FY 2021 Annual Performance Plan and Report - Goal 2 Objective 2

Fiscal Year 2021
Released March, 2020

Goal 2. Objective 2: Prevent, treat, and control communicable diseases and chronic conditions

Communicable diseases and chronic conditions affect the lives of millions of Americans every day. The emergence and spread of infectious diseases—such as HIV/AIDS, hepatitis, tuberculosis, measles, and human papillomavirus—can quickly threaten the stability of public health for communities and place whole populations at risk. The rise of globalization and ease of travel also has made it easier for domestic and international outbreaks—such as recent outbreaks of measles, pandemic influenza A, Ebola, Zika, and chikungunya—to create public health challenges. Moreover, the prevalence of chronic conditions—such as diabetes, heart disease, stroke, and cancer—in the United States continues to contribute to the daily struggles of Americans. The occurrence of multiple chronic conditions also exacerbates the adverse health impacts and health care costs associated with chronic conditions and their associated health risks. HHS programs and initiatives focus on promoting partnerships, educating the public, improving vaccine development and uptake, advancing early detection and prevention methods, and enhancing surveillance and response capacity.

The Office of the Secretary leads this objective. The following divisions are responsible for implementing programs under this strategic objective: ACL, ASPA, ASPR, CDC, CMS, FDA, HRSA, IHS, NIH, OASH, OGA, and SAMHSA. In consultation with OMB, HHS has determined that performance toward this objective is progressing. The narrative below provides a brief summary of progress made and achievements or challenges, as well as plans to improve or maintain performance.

Objective 2.2 Table of Related Performance Measures

Increase the percentage of Ryan White HIV/AIDS Program clients receiving HIV medical care and at least one viral load test who are virally suppressed (Lead Agency - HRSA; Measure ID - 16.III.A.4)20

  FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 FY 2021
Target N/A N/A N/A N/A 83% 83% 83% 83%
Result N/A 83% 85% 86% 87% 10/31/21 10/31/22 10/31/23
Status N/A Actual Actual Actual Target Exceeded Pending Pending Pending

The Ryan White HIV/AIDS Program (RWHAP) works to improve health outcomes by preventing disease transmission or slowing disease progression for disproportionately impacted communities. One way RWHAP accomplishes its mission is through the provision of medications that help patients reach HIV viral suppression. People living with HIV who use medications designed to virally suppress the disease are less infectious, which reduces the risk of their transmitting HIV to others. In FY 2020 and FY 2021, RWHAP will continue to play a central role in ending the HIV epidemic by ensuring that persons living with HIV have access to regular care, receive antiretroviral medications, and adhere to a regular schedule for taking their medications.

Increase the percentage of adults aged 18 years and older who are vaccinated annually against seasonal influenza (Lead Agency - CDC; Measure ID - 1.3.3a)

  FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 FY 2021
Target 50% 53% 56% 59% 62% 66% 70% 70%
Result 44% 42% 43% 38% 45.3% 09/30/20 09/30/21 09/30/22
Status Target Not Met but Improved Target Not Met Target Not Met but Improved Target Not Met Target Not Met but Improved Pending Pending Pending

In the United States, on average 5-20 percent of the population contracts the flu, more than 200,000 people are hospitalized from seasonal flu-related complications, and approximately 36,000 people die from seasonal flu-related causes. This measure reflects the universal influenza vaccination recommendation and aligns with the Advisory Committee on Immunization Practices' updated recommendation (as of 2010) for the seasonal influenza vaccine. Seasonal influenza vaccination rates for adults aged 18 and older increased from 38 percent in FY 2017 to 45.3 percent in FY 2018. Interpretation of these results should take into account limitations of the survey, which include reliance on self-reporting of vaccination status and a decrease in response rates. Preliminary estimates from claims-based data systems showed no decreases in flu vaccination coverage. Four in ten adults report receiving a flu vaccination. In FY 2020 and FY 2021, CDC will continue to monitor the percentage of adults aged 18 and older who receive annual are vaccination against seasonal influenza to inform its strategies for improving adult vaccination coverage rates.

Measure 1.3.3a reflects the universal influenza vaccination recommendation and aligns with the Advisory Committee on Immunization Practices' recommendation (as of 2010) for the seasonal influenza vaccine. Interpretation of these results should take into account limitations of the survey, including reliance on self-report of vaccination status and decreasing response rates. No decreases in flu vaccination coverage were seen in preliminary estimates from claims-based data systems. Flu vaccination coverage among adults remains at about 4 in 10 adults reporting receipt of a flu vaccination.

