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AIDS 2012: Sebelius unveils public-private collaborations to fight disease

HHS to work with MAC AIDS Fund, Walgreens, others

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Secretary of Health & Human Services Kathleen Sebelius announced four HIV/AIDS private-public initiatives Sunday. (Blade photo by Michael Key)

Health & Human Services Secretary Kathleen Sebelius announced four new public-private initiatives on Sunday night aimed at removing barriers that cause some living with HIV/AIDS within the United States to fall out of care.

Sebelius announced the projects — including a new $4.5 million multi-year project with the MAC AIDS Fund called the Care for Life Initiative — during remarks she delivered as the final speaker on the opening night of the 19th International AIDS Conference, which is being held in the United States for the first time since 1990. An estimated 25,000 are in attendance for the week-long conference in D.C.

“Perhaps the most important principle in our national strategy is one we’ve been reminded of over and over again in our response to HIV/AIDS: none of us can do this alone,” Sebelius said. “That’s why we’re making a new effort to reach to community-based organizations, businesses, foundations, NGOs, faith organizations and more.”

The Care for Life Initiative is a collaboration of the MAC AIDS fund, which was established in 1994 to support people who are living with HIV/AIDS across the world, and has three arms that aim to keep people with HIV/AIDS within care, according to a statement from the organization:

  • A $4 million partnership with AIDS United over the next three years to create an innovation fund on the both the national and regional levels to improve retention in care and treatment adherence. Geographic focuses will be determined based on need and capacity of the local providers to address that need. It will also involve an open call for proposals.
  • Working with the Health Resources and Services Administration, or HRSA, for a pilot launch of UCARE4LIFE, an evidence-based program that will employ mobile texting to improve care retention and medication adherence. With a focus on Southern states, the two-year project consists of developing a message library for delivering phone text notifications to HIV-positive individuals — in English and Spanish — regarding medical appointment reminders and taking medications.
  • MAC AIDS Fund will work with HHS and the President’s Emergency Plan for AIDS Relief to convene a meeting of international leaders in fall 2012 on leveraging global lessons on HIV care. This forum is expected to explore lessons from PEPFAR that can be applied to the United States for best practices on treatment and retention.

According to the MAC AIDS Fund, under the current system, one in two people living with HIV/AIDS in the United States falls out of care.

Nancy Mahon, global executive director of the MAC AIDS Funds, said the Care for Life Initiative is important because it uses new technologies and ideas in its outreach to people with HIV/AIDS.

“We cannot end the epidemic without breakthrough approaches that support and empower those living with HIV/AIDS to stay connected to the care and life-saving treatment they deserve,” Mahon said.

Besides the Care for Life Initiative, Sebelius also hit on the other three initiatives during her remarks. With the pharmaceutical retailer Walgreens, she announced a three-year partnership with the Centers for Disease Control to explore ways in which pharmacies can help patients stay on their medications. According to a news statement, Walgreens is supplying nearly $1 million in in-kind services for this initiative.

With Medscape, a leading provider of online continuing education for U.S. clinicians, Sebelius unveiled partnership training programs with the Centers for Medicare & Medicaid to help clinicians better understand and address HIV patients’ needs. According to a news statement, three new training modules have already been created for physicians, nurses and other medical professionals.

Finally, Sebelius announced that HHS is partnering with the eight largest AIDS drug companies — Abbot Laboratories, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Genentech, Johnson & Johnson, Merck and ViiV — to create a single application form for AIDS medications offered through their patient assistance programs.

“I want to thank all of these partners for stepping up,” Sebelius said. “And we will continue to seek out new public-private collaborations that will help us beat this disease.”

In addition to announcing the new public-private partnerships, Sebelius also revealed that the Food & Drug Administration would announce this week that more than 150 antiretroviral drugs are now available through PEPFAR.

The secretary also enumerated earlier initiatives of the Obama administration, including last week’s decision to distribute nearly $80 million to the states “to allow them to fully clear” wait lists for AIDS Drug Assistance Programs, which provide HIV/AIDS drugs to low-income people. An estimated 2,000 people nationwide had been awaiting drugs through programs.

