We are at the first anniversary of the Oct. 7 attack launched against Israel by the terrorist organization Hamas. In that attack nearly 1,200 Israelis were slaughtered, many women sexually mutilated, and 251 hostages taken. There are 97 hostages still unaccounted for. We must never forget who began this war on Oct. 7, 2023, and recognize this is a war between Israel and Hamas, not Israel and the Palestinian people.

I am an American Jew whose parents escaped Hitler, and whose grandparents were killed in Auschwitz. While I will never forget, or forgive Hamas, over the past year I have written about how poorly the far-right Israeli government of Israel has responded. They have every right to defend themselves, but it appears many of the deaths of innocent Palestinian women and children, should have been avoided. But Hamas must take responsibility for these deaths as well as Israel. They hide in tunnels beneath hospitals and houses, and in the midst of Palestinian civilians. Both sides have refused to agree to any ceasefire terms. Reality is had Hamas agreed to return the hostages, including 30 Americans, and many from other countries, many of the Palestinian deaths could have been avoided. We don’t even know if the close to 100 hostages they still hold, are dead or alive. 

Over the past year the Palestinian people in Gaza have had their lives torn apart. Their homes have been bombed, and thousands of women and children have died. Much of Gaza has been destroyed. Their healthcare system destroyed, and many are starving, living without any power. Once again, let us not forget who began this war. The stated aim of some Hamas leaders when they began the war was to draw Israel into a wider war. While that may now be happening, contrary to what Hamas wanted, Israel is winning it, and the Arab countries surrounding Israel, are not coming to the aid of the Palestinian people.

No one should feel joy in any of this. It means more innocent people are dying every day. Israelis in the north have been evacuated from their homes and many killed, and there isn’t a family in Israel not impacted. The Palestinian people are still suffering and have not rid themselves of Hamas, even though some are now speaking out saying they want to. I am not sure how they can do that. Then the Israeli people have still not rid themselves of Netanyahu, and his right-wing government, and they have better options to do that, and must take them if they ever want lasting peace. 

Today we see the terrorist group Hezbollah continue to bomb Israel, and now Israel is expanding its fight in Lebanon. Hezbollah is losing and innocents in Lebanon are losing their homes, and their lives. Hezbollah, like Hamas, is a terrorist group funded by Iran. The legitimate government in Lebanon cannot control them. Iran, which funds terrorist organizations against Israel, has now directly fired a second round of missiles into Israel. They didn’t expect the Arab nations surrounding Israel would come to Israel’s aid the first time, but they did, in some ways to protect themselves from the missiles. The United States, whose ships are stationed off shore, shot down Iranian missiles and Israel’s Iron Dome protected it from major casualties or destruction. Again, if Hamas thought the Arab nations around Israel would come to their aid, they have been proven wrong. If Israel goes after Iran directly, which the United States is officially urging them not to do, the war could spread further. Iranian oil fields and ports are at risk, which will impact the world. Iran has no Iron Dome.

So, after a year, what has Hamas accomplished? What have they done for the Palestinian people? Are the Palestinian people any better off? Clearly not. We have seen Palestinian students here in the United States, and around the world, trying to get universities and corporations to disinvest from Israel, as the BDS movement has tried for years. But there has been practically no impact at all. Investment money has not been withdrawn from Israel, and no country has withdrawn from their treaty with Israel. I spoke out and wrote, as have many Jews over the past year, asking Israel to declare a unilateral ceasefire in the war with Hamas to allow food and medicine to be delivered into Gaza. They haven’t done that, but then Hamas has not agreed to any ceasefire. 

I support a two-state solution giving the Palestinian people their own state, which their leaders turned down in 1947 when it was offered by the United Nations. We saw in Israel’s 1948 ‘War for Independence,’ as it was called, the surrounding Arab states did nothing to help the Palestinians, rather fought to take more land for themselves. I believe an eventual two-state solution is the only way the Palestinian people will ever be able to live in peace, and the same for the Israeli people. It will only happen if outside nations join together and guarantee Israel will be secure. If that happens, the rest of the world will have to pledge hundreds of billions of dollars to help a new Palestinian state build a sustainable economy. All of this may be wishful thinking, but it seems to be the only answer to secure a lasting peace. 

In the meantime, I join everyone who mourns the lives of the innocents lost this past year, both Israelis and Palestinians, and now those in Lebanon. The world must find a way to end this carnage. 

Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.

I read with interest the article published in the Washington Blade stating that the Republican candidate for Delaware’s 14th Representative District supports LGBTQ rights and specifically “legislation protecting transgender people.” I am glad that this lifelong Delawarean and resident of the legislative district with the largest number of LGBTQ people in Delaware is in support of our community. I do not question what is in his heart. I also do not care what is in his heart or the heart of any person seeking or serving in elective office. I care only about what they have done before they decided to seek public office, and what they do once in office.

I served on the board of Delaware Stonewall Democrats and its successor Delaware Stonewall PAC from 2006 to 2021. During that period, I served as either political vice president or president. I was heavily involved with the passage of all LGBTQ legislation in Delaware. That involvement included the passage of Hospital Visitation Rights and anti-discrimination laws in 2009 up to and including the passage of both marriage equality and transgender protections in 2013. I never saw Republican candidate Simpler at any event, fundraiser or lobbying effort for our bills.

