More than money
Trump initiative to fight HIV is good start.
It’s been a decade since a man with HIV was sentenced to 35 years in prison for spitting into the face of a Dallas police officer.
We’ve learned since then that the virus that causes AIDS cannot be transmitted by spitting or kissing, but there’s still so much disinformation that too many people who could have avoided the disease weren’t able to.
Too many others are afraid to even get tested.
More than 700,000 people have died of AIDS since it was first diagnosed in this country in 1981. More than 1.1 million Americans have HIV and 90,000 of them live in Texas, which with New York, California, Florida and Georgia account for more than half of all HIV cases in the United States.
That’s why it was good to see President Trump take steps this week to fulfill his State of the Union promise to do more to fight HIV. Dr. Robert Redfield, director of the federal Centers for Disease Control and Prevention, was at Texas Southern University Monday to discuss the initiative and what the agency plans to do in Houston.
Trump said in January that his plan would eradicate HIV in 10 years. Redfield, however, outlined a more realistic 10-year goal to cut the national rate of new HIV infections from about 40,000 a year to about 4,000. A 90 percent reduction may be too ambitious as well, but even if the goal isn’t achieved many lives could be saved in trying to reach it.
The president’s 2020 budget includes $290 million for the HIV prevention program’s first year. Much of that money will be spent to purchase medication that can prevent HIV carriers from transmitting the disease during sex and to buy the daily PrEP (pre-exposure prophylaxis) pill that prevents a person who doesn’t have HIV from getting it during high-risk sexual activity.
The administration has also secured an agreement from Gilead Sciences Inc., manufacturer of the PrEP drug Truvada, to donate enough of that medicine to supply up to 200,000 individuals a year for 11 years. That’s a big deal for those who benefit. But PrEP’s current list price of more than $20,000 per person per year is a reminder that Trump has yet to deliver on another promise — to lower the price of prescription drugs. Gilead would have a greater impact by lowering the price of Truvada for all.
Trump’s acknowledgment that HIV-prevention drugs must be more accessible is welcome but seems at odds with his opposition to the Affordable Care Act. Prior to Obamacare, many individuals with HIV were ineligible for insurance coverage to pay for HIV medicine due to their pre-existing illness. The ACA also changed Medicaid rules to cover lowincome individuals with HIV before they become sick or disabled.
The CDC estimates that about 15 percent of Americans who have HIV don’t know it. That means outreach must be a major component of any HIV reduction effort. Redfield’s appearance at TSU, a historically black university, was important given statistics showing African Americans now account for 43 percent of new HIV cases although they are only 12 percent of the U.S. population.
Eradicating HIV and AIDS will take more than money. It will take going into communities and homes where many are loath to talk about a disease associated with homosexuality and providing the information people need to make decisions to protect themselves and others from what is no longer a death sentence but remains a threat to life.
President Trump should be commended for taking steps to improve Americans’ access to the health care they need. However, we encourage the president to go even further in his fight against HIV and to extend the spirit of this effort to every American who struggles to afford quality care.