During his first term, President Donald J. Trump presented a bold initiative to end HIV’s epidemic in the United States by 2030, focusing on 57 jurisdictions with the most urgent needs.
The plan, which Mr Trump announced in 2019 in a management of the Union State, surprised the defense teams. But it was widely praised and successful.
By 2022, the plan had led to new national infections by 30 % in adolescents and young adults and by about 10 percent in most other groups.
This time, Trump’s administration’s attitude on HIV seems to be very the opposite.
The Ministry of Health and Human Services is now thinking of closing the HIV prevention management of the Centers for Disease Control and Prevention and some of its activities to a different service, according to federal officials.
The CDC provides funds to states and territories to detect and respond to HIV fireplaces, prevention, syringe exchange, expanded tests in emergency rooms and training and awareness. About one in four new HIV diagnoses are made with agency funds.
The management plan has not yet been finalized and its possible time is unclear.
“It is not going to happen 100 percent, but 100 percent is discussed,” said a federal official who had not been authorized to speak in the media on the issue.
The discussions were first mentioned by the Wall Street Journal.
HIV prevention efforts, including clinical trials, have already stopped excavating the US service for international development in much of the world.
And some federal funding for prevention and treatment declined because grants were associated with transsexuals, who are between those who had a higher HIV risk
In addition, National Institutes of Health have ended funding for dozens of studies, including those of HIV in children. The role of substance use; and increasing the use of preventive treatments between degraded groups, such as black women.
Trump’s first HIV plan focused on providing assistance to many of these groups.
The initiative was intended to prevent infections in poor black communities and between homosexuals and bisexuals and transsexual women, some of the highest HIV reference risk groups
“It was not his constituency,” he said in an interview in an interview in an interview in an interview with an interview with an interview with an interview with an interview with an interview with last fall. But “the president was wildly supported for that.”
States where the initiative’s efforts have focused on new infections as a total of more than 20 percent by 2022. “That’s exactly what we were trying to do and did it,” Admiral Giroir said on Tuesday.
Trump’s first administration also imposed patents for preventive medicines to negotiate better agreements than manufacturers.
“These actions made a real difference,” said Jeremiah Johnson, executive director of the Prep4all Defense Organization. But, he added, “it does not seem that today’s administration is motivated by previous achievements.”
The administration is considering a temporary plan to move some of the CDC prevention programs to the administration of resources and health services. This organization finances state and local health departments and community -based groups providing HIV services, including through the Ryan White signature program.
“The HHS follows the guidance of the administration and carefully examines all departments to see where there is a coating that could be smoothed to support the president’s broader efforts to restructure the federal government,” said Emily G. Hilliard.
No final decision has been made, he added.
Some organizations have welcomed the ability to move HRSA prevention programs, which could provide integrated HIV and maternal health services – as long as the CDC continued to lead surveillance and treatment guidelines.
“Providing new funding to HRSA opens new capabilities of efficiency in biomedical prevention of HIV and other sexually transmitted infections,” said David C. Harvey, executive director of the National Coalition of STD Directors.
But other experts were deeply concerned about the possible loss of CDC participation.
“The HRSA and the Ryan White program are amazing, but they focus on the care and treatment of HIV,” said Mitchell Warren, AVAC executive director, a defense team.
“They are not involved in the prevention of HIV as a priority, so prevention of CDC is so critical.”
Michael Ruppal, chief executive of the AIDS Institute, said HRSA officials had no experience in how public health prevention was granted and measured.
“The leadership within the CDC and all the institutional knowledge there, we need it in the field – states need it, communities need it,” Mr Ruppal said.
Its organization helps Florida’s counties, including seven of the 57 high -risk jurisdictions included in the 2019 initiative, are planning HIV services. “It just seems to be counterproductive for his personality to let this happen in this program after he put his name on it,” he said, referring to Mr Trump.
Some public health experts are concerned about NIH cutting grants for stigma and prevention studies, especially those involving some LGBTQ populations. Most new HIV infections are between homosexuals and bisexual men and transsexual women.
“There is the epidemic and if you are not there, you do not go to the epidemic,” said Dr. Chris Beyrer, director of Duke Global Health Institute.
About 7 % of the NIH budget goes to HIV research, but some Republican legislators have suggested that HIV funding should be proportional to its national prevalence less than 0.4 %.
“This would certainly not be enough to continue the research towards a vaccine we need, and a treatment,” said Dr. Beyrer, who serves as a consultant to the HIV vaccination network.
Given changes in HIV programs in the United States and abroad, public health organizations will need a new example to continue their work.
This may include companies that are negotiating market agreements directly with states and large non -profit organizations, or may entail completely new partnership models.
“We need to move away from any paralysis or any mistrust or shock, and we really need to see what needs to be built in the future,” Mr Warren said.
“One of the biggest tragedies in all this would be if we let this narrative be entirely written by people who do not understand science or health care or research or external help,” he added.
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