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White House World AIDS Day Event

Washington, D.C.
December 2, 2013

Introduction

We are all here today, because we share President Obama’s belief that an AIDS-free generation is within our reach, if we continue to work together to make it so.

From the very first days of this Administration, President Obama has made these issues an Administration-wide priority.  And together with your help, we’ve worked toward our shared goals of:

  • Decreasing the number of Americans who become infected with HIV;
  • Increasing access to care;
  • Improving health outcomes for people living with HIV;
  • Reducing HIV-related health disparities;
  • Contributing to global efforts to respond to AIDS; and
  • Moving forward toward the dream of finding a cure and ending this epidemic.

Progress We’ve Made

As we gather here today, just a few days after Thanksgiving, there is a lot we can be thankful for, in terms of the progress we’ve been making together ...  the hope we’re providing ….  the lives we’re saving … and the advances we’re making.   

As the President mentioned, we’ve been able to cut the waiting list for the AIDS Drug Assistance Program, or ADAP, from 9,000 to zero in just two years.

Indeed, we've come a long way since 1983, when Congress first passed a bill specifically funding AIDS research and treatment.

There was a time, not too long ago, when getting an HIV diagnosis was like getting a death sentence. Today, because of the hard work of so many – including many who are here with us today -- HIV is now a manageable medical condition.

The science gives us great reason for optimism and hope.

There are currently more than 30 safe and effective antiretroviral drugs and drug combinations – and researchers continue to discover new treatments.

What’s more, we're making significant progress toward new medications and regimens that are longer lasting and simpler to use – with fewer side effects.  

These regimens reduce the amount of HIV in the body, which helps people living with HIV stay healthy and live longer. We also know from NIH-funded research, that HIV transmission is drastically reduced when the amount of HIV virus in an infected person is reduced to undetectable levels.

Meanwhile, the FDA has approved new, rapid diagnostic tests that can be used in various settings to identify HIV-infected individuals who might not be tested in traditional health care settings.

As we speak, NIH grantees and scientists are exploring ways to treat HIV infection by administering anti-HIV antibodies.

And they have begun early-stage human testing of an antibody that was effective in protecting human cells against more than 90 percent of known HIV strains.

Last, but certainly not least: We've made significant progress since we met here last year in understanding how antibodies respond and how they evolve together with the HIV virus in the body of an infected person.

And these advances have brought us closer than ever to finally getting an effective vaccine – and one big step closer to finding a cure.

The announcement the President just made about increasing funding for research by $100 million, will allow us to further the important work being led by Dr. Jack Whitescarver, Dr. Anthony Fouci, and the incredible team at NIH, which is led by Dr. Francis Collins. 

Ultimately, one of the most important things we can do to combat this epidemic is to raise awareness. 

And so as we work to advance the research, we’re also supporting national HIV awareness campaigns and sharing resources with community organizations and health departments across the country.

Last weeks’ signing by the President of the bipartisan HOPE Act is another step in the right direction of making sure our Federal policies are aligned with the most recent scientific understanding of HIV.

Information about these efforts is available at AIDS.gov.

Challenges We Continue to Face

So we have a lot to be thankful for today.  But we still have much work in front of us.

The challenge that we face is substantial: 35 million people across the world are living with HIV/AIDS. In 2012 alone, more than 2 million new HIV infections and 1.6 million AIDS-related deaths were reported around the world.

Here in the U.S., more than 1 million of our neighbors are infected, and millions more are affected by the loss of loved ones.

National HIV/AIDS Strategy

I wanted to share just a few brief thoughts on the National HIV/AIDS Strategy, which President Obama launched three years ago.

Because of these efforts – and your help – we are doing more than ever before to prevent HIV… to deliver high-quality care to people living with HIV… to keep them engaged in that care … and to improve outcomes so they can live longer, healthier, more productive lives.

We’ve also been able to enhance and streamline the coordination of our own federal efforts.  As a result, front-line providers can concentrate on what matters most: providing high quality HIV prevention and care services.

And with your help, we will help more of our fellow Americans through the Ryan White Program in the years ahead.

One of the ways we’re working to improve the quality of life of Americans living with HIV is by working with states to increase access to home and community-based care – so more people living with HIV infection can live in their own homes, in their own neighborhoods, and in their own communities. 

For all the progress we are making, it is still the case in the United States that one in six people living with HIV is undiagnosed, and only one in four people living with HIV in this country is able to achieve control over their infection through medication – which is necessary for their own health and also a critical strategy for preventing viral transmission to partners.

That’s why this July, the President issued an Executive Order launching the HIV Care Continuum Initiative, with the goal of accelerating our Federal efforts to help people get tested, linked to care, and treated for HIV.

Today, the White House released a report with the first set of recommendations from the Federal Working Group charged with implementing the Initiative.

Dr. Howard Koh at HHS has been working in close partnership with Dr. Grant Colfax at the White House. Dr. Koh and Dr. Colfax co-chaired the group, and I would like to thank them and members of the group – including those at CDC, HRSA, NIH, SAMHSA, DOJ, DOL, HUD, and the VA – for their hard work.

This is another example of the Federal government breaking down silos and working together to implement that National HIV/AIDS Strategy.

We are committed to implementing their recommendations.

The Affordable Care Act

As I close, I want to share with you a few of the ways the Affordable Care Act is contributing to our efforts to fight this epidemic.

As you may know, the U.S. Preventive Services Task Force recommends that clinicians screen for HIV infection in adolescents and adults ages 15-65 – and that all pregnant women are screened for HIV.

The new health care law makes this possible, by requiring private health care plans to cover HIV testing and other preventive services at no out-of-pocket cost to the patient.

It makes it illegal for insurance companies to deny children coverage because they have HIV. And no adult can be denied coverage beginning in 2014.

The law makes it illegal for insurance companies to rescind someone’s coverage when they get sick because they made a mistake on their paperwork … or to put a cap on the dollar amount of health benefits they're willing to cover for an HIV patient over their lifetime. 

Next year, annual dollar limits on benefits will be against the law as well.

And in most health care settings, it will finally be illegal to discriminate against someone because of their gender identity, to withhold care from someone when they need it most because of their gender expression.       

The new Health Insurance Marketplace is an important tool in the fight against HIV/AIDS. 

And we are working to make sure that site works well for the vast majority of Americans.

There will be exceptions, and we will continue to make improvements.  But the system is now working smoothly for the vast majority of users.

Medicaid Expansion

Medicaid expansion is another critically important tool. For lower-income Americans, Medicaid expansion can literally be the difference between life and death. 

So far, 25 states and the District of Columbia have decided to expand Medicaid to millions more lower-income Americans.  

If all 50 states were to expand, nearly 80% of the 41.3 million uninsured Americans who would be eligible for new coverage through the Marketplace would qualify for Medicaid, CHIP, or financial assistance with a Marketplace plan. 

This would go a very, very long way toward extending the promise of comprehensive health care services to the most vulnerable HIV/AIDS patients, whose suffering is so often compounded by their limited resources.  

Conclusion

With your help, we have been making a tremendous amount of progress. 

But for all we have to be thankful for, there is still much more work to be done, especially when it comes to addressing the discrimination and stigma that continue to fuel the spread of infection – both at home and around the world.

We have to be vigilant about how we target and direct our resources – especially if Congress is unable or unwilling to reverse the sequester cuts.

All of you are in this room today because you’ve refused to give up. 

The fight to end this epidemic is a fight we can win.  We have many reasons for hope, and many of these reasons are sitting here in this room today. 

Thank you all very much. Working together, we can achieve the goal of an AIDS-free generation.