Trump's plan to end America's HIV epidemic by 2030, explained

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In Tuesday night's State of the Union ad...

Posted: Feb 6, 2019 1:11 PM

In Tuesday night's State of the Union address, President Donald Trump called for the elimination of HIV transmissions in the United States by 2030, raising hope and questions about putting an end to the epidemic.

The initiative aims to reduce new HIV infections by 75% in the next five years and by 90% in the next 10 years, "averting more than 250,000 HIV infections in that span," according to the US Department of Health and Human Services.

The HHS also noted that most HIV infections are now highly concentrated in certain "geographic hot spots" in the United States. For instance, more than 50% of new HIV diagnoses in 2016 and 2017 were in 48 counties, Washington, D.C., and San Juan, Puerto Rico, according to the department.

"In recent years we have made remarkable progress in the fight against HIV and AIDS. Scientific breakthroughs have brought a once-distant dream within reach," Trump said Tuesday.

"My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years. Together, we will defeat AIDS in America."

Trump's plan will fund programs in geographic hot spots, data to identify and track the spread of HIV, and the creation of local efforts in targeted areas to expand HIV prevention and treatment.

Previously, the Joint UN Programme on HIV/AIDS set a goal to end the AIDS epidemic by 2030. In its report, the United Nations estimated that "new HIV infections have been reduced by 47% since the peak in 1996" worldwide.

Dr. Scott Gottlieb, the Food and Drug Administration commissioner, tweeted Tuesday that the plan to end the HIV epidemic in America could be "one of the most significant public health initiatives we undertake together."

Many health experts applauded the effort, but some also criticized the White House for cutting funding for HIV/AIDS programs in the past and remained hopeful that the next budget will reflect Trump's new pledge. Millions of dollars were shifted away from HIV/AIDS prevention programs last year.

"President Trump's pledge to end the HIV epidemic within 10 years is encouraging, but it is difficult to reconcile this statement with his administration's systematic assault on the HIV community -- including undermining access to affordable health insurance and HIV drugs; cutting funds for HIV research; and attacking LGBTQ+ people," New York City Health Commissioner Dr. Oxiris Barbot said in a written statement Wednesday.

"In New York City, we have reached a historic low in new HIV diagnoses, guided by Mayor (Bill) de Blasio's Ending the Epidemic plan, a commitment to end the HIV epidemic in New York City by 2020. The plan is grounded in efforts to increase HIV testing, treatment and prevention and to dismantle HIV-related stigma by relying on sound science and community engagement," she said in the statement.

"A pathway exists for the President to end the HIV epidemic, but he cannot reach this goal by alienating the very communities most affected by it. Any legitimate plan must begin by righting these wrongs."

Tom Hart, the North America executive director for the ONE Campaign advocacy group, said in a written statement Tuesday that the President's new goal turns a "needed spotlight" on AIDS but "actions speak louder than words."

"For the past two years, the Trump administration has proposed drastic cuts to global AIDS programs," said Hart, who has written opinion pieces published by CNN.

"American foreign assistance and global leadership saves lives, lifts people out of poverty, promotes stability, spurs economic growth and brings hope to millions. It also moves us closer to the day in which American foreign assistance is no longer needed," he said in the statement. "We hope President Trump's upcoming budget proposal will reflect these priorities, focus on those who need it most, and fully fund America's global poverty and health programs."

About 1.1 million people in the United States had HIV at the end of 2015, the most recent year for which information is available, according to the US Centers for Disease Control and Prevention. Of those, about 15%, or 1 in 7, did not know they were infected.

Globally, 36.9 million people were living with HIV in 2017, and 21.7 million people were receiving antiretroviral treatment by the end of that year, according to the World Health Organization.

Around the world, there have been some successful efforts to work toward controlling the spread of HIV or human immunodeficiency virus, which weakens a person's immune system by destroying important cells that fight disease and infection.

The United Kingdom has exceeded targets set forth by the United Nations for HIV diagnosis and treatment, proving that efforts to control the epidemic can work. An estimated 92% of the 102,000 people living with HIV in Britain have been diagnosed, according to Public Health England. Of those, 98% are on treatment, and 97% of those on treatment are virally suppressed, meaning HIV is undetectable in their blood.

Those figures make the UK one of the first countries to reach the United Nations' 90-90-90 targets, which urge countries to achieve a 90% success rate in the diagnosis, treatment and viral suppression of HIV, according to the health body.

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