“Today, approximately 1.2 million Americans are living with HIV, and they are able to lead healthier and safer lives due to increased access to care under the Patient Protection & Affordable Care Act (ACA).”
“Since 2003, PEPFAR has changed the trajectory of the HIV epidemic around the globe by expanding access to HIV prevention, treatment, and care interventions. PEPFAR is one of the most successful and cost-effective efforts in the history of American foreign assistance.
“We must apply the lessons of the fight against HIV to our current battle against the COVID-19 pandemic so we can save more lives and get the global economy back on track.”
WASHINGTON – U.S. Senator Ben Cardin (D-Md.) released the following statement in commemoration of World AIDS Day 2021.
“On December 1, we mark the 33rd anniversary of World AIDS Day, which gives us an opportunity to pause and reflect on the lives lost to HIV/AIDS, how far we have come in the fight against this virus, and what we need to do to ensure an AIDS-free future.
“Since the first cases of AIDS were reported domestically in June 1981, more than 700,000 Americans have tragically died due to AIDS-related complications. Significant scientific advances, brought about by public and private partnerships, led to the development of antiretroviral therapies (ARTs), which have been instrumental in decreasing AIDS-related mortality rates by more than 80 percent since they peaked in 1995. Investment in U.S. disease surveillance, prevention, and public education has similarly led to an almost 50 percent decline in the incidence of infection since 2010.
“We are fortunate to have premier scientific research institutes within the State of Maryland working together to combat this deadly virus. The National Institutes of Health, the Walter Reed Army Institute of Research, and the Institute of Human Virology at the University of Maryland all lead U.S. and global research on developing treatments and a vaccine for HIV/AIDS. The world-class research institutions housed in Maryland have not only substantially led the scientific advancements with respect to HIV/AIDS; they have also played a significant role in reducing the number of new cases among Marylanders and affording those who contract HIV/AIDS to continue living full lives. Across Maryland, more than 30,000 adults or adolescents were living with HIV at the end of 2020.
“Last year, Maryland recorded fewer than 1,000 new cases of HIV infection for the third consecutive year, and a significant decrease over the peak of 2,612 new HIV infections among Marylanders in 1991. Public health initiatives the Maryland Department of Health implemented have been instrumental in reducing new infections, including programs like safe-sex education programs, condom distribution, access to prophylactic medication, and a statewide needle-exchange program for injection drug users.
“Today, approximately 1.2 million Americans are living with HIV, and they are able to lead healthier and safer lives due to increased access to care under the Patient Protection & Affordable Care Act (ACA). The ACA has led to increased patient protections such as the prohibitions on rate-setting tied to health status, the elimination of preexisting condition exclusions, and an end to lifetime and annual dollar limits. Still, there are challenges ahead. Increasing prescription drug costs for ART regimens and health insurance benefit designs that shift out-of-pocket costs onto patients risk the progress we have made to end the HIV epidemic in the U.S.
“Although federal financial support to Medicaid – the largest source of insurance coverage for people living with HIV – has increased through the duration of public health emergency due to the COVID-19 relief bills, tightening state budgets amid record Medicaid enrollment could hinder access to treatment or care for the HIV/AIDS population. Forty-two percent of adults with HIV receive health care under Medicaid.
“In the U.S., the fight against this disease also disproportionately affects communities of color, with Black and Latino Americans accounting for a disproportionate share of new HIV diagnoses and deaths, consisting of about 70 percent of new diagnosis despite making up roughly 30 percent of the U.S. population. The Biden-Harris administration’s theme for World AIDS Day this year is “Ending the HIV Epidemic: Equitable Access, Everyone’s Voice,” denoting a strong commitment to addressing health inequities within the epidemic. I share the administration’s determination to address the disproportionate impact of the epidemic on marginalized populations like the LGBTQI+ community and racial and ethnic minorities.
“Internationally, the U.S. has invested more than $100 billion in the global HIV/AIDS response through the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis & Malaria (Global Fund). This investment has saved more than 20 million lives, prevented millions of people from becoming infected, and achieved HIV/AIDS epidemic control in more than 50 countries. Since 2003, PEPFAR has changed the trajectory of the HIV epidemic around the globe by expanding access to HIV prevention, treatment, and care interventions. PEPFAR is one of the most successful and cost-effective efforts in the history of American foreign assistance.
