President Trump’s State of the Union pledge to end the HIV epidemic within 10 years represents a significant turnaround for his administration, which has pushed to cut funding for key programs and fired all the members of a council advising him on the issue during his first year in office.
As a result, some advocates greeted it with wary skepticism.
“It sounds very much like teleprompter Trump saying words but not being invested in the statement itself,” said Scott Schoettes, counsel and HIV project director for Lambda Legal, a civil rights organization focused on the LGBT community.
{mosads}Administration officials on Wednesday released a multi-year, multi-agency approach that would direct “substantial” money to parts of the country most impacted by HIV, including counties in California, Florida and Georgia.
The administration will request funding in its budget to go toward diagnosing and treating HIV, while protecting those at highest risk‚ including the LGBT community and African Americans.
The plan would expand access to antiretrovirals, medicines that treat HIV and PrEP, a drug to prevent HIV for those most at risk.
While Trump’s surprise pledge drew cautious responses from many representatives of groups that have been on the front-lines against HIV/AIDS, some advocates that have been working closely with the administration over the last year said they believe the White House is serious about the effort which aims to reduce diagnoses of HIV by 75 percent within five years and 90 percent within 10 years.
“There’s a lot of distrust of the administration, and we share a lot of that distrust on a lot of issues, but I feel comfortable in my conversations in the last couple of months with them,” said Carl Schmid, deputy executive director of The AIDS Institute and one of the co-chairs of the President’s Advisory Council on HIV/AIDS.
The administration appears to have taken a turn after last year’s appointments of Health and Human Services Secretary Alex Azar and Robert Redfield, director of the Centers for Disease Control and Prevention, and a leading AIDS researcher in the U.S.
“I think they’re looking at things with a new eye,” Schmid said.
Redfield has led the administration’s efforts on the issue, working with officials at the Department of Health and Human Services, the National Institutes of Health, the Health Resources and Services Administration and the Indian Health Service.
“This is a plan to fundamentally change the trajectory of HIV and end the epidemic in America,” said Brett Giroir, HHS’ assistant secretary for health, in a press call with reporters Wednesday.
More than 700,000 people have died from HIV since 1981, and while significant gains have been made since, many people don’t know they have HIV, don’t have access to medication and care and more are at risk of getting infections.
There are about 40,000 new infections throughout the U.S. every year, and more than 1 million people are living with HIV.
Much of the skepticism of the administration on the issue centers on the fact that it to this point has not expressed much of an interest in ending HIV/AIDS.
And Trump only last month named two PACHA co-chairs after firing the entire council more than a year ago. Schmid was sworn in last month, along with John Weisman, secretary of health for Washington State.
It is also viewed with skepticism by Democrats and the public health community given its efforts to end ObamaCare, which expanded health care to thousands living with HIV and protected them from discrimination by insurance companies.
“The problem that I have right now with it is all of his efforts to undermine the Affordable Care Act,” said Rep. Jan Schakowsky (D-Ill.), a member of the Congressional HIV/AIDS Caucus.
“It would take a change in thinking about our general health care system if you really want to eliminate HIV/AIDS.”
Rep. Mark Pocan (D-Wis.), another member of the caucus, said he was “puzzled a little bit” by Trump’s announcement on HIV/AIDS, pointing at the administration’s decision to divert $6 million in funding for an AIDS program to house detained children separated from their parents at the border.
“I’m glad that he understands there’s a priority to put some additional funding out there. But it’s a little hard if, you know, in reality, he’s taking money already away in that area to use for completely unrelated expenses,” he said.
Some advocates argue the plan doesn’t go far enough to reduce the stigma of HIV/AIDS, which prevents many people with AIDS, especially transgender and gay people, from getting tested or treated.
“Just new resources isn’t going to get us there,” Schoettes said.
“You also have to stop engaging in policies that are working against your goal,” he said, referring to Trump’s plan to ban transgender people from the military.
High-ranking HHS officials met with HIV/AIDS advocates Wednesday to brief them on the plan.
“We’ve met with the administration before, and they demonstrated today that they listened to many of our ideas,” said David Harvey, executive director of the National Coalition of STD Directors.
Harvey said he was assured the programs the administration has tried to cut in the past would be “protected” in the upcoming budget request.
“This is a commitment at the highest level of the federal government,” he said.
“Our job is to work cooperatively with the administration and hold them accountable.”