According to a statement from HHS, around $69 million will be sent to 25 states and territories and, based on estimates provided by the states, will eliminate any waiting lists. The remaining $10 million — a portion of which was allocated by the Affordable Care Act — will be distributed to community-based health clinics nationwide to expand access for 14,000 new HIV/AIDS patients for medical and support services.

Other initiatives against HIV/AIDS under the Obama administration that Sebelius touted were recent FDA approval of an at-home HIV test and using Truvada to prevent HIV infection. Sebelius also credited the Bush administration, calling PEPFAR, which was established under the previous administration, one of “the great health success stories of the 21st century.”

“Our task now is to make it even stronger,” Sebelius said.

“Under President Obama, we’re on pace to achieve an ambitious goal of reaching an additional two million people around the world with life-saving treatment by the end of 2013. At the same time, we’re putting a renewed focus on the key ‘combination prevention’ interventions that have proven most effective in combating HIV.”

The secretary’s mention of PEPFAR received among the most applause of anything discussed that evening before an audience that included many HIV/AIDS advocates from overseas. Obama’s fiscal year 2013 budget request cuts the program by half a billion dollars, but the White House has said PEPFAR is an example of a program that is doing more with less because of the reduced cost of drugs.

Sebelius wasn’t the only public official representing the United States on the stage during the opening night of the conference. Rep. Barbara Lee (D-Calif.), a renowned LGBT and HIV/AIDS advocate, also spoke on stage to call for an end to the epidemic, observing it has had a particularly devastating impact on black Americans.

“Although AIDS has made the transition from a death sentence to a chronic disease, new infections unfortunately continue at alarming rates,” Lee said. “HIV/AIDS disproportionately affects no group of people in our country more than African Americans. Of the 1.4 million people in the United States living with HIV, nearly half are black men and women, even though blacks make up 14 percent of the population.”

Last week, Lee announced that had introduced into the U.S. House legislation called the “Ending the HIV/AIDS Epidemic Act.” The bill has 26 co-sponsors who are all Democrats and aims to establish a policy and financing framework to eliminate AIDS domestically and abroad.

The bill aims to fight HIV/AIDS by providing additional funds for programs such as the AIDS Drug Assistance Programs; addressing policy barriers to accessing prevention and care, such as encouraging condom use in prisons; and calling for a more advanced strategy overseas to end the global AIDS epidemic.

D.C. Mayor Vincent Gray (Washington Blade photo by Michael Key)

D.C. Mayor Vincent Gray also took to the stage to welcome international attendees to D.C. and talk about how HIV/AIDS has impacted the city.

“HIV/AIDS has crossed all racial, ethnic, religious and socio-economic borders,” Gray said. “It is a disease that knows no boundaries.”

According to Gray, an estimated 20,000 people in D.C. have been infected with HIV/AIDS, and 10,000 residents have died as a result of the disease.

Other speakers on Sunday were Annah Sango, a Zimbabwe advocate living with HIV who seeks visibility for female patients, World Bank President Jim Yong Kim, who said he was the first World Bank president to the address the international conference, UNAIDS Executive Director Michel Sidibé, South African Deputy President Kgalema Motlanthe and Mark Dybul, global AIDS coordinator for President George W. Bush who touted that administration’s achievements in the global AIDS fight.

The co-chairs of the conference, Elly Katabira, a Ugandan activist and president of the International AIDS Society, and Diane Havlir, chief of HIV/AIDS Division at the University of California, San Francisco, welcomed attendees to the conference. U.N. Secretary General Ban Ki-Moon prepared a video message for attendees.

Also on Sunday, the White House unveiled a video message from Obama welcoming the international attendees to the conference. The video message was prepared in lieu of a live appearance by Obama at the conference.

In the video, Obama talks about HIV/AIDS advocates’ commitment to fighting the disease and a voice-over talks about discovery of the disease in the 1980s as well as activism and scientific advances to thwart it.

