Connect with us

Health

Obama AIDS panel bucks White House on drug funds

Resolution calls for $126 million ADAP emergency measure

Published

on

Members of the Presidential Advisory Council on HIV/AIDS this week called on President Obama and Congress to approve $126 million in emergency funds for the struggling AIDS Drug Assistance Program. (Photo by Pete Souza, courtesy White House)

President Obama’s newly appointed Presidential Advisory Council on HIV/AIDS adopted a resolution Tuesday urging the White House and Congress to do something they have been reluctant to do: approve $126 million in emergency funds for the struggling AIDS Drug Assistance Program.

The federal program, which is operated jointly with states, provides subsidies for life-saving anti-retroviral drugs needed by low-income people with HIV and AIDS who lack health insurance coverage.

Due to several developments, including sharp budget cuts by states, a record 1,924 people eligible to enroll in the program in 11 states have been placed on waiting lists as state ADAPs have run out of money to pay for the drugs, state officials have said. The waiting lists are expected to grow in the coming weeks and months.

AIDS activists have criticized the White House and Democratic leaders in Congress for not taking immediate steps to push the emergency funding this year, saying people on the waiting lists face possible life-threatening illnesses related to HIV without their medication.

More than 50 members of the House, including gay Reps. Barney Frank (D-Mass.) and Tammy Baldwin (D-Wis.) sent a petition to the White House earlier this year calling for $126 million in supplemental funds for ADAP in the current fiscal year.

The presidential AIDS panel, known as PACHA, adopted its resolution at a special conference call meeting Tuesday.

The conference call came after some PACHA members complained that the panel was distracted from adopting the resolution and addressing other important business at its previous in-person meeting at the White House in April by administration staffers who overly “stage managed” the meeting, according to insiders familiar with the panel.

The 24-member PACHA includes seven out gay members. It’s chaired by Dr. Helen Gale, a nationally recognized AIDS physician and former top official at the U.S. Centers for Disease Control & Prevention.

“I don’t think the PACHA is being stage managed, but I do think that it is being over handled,” said PACHA member Phill Wilson, executive director of the Black AIDS Institute in Los Angeles.

Wilson said it would be an exaggeration to characterize as a “rebellion” the call by PACHA members for a special meeting this week to vote on the ADAP resolution, as one source familiar with PACHA called it.

But he said PACHA members assigned to a subcommittee that monitors ADAP issues made it clear that it would be unacceptable for the advisory body to wait until its next regularly scheduled meeting in September to take up the ADAP issue.

Wilson and fellow PACHA member A. Cornelius Baker, former executive director of the National Association of People with AIDS and the Whitman-Walker Clinic, said the newly reconstituted PACHA appeared to be having some organizational and logistical problems.

Among other things, Baker and PACHA member Rosie Perez, actress and AIDS activist, expressed concern at the April meeting that White House officials arranged for the meeting to be held in an auditorium at the Eisenhower Executive Office Building next to the White House that was not conducive for members to conduct business.

Most of the first day of the two-day meeting in April was devoted to listening to comments by members of the public, including AIDS activists. Although a precedent for listening to public comments began under the Clinton administration, one AIDS activist attending the April meeting said it evolved into a “chaotic” town hall type meeting that prevented members — who were appointed for their expertise in various aspects of public health, medicine and public policy — from tackling issues such as ADAP.

Sessions on the second day were not open to the public, raising questions that administration staffers violated a federal law that requires all federal government advisory bodies to conduct business in public.

Christopher Bates, PACHA’s staff executive director, told activists who complained about the closed meeting that the session was limited to discussing “administrative” matters and no official business was conducted.

Wilson and Baker said this week that the White House and the Department of Health & Human Services, which has direct supervision over PACHA, were working to correct the problems, with the possibility that new meeting space would be found.

But new organizational and technical issues surfaced during Tuesday’s conference call when an audio muting mechanism prevented members of the public who were approved in advance to speak from being heard by Gale, who presided over the call.

