U.S. Senator Ben Cardin

Letters From Ben

December 2, 2023

World AIDS Day

Dear Fellow Marylanders,

This week was World AIDS Day. For 35 years, people around the country and around the world have come together to re-dedicate themselves to the global struggle to end AIDS. We honor those we have lost while supporting those living with and at risk of the HIV virus. We stand united in efforts to reach a day when HIV is no longer stigmatized or a public health threat.

Since the first U.S. cases of AIDS were reported in June 1981, more than 700,000 individuals in the U.S. have died from HIV-related illnesses. In 2021, in the U.S. over 36,000 people were diagnosed with HIV (751 in Maryland), with more than 1.1 million in our country (31,000 in Maryland) currently living with this virus. Many more are at risk of HIV infection.

Recent data show that minority populations continue to remain disproportionately affected by HIV/AIDS. In 2021, Black Americans accounted for 40 percent of HIV diagnoses, while Hispanic/Latino Americans accounted for 29 percent of HIV diagnoses. This is evidence of the persistent health challenge HIV/AIDS presents in Maryland and in the U.S. The work to improve health equity and ending the disparities in access to prevention, care, and treatment is not over.

World AIDS Day (December 1) also reminds us that HIV is not just a medical issue. It is a human rights issue. Criminalization, discrimination and social stigmas continue to target the most vulnerable populations across the globe. In sub-Saharan Africa, violence and discrimination against women and girls continues to fuel the epidemic. Children who are orphaned or otherwise affected by HIV face a range of abuses, from school dropout to child labor, to the worst forms of exploitation.

Fortunately, scientists have made significant strides in developing antiretroviral therapies (ART) against HIV infections in recent decades. Thanks to breakthroughs in the private and public sectors, the U.S. Food and Drug Administration (FDA) has now approved more than 30 medicines to treat HIV infection including the new class of antiretroviral drugs most recently approved by the FDA at the end of 2022. These treatment regimens have transformed HIV from a death sentence to a chronic, manageable disease. They help extend and stabilize the lives of those living with HIV, while also dramatically reducing the risk of HIV transmission.

We are fortunate to have premier scientific research institutes within Maryland working to combat this deadly virus – including the National Institutes of Health (NIH), the Walter Reed Army Institute of Infectious Disease Research, the Institute of Human Virology at the University of Maryland, and Johns Hopkins University. These world-class research institutions have not only substantially led the scientific advancements with respect to HIV/AIDS, they also have played a significant role in reducing the number of new cases among Marylanders and allowing those living with HIV the opportunity to continue to live full lives.

In addition, thanks to the Affordable Care Act (ACA), Americans diagnosed with HIV or at risk of transmission have greater access to healthcare coverage and health insurance. Today, Americans cannot be dropped or denied coverage because of pre-existing health conditions, such as asthma, cancer, HIV, or COVID-19. The ACA also gives states the option to expand Medicaid, the largest payer for those who need HIV treatment in the country, and so far, 41 states (including the District of Columbia) have expanded this coverage. I look forward to seeing the 10 remaining states join this list.

However, HIV/AIDS is not an issue the U.S. faces in isolation. Around the world, HIV remains a grave public health challenge. In 2022, 39 million people lived with HIV globally, including an average of 1.3 million people who became newly infected. Last year, roughly 630,000 people died from AIDS-related illnesses, down from 2 million people in 2004 and 1.4 million in 2010. This reflects breathtaking progress in scaling up HIV testing and treatment over recent decades, with close to 30 million people or 76 percent of those living with HIV receiving antiretroviral treatment.

Shaping such dramatic progress has been the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which, since its inception in 2003, has represented an extraordinary commitment to global health, aiming to prevent, diagnose, and treat HIV infections. PEPFAR also has served as the model for bipartisan cooperation. It was established by a Republican president, George W. Bush, and enacted with near-unanimous congressional support, reauthorized three times over the span of four presidential administrations, and has consistently secured the bipartisan backing of members of Congress across the ideological spectrum.

This year, President Biden commemorated the 20th anniversary of PEPFAR, honoring the 25 million lives that have been saved worldwide in the fight to end HIV/AIDS as a public health crisis.

Through U.S. leadership, PEPFAR has changed the trajectory of the HIV epidemic around the globe. As one of the most successful and cost-effective efforts in the history of American foreign assistance, I am proud that the Senate Foreign Relations Committee held a hearing on PEPFAR earlier this year, and I am hopeful that we will get reauthorization across the finish line soon. The next 5 years are critical to meet the goal of ending the global HIV/AIDS epidemic by 2030.

PEPFAR’s broad coalition of supporters extends far beyond the federal government. Faith leaders worldwide have spoken out on the importance of the life-saving program, and the urgent need for a five-year reauthorization. In many cases, faith-based organizations are the soldiers on the frontlines in the war against HIV/AIDS, partnering with local communities to carry out the program.

PEPFAR does not – nor has it ever – funded abortions. Nevertheless, a handful of anti-abortion groups are waging an all-out assault against the initiative, whipping votes in Congress to attach unnecessary, restrictive and politically divisive language to its reauthorization. They are attempting to slash the program’s renewal from five-years to one – making it nearly impossible to strategically implement funding, plan for contingencies, or adapt to changing conditions in target countries. They also are threatening to smear lawmakers who support a five-year renewal.

President Bush himself – arguably one of the most conservative Presidents elected in modern political history – has joined the public to push back on the lies being spread about PEPFAR. “There is no program more pro-life than one which has saved more than 25 million lives,” he wrote. “We are on the verge of ending the HIV/AIDS epidemic. To abandon our commitment now would forfeit two decades of unimaginable progress and raise further questions about the worth of America’s word.”

Our battle against HIV is far from over and the U.S. must continue to show global health leadership and facilitate cooperation with our foreign partners and allies. While supporting quality healthcare initiatives at home, we must invest in the communities and local leaders that know their own health needs best. All people, regardless of age, sex, gender identity, sexual orientation, race, ethnicity, religion, disability, geographic location, or socioeconomic circumstance should have access to prevention, treatment, and care.

In the spirit of World AIDS Day, I would like to recognize the work of international partners, academic partners, faith-based organizations and civil society for their long-held commitment to ending AIDS. Most importantly, I want to recognize those living with HIV/AIDS across Maryland and across the globe. Your demand for dignity and access to health care has shown us what is possible when the world works together to fight a public health scourge, and in accordance with that spirit, we will prevail in doing so. We must recommit ourselves to continuing this fight because success is within our reach. 

Thank you for your time. Please feel free to reply to this email with your thoughts on this and any other topic.


Ben Cardin