)

• Although the U.S. has been involved in efforts to address the global AIDS crisis since the mid-1980s, the creation of the President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003 marked a significant increase in funding and attention to the epidemic.
• PEPFAR is the largest commitment by any nation to address a single disease in the world; to date, its funding has totaled more than $110 billion, including funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), to which the U.S. government is the largest donor. PEPFAR is credited with saving millions of lives and helping to change the trajectory of the global HIV epidemic.
• U.S. funding for PEPFAR grew from $2.2 billion in FY 2004 to $7.0 billion in FY 2022; FY 2022 funding includes $5.4 billion provided for bilateral HIV efforts and $1.6 billion for multilateral efforts ($50 million for UNAIDS and $1.56 billion for the Global Fund).
• As the COVID-19 pandemic continues to have profound effects across the world, PEPFAR has acted to respond to COVID-19 in countries that receive support in order to minimize HIV service disruptions and leverage the program’s capabilities to address COVID-19 more broadly.
• Looking ahead, PEPFAR faces several issues and challenges, including how best to: address the short- and long-term impacts of COVID-19 on PEPFAR and the HIV response; accelerate progress toward epidemic control in the context of flat funding; support and strengthen community-led responses and the sustainability of HIV programs; define its role in global health security and broader health systems strengthening efforts; and continue to coordinate with other key players in the HIV ecosystem, including the Global Fund.

Key Activities and Results (As provided by Kaiser Health & Family Foundation)

PEPFAR activities focus on expanding access to HIV prevention, treatment, and care interventions. These include provision of antiretroviral treatment, pre-exposure prophylaxis, voluntary male circumcision, condoms, and other commodities related to HIV services. In addition, PEPFAR has launched specific initiatives in key strategic areas. For example, in 2015, PEPFAR launched DREAMS, a public-private partnership that aims to reduce HIV infections in adolescent girls and young women.

The latest results reported by PEPFAR indicate that it has:

• supported testing services for 63.4 million people in FY 2021;
• prevented 2.8 million babies from being born with HIV, who would have otherwise been infected;
• provided care for more than 7.1 million orphans and vulnerable children (OVC);
• supported training for nearly 300,000 new health care workers; and
• supported antiretroviral treatment for 18.96 million people.
• In the 15 countries implementing the DREAMS initiative, new diagnoses among adolescent girls and young women have declined with most DREAMS areas (96%) experiencing declines greater than 25% and nearly two-thirds with declines greater than 40%.

The achievements of the PEPFAR program have been remarkable, well-documented by outside evaluators, and hugely applauded throughout the advocacy community and the developing world. In general, milestones have been met, the program has been enlarged (for instance, to include some research on implementation of medical assistance), the roster of PEPFAR countries has grown and spending plans have not been exceeded.