When a roll call vote was taken on the ADAP resolution, some of the PACHA members also could not be heard, alerting the staff that a technical glitch kept the PACHA members’ phone on mute.

As required by a federal advisory body statute, the conference call meeting was announced two weeks earlier in the Federal Register, which instructed people interested in speaking during a public comment period how to dial in to the call.

A technician facilitating the conference call eventually lifted the muting mechanism to allow everyone to speak. But shortly after that happened, someone apparently called the meeting to an end while the phone lines remained open. At least two callers expressed outrage that they were not allowed to speak, and several callers began their own discussion before someone terminated the conference call.

Before the confusion began, Gale announced the roll call vote had been completed and the resolution calling for the $126 million emergency ADAP funds had been approved.

Prior to the discussion and vote on the resolution, HHS official Deborah Parham told call participants the administration would allocate $17.5 million in Ryan White funds in August that states could use for their ADAP programs. She said additional Ryan White funds were available to help struggling states in their overall programs to assist people with HIV/AIDS.

HHS recognizes “the need to improve access to critical HIV/AIDS prescription drugs and we’re working to prevent and ultimately eliminate the need for ADAP waiting lists,” Parham told call participants. But she did not say whether the administration would agree to the $126 million emergency funding allocation for ADAP called for by the PACHA resolution.

President Bill Clinton created PACHA in the 1990s. President George W. Bush retained the panel and continued Clinton’s practice of naming several gays to serve on PACHA, including several gay Republican activists.

The Obama administration did not call any PACHA meetings in its first year in office, prompting some activists to ask if the new administration planned to retain the panel. But in February, the White House disclosed it had dismissed all PACHA members appointed by Bush and introduced what it called a “reconstituted” PACHA with 24 new members.

According to Jeff Crowley, director of the White House Office of National AIDS Policy, the new members were appointed by Health & Human Services Secretary Kathleen Sebelius with White House consultation.

At the first meeting Feb. 2, Sebelius administered the oath of office for members and said she and the White House would utilize PACHA as a “platform for the administration to share our plans and insights” on AIDS programs and proposals.

“Today, I’m pleased to have a new group of experts joining PACHA,” Obama said in a statement released at the February meeting. “And I look forward to hearing from the council about our continued efforts to prevent the spread of HIV infections in the United States and to provide care and treatment to people living with HIV/AIDS around the world.”

Advertisement
FUND LGBTQ JOURNALISM
SIGN UP FOR E-BLAST

Monkeypox

US contributes more than $90 million to fight mpox outbreak in Africa

WHO and Africa CDC has declared a public health emergency

Published

on

The U.S. has contributed more than $90 million to the fight against the mpox outbreak in Africa. (Photo courtesy of the Centers for Disease Control and Prevention)

The U.S. has contributed more than $90 million to the fight against the mpox outbreak in Africa.

The U.S. Agency for International Development on Tuesday in a press release announced “up to an additional” $35 million “in emergency health assistance to bolster response efforts for the clade I mpox outbreak in Central and Eastern Africa, pending congressional notification.” The press release notes the Biden-Harris administration previously pledged more than $55 million to fight the outbreak in Congo and other African countries.

“The additional assistance announced today will enable USAID to continue working closely with affected countries, as well as regional and global health partners, to expand support and reduce the impact of this outbreak as it continues to evolve,” it reads. “USAID support includes assistance with surveillance, diagnostics, risk communication and community engagement, infection prevention and control, case management, and vaccination planning and coordination.” 

The World Health Organization and the Africa Centers for Disease Control and Prevention last week declared the outbreak a public health emergency.

The Washington Blade last week reported there are more than 17,000 suspected mpox cases across in Congo, Uganda, Kenya, Rwanda, and other African countries. The outbreak has claimed more than 500 lives, mostly in Congo. 

Continue Reading

Health

Mpox outbreak in Africa declared global health emergency

ONE: 10 million vaccine doses needed on the continent

Published

on

The declaration of a public health emergency over an mpox outbreak in Africa has prompted calls for additional vaccine doses for the continent. (Photo courtesy of the Centers for Disease Control and Prevention)

Medical facilities that provide treatment to gay and bisexual men in some East African countries are already collaborating with them to prevent the spread of a new wave of mpox cases after the World Health Organization on Wednesday declared a global health emergency.

