| March
24, 2006
This Week in Washington
1. Presidential Advisory Council on HIV/AIDS Holds 29th Meeting
Announcements
1. AIDS Drug Assistance Program Forum in Washington, DC, March
30
2. NAPWA To Hold AIDSWatch 2006 from May 8 - 10
This Week in Washington
1. Presidential Advisory Council on HIV/AIDS Holds 29th Meeting
On Thursday, March 16 and Friday, March 17 the Presidential Advisory
Council on AIDS (PACHA) held its 29th meeting in Washington, DC.
AIDS Action staff was in attendance at the meeting that began
with the introduction of the five new members of the Advisory
Council.
- Alan Holmer, president and CEO, Holmer Associates
LLC, was previously the chair of PhRMA (Pharmaceutical Research
and Manufacturers of America). He will be a member of PACHA’s
International Committee.
- Robert Redfield, M.D. is the associate director
of the Institute of Human Virology (IHV) and director of the
Clinical Care and Research Division within the IHV at the University
of Maryland. He will chair the International Committee.
- Troy Benavidez works for AstraZeneca, a
pharmaceutical manufacturer, and is a member of the Board of
Directors of the Log Cabin Republicans. He will be a member
of the Care and Treatment Committee. He said he “hopes to focus
the Council on the impact of HIV on the Latino community.”
- Robert Bollinger, Jr., M.D., M.P.H. is a
professor at the Johns Hopkins School of Public Health. He continues
to practice medicine in Baltimore caring for HIV positive patients.
He has also done extensive work on HIV in India for the past
fifteen years. He will be a member of the International Committee.
- Reverend Herbert Lusk is pastor of the Greater
Exodus Baptist Church; he is also a former Philadelphia Eagles
football player. According to his introduction, under his leadership
the church has formed two ministries to assist the indigenous
people in South Africa and Mozambique. He will be a member of
the Treatment and Care committee.
The meeting continued with a presentation from
John Agwunobi, MD, MPH, MBA, assistant secretary for health at
the Department of Health and Human Services (HHS). Dr. Agwunobi,
a pediatrician by training, explained his deep interest in working
to eradicate HIV in the United States. Early in his medical career
he served as a physician in the District of Columbia in the 1990s.
He said that he saw far too many cases of vertical transmission
of HIV (from mother to infant) and he knew then that an “aggressive
strategic intervention” was needed to turn the epidemic around.
He was pleased to announce that when he left as secretary of health
in Florida June 2005 there had been no babies born with vertical
transfer of HIV.
He expressed his excitement to work with the
members of PACHA because he believes that the challenges in the
HIV arena change quickly and the President needs the input from
PACHA to respond to these changes swiftly. He agreed to facilitate
the movement of the Council’s input through the HHS structure
and get all information directly to the President. After his remarks,
Dr. Agwunobi swore in the new members of PACHA. Dr. Agwunobi was
followed by series of presenters discussing prevention and treatment
and care topics.
Doug Michels, President and CEO of Orasure Technologies,
discussed the false positive tests that were discovered over the
last year with the Oraquick ADVANCE (oral) HIV rapid
test. He explained that the number of false positive test results
were not out of the range of the “actual field performance” that
was claimed when they introduced the product. The specificity
was 99.3% as opposed to 99.8% accurate when Orasure Technologies
reviewed the product again. He was not able to give a definitive
answer as to why the false positives were reported. He suggested
that one possible problem was that the technicians were over-swabbing
oral fluid when collecting their samples. The directions suggest
two swabs and the technicians were swabbing four times. The last
point that Mr. Michels made was that the test is a screening test
and any positive result should be confirmed with another test.
Tim Mastro is the deputy director for science
at the Division of HIV/AIDS Prevention, Centers for Disease Control
and Prevention (CDC). He presented the CDC’s “Revised Recommendation
for HIV Testing of Adults, Adolescents, and Pregnant Women in
Health Care Settings,” explaining that the recommendations are
being revised since “many HIV-infected persons access health care
but are not tested for HIV until symptomatic.” Dr. Mastro went
on to say “effective treatment is available” for people living
with HIV to remain healthy longer and that “awareness of HIV infection
leads to substantial reductions in high-risk behavior.” People
do not pass the virus if they are aware of their status, he said.