“Despite the progress we have made around the globe, there is still significant work to do. Of the 38 million people globally living with HIV, 12.6 million are not accessing life-saving treatment. In 2019, there were 1.7 million people newly infected with HIV – more than three times the global target – and 690,000 people perished from this terrible disease. While we have made strides in combating HIV/AIDS in eastern and southern Africa, we have seen increases in new infections in Eastern Europe, central Asia, the Middle East, and Latin America.
“As with last year’s commemoration, this year’s World AIDS Day finds us continuing to battle the COVID-19 pandemic. Support through PEPFAR and the Global Fund has financed efforts to minimize the disruption of the pandemic on HIV epidemic response efforts, through services like telehealth and multi-month dispensing of antiretroviral therapies. The COVID-19 pandemic, however, continues to affect the global response to HIV and threatens the decades of progress we have made against this disease. In addition to disrupting HIV treatments and prevention services, downstream impacts of the pandemic have cut off vulnerable populations from educational and social support services, and growing inequalities resulting from the economic downturn are likely to lead to increases in HIV risk behaviors and vulnerability. The Global Fund reported that last year, HIV testing dropped by 22 percent and the percentage of HIV-positive TB patients on antiretroviral therapies dropped 16 percent.
“A world free from HIV requires global leadership from the United States, and we have stepped up to the plate by heavily investing in the global response to HIV. From significant contributions to the Global Fund to the creation of PEPFAR, U.S. global health leadership and international collaboration helped to turn the tide on the global epidemic. This is as true today as it was 33 years ago. International public health crises require international responses. Unlike the previous administration, I support President Biden’s actions to re-prioritize cooperative global health response efforts. We are only as strong as the weakest health system, and it is incumbent upon the U.S. to lead global health response efforts as we look to end the COVID-19 pandemic and HIV/AIDS epidemic.
“One of the biggest tragedies of the HIV epidemic is that millions of people around the world died while waiting for treatment and once treatment became available in 1987, it was out-of-reach. At about $8,000 a year (more than $17,000 in today’s dollars), the first HIV drug was too expensive for populations who needed it most – low-income communities in the U.S. and low and middle-income countries. While Congress authorized $30 million in emergency funding to States to pay for low-income patients’ treatment, global access to the drug lagged. For example, when we established PEPFAR in 2003, only 50,000 people in Africa were accessing lifesaving HIV treatment.
“We cannot make the same mistake with COVID-19. While we have made great strides domestically to vaccinate our population, it is equally important to vaccinate the rest of the world from COVID-19. The Biden administration has made significant strides to supply and commit future supplies of vaccines to low-income countries, and I implore the administration to continue working with vaccine manufacturers to expedite this effort as fast as humanly and safely possible. Equally important is ensuring access, when approved, to antiviral treatments. One potential antiviral treatment reduces the risk of hospitalization and death by 89 percent in high-risk adults when used in conjunction with ritonavir, a medication commonly used to treat HIV. The potential success of this antiviral treatment is a testament to the biomedical infrastructure of the United States, where the incredibly innovative treatments we developed for HIV may be effective in battling the COVID-19 pandemic, too.
“COVID-19 does not respect borders. To protect our domestic health, we must ensure that our allies and low and middle-income countries around the world have affordable access to eventually approved COVID-19 vaccines, diagnostics, and therapeutics. While we celebrate the progress we have made with respect to HIV/AIDS this World AIDS Day, we must recommit ourselves to continuing this fight because success is within our grasp.
“We have made so much progress through international partnerships. Donor nations; civil society; people living with HIV; faith-based organizations; scientific research community and academic partners such as Johns Hopkins University, the University of Maryland, and the Walter Reed Army Institute of Infectious Disease Research; the private sector; foundations; and implementing organizations such as Catholic Relief Services and Lutheran World Relief have complemented those partnerships tremendously. We must apply the lessons of the fight against HIV to our current battle against the COVID-19 pandemic so we can save more lives and get the global economy back on track.”