The collaboration, both in Uganda and Kenya, comes amid WHO’s latest report released on Aug. 12, which reveals that nine out of every 10 reported mpox cases are men with sex as the most common cause of infection. 

The global mpox outbreak report — based on data that national authorities collected between January 2022 and June of this year — notes 87,189 of the 90,410 reported cases were men. Ninety-six percent of whom were infected through sex.

Sexual contact as the leading mode of transmission accounted for 19,102 of 22,802 cases, followed by non-sexual person-to-person contact. Genital rash was the most common symptom, followed by fever and systemic rash.

The WHO report states the pattern of mpox virus transmission has persisted over the last six months, with 97 percent of new cases reporting sexual contact through oral, vaginal, or anal sex with infected people. 

“Sexual transmission has been recorded in the Democratic Republic of Congo among sex workers and men who have sex with men,” the report reads. “Among cases exposed through sexual contact in the Democratic Republic of the Congo, some individuals present only with genital lesions, rather than the more typical extensive rash associated with the virus.”

The growing mpox cases, which are now more than 2,800 reported cases in at least 13 African countries that include Kenya, Uganda, Rwanda, and prompted the Africa Centers for Disease Control and Prevention this week to declare the disease a public health emergency for resource mobilization on the continent to tackle it.

“Africa has long been on the frontlines in the fight against infectious diseases, often with limited resources,” said Africa CDC Director General Jean Kaseya. “The battle against Mpox demands a global response. We need your support, expertise, and solidarity. The world cannot afford to turn a blind eye to this crisis.” 

The disease has so far claimed more than 500 lives, mostly in Congo, even as the Africa CDC notes suspected mpox cases across the continent have surged past 17,000, compared to 7,146 cases in 2022 and 14,957 cases last year.   

“This is just the tip of the iceberg when we consider the many weaknesses in surveillance, laboratory testing, and contact tracing,” Kaseya said.  

WHO, led by Director General Tedros Adhanom Ghebreyesus, also followed the Africa CDC’s move by declaring the mpox outbreak a public health emergency of international concern.

The latest WHO report reveals that men, including those who identify as gay and bisexual, constitute most mpox cases in Kenya and Uganda. The two countries have recorded their first cases, and has put queer rights organizations and health care centers that treat the LGBTQ community on high alert. 

The Uganda Minority Shelters Consortium, for example, confirmed to the Washington Blade that the collaboration with health service providers to prevent the spread of mpox among gay and bisexual men is “nascent and uneven.” 

“While some community-led health service providers such as Ark Wellness Clinic, Children of the Sun Clinic, Ice Breakers Uganda Clinic, and Happy Family Youth Clinic, have demonstrated commendable efforts, widespread collaboration on mpox prevention remains a significant gap,” UMSC Coordinator John Grace stated. “This is particularly evident when compared to the response to the previous Red Eyes outbreak within the LGBT community.”

Grace noted that as of Wednesday, there were no known queer-friendly health service providers to offer mpox vaccinations to men who have sex with men. He called for health care centers to provide inclusive services and a more coordinated approach.

Although Grace pointed out the fear of discrimination — and particularly Uganda’s Anti-Homosexuality Act — remains a big barrier to mpox prevention through testing, vaccination, and treatment among queer people, he confirmed no mpox cases have been reported among the LGBTQ community.

Uganda so far has reported two mpox cases — refugees who had travelled from Congo.

“We are for the most part encouraging safer sex practices even after potential future vaccinations are conducted as it can also be spread through bodily fluids like saliva and sweat,” Grace said. 

Grace also noted that raising awareness about mpox among the queer community and seeking treatment when infected remains a challenge due to the historical and ongoing homophobic stigma and that more comprehensive and reliable advocacy is needed. He said Grindr and other digital platforms have been crucial in raising awareness.