To receive a copy of the guidelines email dcrews@aidsaction.org,
and write “CDC Guidelines” in the subject line. The comment period
for the guidelines ends on March 29, 2006.
Tom Liberti, Chief of the Bureau of HIV/AIDS
at the Florida Department of Health, and Spencer Lieb, MPH, Senior
Epidemiologist at the Bureau, presented the successes of Florida’s
HIV prevention efforts. The data presented suggest that prevention
interventions in Florida have achieved significant reductions
in the rate of HIV diagnoses, particularly among people of color.
According to the data, HIV case rates per 100,000 decreased by
9.1% overall in the Black community from 1999-2004. Rates among
Black females decreased by 10.8% during the same time period.
White and Hispanic females also showed decreases, 2.8 and 2.3%
respectively. Black males showed a decrease of 7.8% overall and
Black men having sex with men (MSM) showed a 0.7% decrease.
A presentation on how the Medicare Part D prescription
drug benefit affects people with HIV was given by Mary Vienna,
Deputy Director, Division of Training and Technical Assistance
of the HIV/AIDS Bureau, Health Resources and Services Administration
(HRSA). Ms. Vienna addressed the proposed guidelines for Medicare
Part D plans, issued by the Centers for Medicare and Medicaid
Services (CMS), which will be finalized later this year. The guidelines
require that all antiretrovirals approved by the U.S. Food and
Drug Administration (FDA) through April 17, 2006 be covered by
the drug plans. Community members, including AIDS Action, have
expressed concerns that this requirement is too limited, however,
as several new HIV drugs are scheduled to receive FDA approval
after April 17 but before December 31, 2006. Addressing this concern,
Ms. Vienna said that patients who need drugs which are not offered
on drug plan formularies should go through CMS’s established appeal
process to receive the medications.
On Friday the members of PACHA heard from Wilbert
Jordan, MD, MPH from Charles Drew Hospital in Los Angeles. Dr.
Jordan runs an HIV testing program at Oasis Clinic in Los Angeles
that has been highly successful in getting HIV positive individuals
who were unaware of their status tested. The reason for his success
is that he encourages his clients to bring in people who are a
part of their social network to be tested for HIV. He also explained
that the National Medical Association (NMA)* just passed a resolution
to implement a project on HIV. From May 15th to Juneteenth (June
19th) NMA will ask all black doctors to test all of their black
patients. They feel that by doing this once a year they will bring
focus to the issue of HIV in the African American community.
Thomas Frieden, MD, MPH, commissioner of Health
and Mental Hygiene for the City of New York, presented the Council
with his plans to stop the HIV epidemic in New York City. He began
his comments by saying, “I would like to fully apply the public
health model” in the care and treatment of people living with
HIV. Dr. Frieden believes that the continued late diagnosis of
people with AIDS can be averted if we begin to routinize HIV testing.
Far too often individuals are coming to health care facilities
with full blown AIDS, he said. More than likely the individual
had been HIV positive for over ten years. These same individuals
may have been visited the same health care settings over the years
they were HIV positive and no one offered them a test. He noted
that if these same individuals had been offered a test, they would
have been able to access HIV care for their individual health,
as well as behavioral counseling to help them to not unknowingly
pass the virus to anyone else.
According to Dr. Frieden, testing and linkage
to care are critically important to addressing the HIV epidemic.
He stated that in New York City 4 in 10 individuals do not get
tested for HIV until they are in the late stages of HIV infection.
He also said HIV is treatable for those fortunate enough to receive
treatment even though there is no cure. Dr. Frieden stated, “early
diagnosis facilitates effective medical prevention, and social
services which will improve quality of life, suppress viral load,
prevent hospitalizations, and prolong lives,” adding that “People
diagnosed late in their illness are ten times more likely to die
within the first year after diagnosis.” He stated that early diagnosis
“will also reduce HIV transmission.”