Watch the video below:

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State Department

State Department releases annual human rights report

Antony Blinken reiterates criticism of Uganda’s Anti-Homosexuality Act

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(Photo courtesy of the Library of Congress)

Secretary of State Antony Blinken on Monday once again reiterated his criticism of Uganda’s Anti-Homosexuality Act upon release of the State Department’s annual human rights report.

“This year’s report also captures human rights abuses against members of vulnerable communities,” he told reporters. “In Afghanistan, the Taliban have limited work opportunities for women, shuttered institutions found educating girls, and increasing floggings for women and men accused of, quote, ‘immoral behavior,’ end quote. Uganda passed a draconian and discriminatory Anti-Homosexuality Act, threatening LGBTQI+ individuals with life imprisonment, even death, simply for being with the person they loved.”

Ugandan President Yoweri Museveni last May signed the law, which contains a death penalty provision for “aggravated homosexuality.”

The U.S. subsequently imposed visa restrictions on Ugandan officials and removed the country from a program that allows sub-Saharan African countries to trade duty-free with the U.S. The World Bank Group also announced the suspension of new loans to Uganda.

Uganda’s Constitutional Court earlier this month refused to “nullify the Anti-Homosexuality Act in its totality.” More than a dozen Ugandan LGBTQ activists have appealed the ruling.

Clare Byarugaba of Chapter Four Uganda, a Ugandan LGBTQ rights group, on Monday met with National Security Council Chief-of-Staff Curtis Ried. Jay Gilliam, the senior LGBTQI+ coordinator for the U.S. Agency for International Development, in February traveled to Uganda and met with LGBTQ activists who discussed the Anti-Homosexuality Act’s impact. 

“LGBTQI+ activists reported police arrested numerous individuals on the basis of their sexual orientation or gender identity and subjected many to forced anal exams, a medically discredited practice with no evidentiary value that was considered a form of cruel, inhuman, and degrading treatment and could amount to torture,” reads the human rights report.

The report, among other things, also notes Ugandan human rights activists “reported numerous instances of state and non-state actor violence and harassment against LGBTQI+ persons and noted authorities did not adequately investigate the cases.”

Report highlights anti-LGBTQ crackdowns in Ghana, Hungary, Russia

Ghanaian lawmakers on Feb. 28 approved the Promotion of Proper Human Sexual Rights and Ghanaian Family Values Bill. The country’s president, Nana Akufo-Addo, has said he will not sign the measure until the Ghanaian Supreme Court rules on whether it is constitutional or not.

The human rights report notes “laws criminalizing consensual same-sex sexual conduct between adults” and “crimes involving violence or threats of violence targeting lesbian, gay, bisexual, transgender, queer or intersex persons” are among the “significant human rights issues” in Ghana. 

The report documents Hungarian Prime Minister Viktor Orbán and members of his right-wing Fidesz party’s continued rhetoric against “gender ideology.” It also notes Russia’s ongoing crackdown against LGBTQ people that includes reports of “state actors committed violence against LGBTQI+ individuals based on their sexual orientation or gender identity, particularly in Chechnya.”

The report specifically notes Russian President Vladimir Putin on July 24 signed a law that bans “legal gender recognition, medical interventions aimed at changing the sex of a person, and gender-affirming care.” It also points out Papua New Guinea is among the countries in which consensual same-sex sexual relations remain criminalized.

The Hungarian Parliament on April 4, 2024. Prime Minister Viktor Orbán and his right-wing Fidesz party in 2023 continued their anti-LGBTQ crackdown. (Washington Blade photo by Michael K. Lavers)

The Cook Islands and Mauritius in decriminalized homosexuality in 2023.

The report notes the Namibia Supreme Court last May ruled the country must recognize same-sex marriages legally performed outside the country. The report also highlights the Indian Supreme Court’s ruling against marriage equality that it issued last October. (It later announced it would consider an appeal of the decision.)

Congress requires the State Department to release a human rights report each year. 

The Biden-Harris administration in 2021 released a memorandum that committed the U.S. to promoting LGBTQ+ and intersex rights abroad.