It is because Simpler, from a local politically active family, is not known to ever actively support the efforts of our community, a community with a significant number of voters in the district he seeks to represent, that I must question the motives behind his expressing his support in the Blade now. I have not seen such expressions of support in his campaign literature or advertising supporting his candidacy. Delaware, and this area, have had more than their share of office seekers, of both parties, expressing their support, even love, for the LGBTQ community and then doing NOTHING to advance our rights once elected. I fear Simpler is just the latest. However, there is a clear alternative.

Claire Snyder Hall is the Democratic candidate. She is also a member of the LGBTQ community and, in her personal capacity and during her years as executive director of Common Cause, Delaware, has supported and even lobbied for all the legislation mentioned above. Knowing that, LGBTQ members of the 14th Representative District, and their allies, have no reason to look beyond Claire to find a representative who we know will have our backs — it is her back too. Claire is the former chair of the 14th Representative District Democratic Committee, during my term as chair of the Sussex County Democratic Committee, and she is endorsed by Delaware Stonewall. I thank Simpler for “supporting” our community and transgender rights. However,  I support and have contributed to Claire Snyder Hall, who has a track record of helping us achieve those rights.     

Mitch Crane is a former president of Delaware Stonewall PAC and a resident of Lewes, Del. 

The Biden-Harris administration has a historic opportunity to help end HIV. New, cutting-edge drugs that prevent HIV are hitting the market, but insurance companies are trying to twist the rules to deny access to these remarkable therapies.

The White House could stop these abuses and put the country on the right course for decades ahead and prevent hundreds of thousands of new HIV transmissions.

Pre-Exposure Prophylaxis (PrEP) drugs represent one of the strongest tools we have to combat HIV. These highly effective therapies can reduce the risk of contracting HIV by up to 99%. So far, the FDA has approved two once-daily PrEP pills, and in 2021 approved the first long-acting version of PrEP. Other groundbreaking PrEP innovations, such as a biannual dosage form, are in active development. 

PrEP is a major reason why new HIV infections dropped 12% from 2018 to 2022. Yet there’s still work to do. Currently, just 36% of people who could benefit from PrEP are using it. Racial and ethnic groups face wide disparities in PrEP uptake. For example, Black individuals constitute 39% of new HIV diagnoses but only 14% of PrEP users. Hispanics make up 31 percent of new HIV diagnoses, but only 18 percent of PrEP users.

A new federal directive, if properly enforced, could help close these gaps. In August 2023, a panel of prevention experts issued an updated recommendation to clinicians, recommending PrEP — including long-acting forms of the drugs — to people who want to prevent HIV acquisition. Under the Affordable Care Act, most newly issued private health plans must cover without patient cost-sharing to comply with this recommendation beginning this month.

Yet many HIV experts and patient advocates have raised concerns that insurers could misinterpret — or downright ignore — the task force’s decision and keep barriers to PrEP in place. 

One top concern is that insurance companies could decide to cover only one kind of PrEP, even though the task force’s recommendation isn’t drug-specific — it applies to all versions. For example, a health plan might refuse to cover long-acting PrEP and force patients to take oral pills instead. 

Yet long-acting PrEP is a critical option for many patients, such as those who struggle to adhere to once-daily drug regimens, are unhoused, or have confidentiality concerns. One study found that patients taking long-acting PrEP had a 66% reduction in HIV infections compared to those using oral pills. Another analysis calculated that long-acting PrEP could help avert 87% more HIV cases than oral pills, and could save over $4 billion over the course of a decade.

Another concern relates to insurers’ increasing use of “prior authorization,” a practice in which health plans refuse to cover certain drugs unless doctors obtain prior permission. Insurers could also force patients to try a number of therapeutic alternatives before agreeing to cover the medicine they and their doctors agreed upon — this is known as “step therapy.” There’s evidence that “prior authorization” policies may disproportionately impact Black and Hispanic individuals, who are already at higher risk of HIV.

Fortunately, these insurer-imposed barriers aren’t inevitable. The Biden-Harris administration, through the Centers for Medicare & Medicaid Services (CMS), has an opportunity to issue clear, detailed guidance that ensures health plans follow through on the legal requirement to cover PrEP for all eligible patients and at no cost.

CMS’s guidance should clarify that insurance companies are obliged to cover all FDA-approved versions of PrEP, including both daily pills and long-acting injectables. When now Vice President Harris was Sen. Harris, she introduced groundbreaking legislation called the PreP Access and Coverage Act, which would require all insurers to cover all forms of PrEP without cost-sharing and prior authorizations. So we know where she stands on the issue. 

A number of states, including New York and California, have already established similar coverage requirements and prohibitions on prior authorization for PrEP. 

A similar requirement already exists for contraception. Plans are required “to cover without cost sharing any contraceptive services and FDA-approved, -cleared, or -granted contraceptive products that an individual’s attending provider determined to be medically appropriate.”  

CMS just needs to adopt language along these lines for PrEP. Doctors — not insurance companies — should decide which drugs best suit patients’ needs.

Thanks to revolutionary research happening every day, people with a reason to be on PrEP have more options available to them than ever before. Yet insurers are intent on restricting access to these innovative therapies. New federal guidance can help combat this and if properly enforced set us on a path toward ending HIV.

Carl Schmid is executive director of the HIV+Hepatitis Policy Institute.