Dr. Frieden said that he is not proposing mandatory
HIV testing or treatment, nor is he proposing dissemination of
client level data. All data will remain strictly confidential
and services not will be reduced for people living with HIV or
AIDS according to Dr. Frieden. He concluded his remarks saying,
“We can stop the HIV/AIDS epidemic if we expand prevention programs
that work, make it easier for people to learn their HIV status,
improve linkage to care of people diagnosed with HIV infection,
and improve care of people living with HIV and AIDS.”
The speakers’ presentations written about in
this article are available on the PACHA website. Go to http://www.pacha.gov/meetings/#pastmeetings.
*The NMA is an association that “promotes
the collective interests of physicians and patients of African
descent.”
Announcements
1. AIDS Drug Assistance Program Forum in Washington, DC, March
30
The Kaiser Family Foundation and the National Alliance of State
and Territorial AIDS Directors are releasing their annual survey
of AIDS Drug Assistance Programs (ADAPs) in the 50 states, the
District of Columbia, territories, and associated jurisdictions.
The survey will bee released during a policy forum that the two
organizations are holding on Thursday, March 30, 2005. The forum’s
discussion will include the implications of proposed policy changes
to ADAP. The event will take place at the Barbara Jordan Conference
Center, Kaiser Family Foundation Building, 1330 G Street NW, Washington,
D.C. (one block west of Metro Center). It is schedule between
12:00 and 1:30 p.m., and lunch will be provided.
The topics to be covered during the forum are as follows:
- How have ADAPs and their clients adapted
to the new Medicare Part D Prescription Drug Benefit?
- What lessons were learned for ADAPs and
the Ryan White CARE Act from the experience of Hurricane Katrina?
- What are the key issues at stake for ADAPs
in the reauthorization of the Ryan White CARE Act?
- What are the trends in ADAP clients served,
drug expenditures, and program budgets over time?
- How many states have waiting lists for HIV
medications?
- How are states working with pharmaceutical
companies to provide HIV medications?
RSVP by Monday, March 27 to Tiffany Ford at
tford@kff.org or (202) 347-5270.
2. NAPWA To Hold AIDSWatch
2006 from May 8 - 10
The National Association of People With AIDS (NAPWA) will hold
AIDSWatch, its annual DC-based advocacy event, from Monday, May
8 to Wednesday, May 10. Each year, NAPWA invites people living
with HIV to Washington, DC, where they first participate in advocacy
training sessions and then take their stories, new skills, and
updated materials to Capitol Hill. While on Capitol Hill, participants
meet with Members of Congress and their staffs to urge them to
strengthen essential health care programs—like the Ryan White
CARE Act, Housing Opportunities for Persons with AIDS, and Medicaid/Medicare—through
increases in funding and improvements in legislation.
This year, AIDSWatch will also assist individuals
unable to travel to Washington, DC with the scheduling of meetings
closer to home, in the district offices of their Members of Congress.
Interested parties may learn more about this
year’s AIDSWatch by linking to http://www.napwa.org/aidswatch.html
and may register for AIDSWatch at http://www.napwa.org/register_online.html.
Individuals who have questions, cannot register
online, or wish to talk their plans over may contact High Noon
Communications, toll-free, at 1-866-243-7282 or by sending an
email to becky@highnooncommunications.com.
The AIDS Action Weekly Update
The Weekly Update is written with
a mind toward the interests of our members. If you are interested
in membership with AIDS Action, we invite you to contact members@aidsaction.org.
AIDS Action works
to end the HIV epidemic by advancing public policies that
prevent new infections, provide care for people living with
HIV, and support the search for a cure. AIDS Action serves
as the national voice for people living with HIV and represents
AIDS service organizations, health departments, and a diverse
network of community-based organizations across the country. |
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