CDC's efforts to improve adult vaccination coverage rates include:

  • Increasing patient and provider education.
  • Funding state and local health departments to implement the Standards for Adult Immunization Practice.
  • Partnering with professional organizations to develop and implement strategies to improve adult immunization at provider, practice, and systems levels.
  • Enhancing evidence-based communication campaigns to increase public awareness.
  • Expanding the reach of vaccination programs including new venues such as pharmacies and other retail clinics.
  • Designing and funding investigations into the factors associated with disparities in adult vaccination among racial and ethnic populations.

Continue advanced research and development initiatives for more effective influenza vaccines and the development of safe and broad-spectrum therapeutics for use in seriously ill and/or hospitalized patients, including pediatric patients (Lead Agency - ASPR; Measure ID - 2.4.15b)

  FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 FY 2021
Target N/A N/A N/A Baseline 2 2 2 2
Result N/A N/A N/A 2 7 6 12/31/20 12/31/21
Status N/A N/A N/A Actual Target Exceeded Pending Pending Pending

It is estimated that a highly contagious and virulent airborne pathogen, such as a new influenza virus (the "flu"), could kill tens of millions of people globally in less than a year. Influenza and other emerging infectious diseases with pandemic (global epidemic) potential continue to change, evolve, spread geographically, and infect large numbers of animals and humans. Vaccination is a very effective way to prevent these kinds of diseases and prepare for a possible pandemic. Influenza vaccines are generally very safe and serious reactions are uncommon. Effective treatments for those who are severely ill with influenza are critical for pandemic preparedness and effective response. Efforts to prepare for pandemics promote significant benefits during annual flu seasons. HHS continues to expand the national vaccine manufacturing capacity. In addition, partnerships between HHS and private companies has led to improved and modernized influenza vaccine technologies. Such technologies increase vaccine supplies and improve vaccine effectiveness. ASPR supports production of more effective vaccines that have a stronger response and provide more protection to the vaccinated person.

During 2019, ASPR supported manufacturing efficiency improvements expected to achieve an increase in the number of pandemic influenza vaccine doses produced, which led to the incorporation of improved vaccines into the national supplies for seasonal influenza. ASPR assisted programs designed to support the development of improved influenza vaccines or next generation vaccines. In addition, ASPR assisted programs for late stage development of influenza antivirals and therapeutics. These programs include support for antiviral drugs with new and unique novel mechanisms of action. Development of these products improves our pre-pandemic preparedness and supports use of products that address seasonal influenza. In FY 2020 and FY 2021, ASPR will continue to support many initiatives designed to increase our ability to respond to a pandemic response capability and improve the quality of treatments available for response to seasonal influenza. A key component of ASPR's strategy is to speed-up vaccines production. To do this, ASPR supports modern, egg-independent, cell or recombinant-based approaches so that the right vaccine is available in the right place and at the right time.

HHS FY 2020-2021 Agency Priority Goals

The HHS FY 2020-2021 APGs support multiple objectives across the HHS Strategic Plan. For presentation purposes, the Department has chosen to display these APGs under their most closely aligned strategic objectives. For more information on these goals, go to Performance.gov.

Ending the HIV Epidemic. Ending the HIV Epidemic. End the HIV epidemic by reducing new HIV infections through 1) linking people to HIV medical care as quickly as possible so that treatment can be initiated; and 2) preventing HIV through prescribing pre-exposure prophylaxis (PrEP) to those who have indications for PrEP. Starting from the baselines for December 31, 2017, by September 30, 2021:

  • Reduce by 15 percent new HIV infections among persons aged 13 or older.
  • Increase by 15 percent linkage to HIV medical care within one month of diagnosis among persons aged 13 or older.
  • Increase by 15 percent the number of persons with indications for PrEP who are prescribed PrEP.

Kidney Care. Reduce morbidity and mortality associated with end-stage renal disease and increase patient choice by improving access to alternatives to center-based dialysis. Starting from the baseline for the calendar year ending December 31, 2018, by September 30, 2021:

  • Increase by 10 percent the number of new end-stage renal disease patients on home dialysis.
  • Increase by 10 percent the number of kidney transplants performed.

20 Changes in the Ryan White Services Report on how viral suppression data derived before 2015 used a different data collection methodology and are not comparable to data collected using the current methodology.


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