The declarations of mpox as a global health emergency have already attracted demand for global leaders to support African countries to swiftly obtain the necessary vaccines and diagnostics.

“History shows we must act quickly and decisively when a public health emergency strikes. The current Mpox outbreak in Africa is one such emergency,” said ONE Global Health Senior Policy Director Jenny Ottenhoff.

ONE is a global, nonpartisan organization that advocates for the investments needed to create economic opportunities and healthier lives in Africa.

Ottenhoff warned failure to support the African countries with medical supplies needed to tackle mpox would leave the continent defenseless against the virus.  

To ensure that African countries are adequately supported, ONE wants governments and pharmaceutical companies to urgently increase the provision of mpox vaccines so that the most affected African countries have affordable access to them. It also notes 10 million vaccine doses are currently needed to control the mpox outbreak in Africa, yet the continent has only 200,000 doses.

The Blade has reached out to Ishtar MSM, a community-based healthcare center in Nairobi, Kenya, that offers to service to gay and bisexual men, about their response to the mpox outbreak. 

Continue Reading

Health

White House urged to expand PrEP coverage for injectable form

HIV/AIDS service organizations made call on Wednesday

Published

on

Apretude is a long-lasting PrEP injection that has proven to be significantly more effective at reducing the risk of sexually-acquired HIV. (Photo courtesy of ViiV Healthcare)

A coalition of 63 organizations dedicated to ending HIV called on the Biden-Harris administration on Wednesday to require insurers to cover long-acting pre-exposure prophylaxis (PrEP) without cost-sharing.

In a letter to Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services, the groups emphasized the need for broad and equitable access to PrEP free of insurance barriers.

Long-acting PrEP is an injectable form of PrEP that’s effective over a long period of time. The FDA approved Apretude (cabotegravir extended-release injectable suspension) as the first and only long-acting injectable PrEP in late 2021. It’s intended for adults and adolescents weighing at least 77 lbs. who are at risk for HIV through sex.

The U.S. Preventive Services Task Force updated its recommendation for PrEP on Aug. 22, 2023, to include new medications such as the first long-acting PrEP drug. The coalition wants CMS to issue guidance requiring insurers to cover all forms of PrEP, including current and future FDA-approved drugs.

“Long-acting PrEP can be the answer to low PrEP uptake, particularly in communities not using PrEP today,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “The Biden administration has an opportunity to ensure that people with private insurance can access PrEP now and into the future, free of any cost-sharing, with properly worded guidance to insurers.”

Currently, only 36 percent of those who could benefit from PrEP are using it. Significant disparities exist among racial and ethnic groups. Black people constitute 39 percent of new HIV diagnoses but only 14 percent of PrEP users, while Latinos represent 31 percent of new diagnoses but only 18 percent of PrEP users. In contrast, white people represent 24 percent of HIV diagnoses but 64 percent of PrEP users.

The groups also want CMS to prohibit insurers from employing prior authorization for PrEP, citing it as a significant barrier to access. Several states, including New York and California, already prohibit prior authorization for PrEP.

Modeling conducted for HIV+Hep, based on clinical trials of a once every 2-month injection, suggests that 87 percent more HIV cases would be averted compared to daily oral PrEP, with $4.25 billion in averted healthcare costs over 10 years.

Despite guidance issued to insurers in July 2021, PrEP users continue to report being charged cost-sharing for both the drug and ancillary services. A recent review of claims data found that 36 percent of PrEP users were charged for their drugs, and even 31 percent of those using generic PrEP faced cost-sharing.

The coalition’s letter follows a more detailed communication sent by HIV+Hepatitis Policy Institute to the Biden administration on July 2.

Signatories to the community letter include Advocates for Youth, AIDS United, Equality California, Fenway Health, Human Rights Campaign, and the National Coalition of STD Directors, among others.

Continue Reading
Advertisement World Pride Guide
Advertisement
Advertisement

Sign Up for Weekly E-Blast

Follow Us @washblade

Advertisement

Popular