The full report can be read here.

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National

Same-sex couples vulnerable to adverse effects of climate change

Williams Institute report based on Census, federal agencies

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Beach erosion in Fire Island Pines, N.Y. (Photo courtesy of Savannah Farrell / Actum)

A new report by the Williams Institute at the UCLA School of Law finds that same-sex couples are at greater risk of experiencing the adverse effects of climate change compared to different-sex couples.

LGBTQ people in same-sex couple households disproportionately live in coastal areas and cities and areas with poorer infrastructure and less access to resources, making them more vulnerable to climate hazards.

Using U.S. Census data and climate risk assessment data from NASA and the Federal Emergency Management Agency, researchers conducted a geographic analysis to assess the climate risk impacting same-sex couples. NASA’s risk assessment focuses on changes to meteorological patterns, infrastructure and built environment, and the presence of at-risk populations. FEMA’s assessment focuses on changes in the occurrence of severe weather events, accounting for at-risk populations, the availability of services, and access to resources.

Results show counties with a higher proportion of same-sex couples are, on average, at increased risk from environmental, infrastructure, and social vulnerabilities due to climate change.

“Given the disparate impact of climate change on LGBTQ populations, climate change policies, including disaster preparedness, response, and recovery plans, must address the specific needs and vulnerabilities facing LGBTQ people,” said study co-author Ari Shaw, senior fellow and director of international programs at the Williams Institute. “Policies should focus on mitigating discriminatory housing and urban development practices, making shelters safe spaces for LGBT people, and ensuring that relief aid reaches displaced LGBTQ individuals and families.”

“Factors underlying the geographic vulnerability are crucial to understanding why same-sex couples are threatened by climate change and whether the findings in our study apply to the broader LGBTQ population,” said study co-author Lindsay Mahowald, research data analyst at the Williams Institute. “More research is needed to examine how disparities in housing, employment, and health care among LGBT people compound the geographic vulnerabilities to climate change.”

Read the report

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Federal Government

Lambda Legal praises Biden-Harris administration’s finalized Title IX regulations

New rules to take effect Aug. 1

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U.S. Secretary of Education Miguel Cardona (Screen capture: AP/YouTube)

The Biden-Harris administration’s revised Title IX policy “protects LGBTQ+ students from discrimination and other abuse,” Lambda Legal said in a statement praising the U.S. Department of Education’s issuance of the final rule on Friday.

Slated to take effect on Aug. 1, the new regulations constitute an expansion of the 1972 Title IX civil rights law, which prohibits sex-based discrimination in education programs that receive federal funding.

Pursuant to the U.S. Supreme Court’s ruling in the landmark 2020 Bostock v. Clayton County case, the department’s revised policy clarifies that discrimination on the basis of sexual orientation and gender identity constitutes sex-based discrimination as defined under the law.

“These regulations make it crystal clear that everyone can access schools that are safe, welcoming and that respect their rights,” Education Secretary Miguel Cardona said during a call with reporters on Thursday.

While the new rule does not provide guidance on whether schools must allow transgender students to play on sports teams corresponding with their gender identity to comply with Title IX, the question is addressed in a separate rule proposed by the agency in April.

The administration’s new policy also reverses some Trump-era Title IX rules governing how schools must respond to reports of sexual harassment and sexual assault, which were widely seen as imbalanced in favor of the accused.

Jennifer Klein, the director of the White House Gender Policy Council, said during Thursday’s call that the department sought to strike a balance with respect to these issues, “reaffirming our longstanding commitment to fundamental fairness.”

“We applaud the Biden administration’s action to rescind the legally unsound, cruel, and dangerous sexual harassment and assault rule of the previous administration,” Lambda Legal Nonbinary and Transgender Rights Project Director Sasha Buchert said in the group’s statement on Friday.

“Today’s rule instead appropriately underscores that Title IX’s civil rights protections clearly cover LGBTQ+ students, as well as survivors and pregnant and parenting students across race and gender identity,” she said. “Schools must be places where students can learn and thrive free of harassment, discrimination, and other abuse.”

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