Opinion Editorial by: Taylor Weyeneth, Managing Director of 20K Strategies
Posted on WashingtonExaminer.com.
President Trump has a plan to stop the HIV epidemic by 2030. It's an ambitious and worthy goal that some people seem to think is unattainable.
However, the Trump administration is already chipping away at the epidemic and improving the prospects for success by using one little-known tool in the President’s arsenal: The 340B drug discount program, which costs taxpayers nothing but helps ensure access to HIV-related medications for vulnerable populations including many core voters in Trump country.
Trump’s plan would see new HIV infections cut by 75 percent by 2025 and by 90 percent by 2030. Key to achieving those reductions and saving lives is supplying people with the prevention medication they need. A key implementation tactic will be making drugs available at a discount to those who need them but cannot afford them, and making them available at the types of clinics and hospitals that Americans who are most at-risk will use. That means keeping rural health care providers open; many of them are applicable with the 340B program.
Assistant Secretary Brett Giroir of the Department of Health and Human Services, said at a Kaiser Family Foundation event on April 22, while describing when it comes to getting HIV-prevention medication into the hands of at-risk populations, “community health centers leveraging the 340B program, where we get highly competitive prices, are really the way to go.” Jen Kates, Vice President and Director of Global Health and HIV policy at the Kaiser Family Foundation sees positive prospects for using the program simply as it exists today to provide HIV-prevention medication "to a wider group of people and to communities."
HIV prevention medication – known as Truvada – often retails for $1,600-1,700 for a 30-day bottle – a staggering amount that few Americans could afford. Complicating matters are the rates on uninsured Americans who are considered to be in at-risk areas, meaning that there is no way they can afford the HIV prevention medication they need.
According to Gilead, the makers of Truvada, only about 20 percent of the people who need the drug are actually taking it. If we are going to combat HIV, it’s important to leverage every tool available to get more treatment options into the hands of those most at-risk.
Unfortunately, with the opioid crisis, drug use through injectable means places them at great risk. In Trump Country, HIV diagnoses are high and rising— heroin use and HIV infection previously viewed as a Bay Area issue, has spread throughout all political divides, religious affinities, socioeconomic backgrounds, and ethnicities. According to the CDC.
In the United States (US), HIV diagnoses are not evenly distributed across states and regions. Southern states accounted for more than half of the 38,739 new HIV diagnoses in 2017.
In the South, 23% of new HIV diagnoses are in suburban and rural areas, and in the Midwest 21% are suburban or rural—higher proportions than in the Northeast and West. The South’s larger and more geographically dispersed population of people living with HIV creates unique challenges for prevention and treatment.
All of Florida, North Carolina, Ohio and Pennsylvania — which Trump won in 2016 — are seeing fairly high (and certainly higher than should exist) diagnosis rates. The 2020 election shouldn’t be — and isn’t — the driver for Trump addressing the HIV epidemic, but if it helps push him to throw the strength of the Executive Branch at such a costly issue for human life, then we should stand behind him. The sad reality is, a lot of establishment Republicans never recognized the pain and suffering caused by the opioid crisis — which has direct ties with the HIV crisis for many people. Due to the focus of President Trump on this very issue, he is and has garnered the votes of afflicted communities votes — just take a look at his New Hampshire primary total.
It’s worth noting that the Trump administration is not just leaning on 340B to address the HIV epidemic. HHS Secretary Alex Azar has confirmed that the administration is negotiating with Gilead to bring down the cost of Truvada, too. At the April 22nd event held by Kaiser, Assistant Secretary Giroir sounded very optimistic about the chances of lowering prices, although he could not officially comment on the outcome of ongoing negotiations.
The opioid crisis and other crises stemming from it, affect nearly every person in America either directly or indirectly. Supporters on both sides of the political divide are beginning to change their opinions of those who endure addiction as the stigma is lifted. The President and Democratic Candidates will talk a good game, but it always comes down to actions taken. Trump is off to a good start with having declared the opioid crisis a National Public Health Emergency and now using his Office to hold drug makers accountable and creating new avenues for people to access affordable treatment. Democrats should show bi-partisanship and support the president in this move — if not, they will prove no issue is important enough to lay down their swords and love their country over their party.
Taylor Weyeneth is the former deputy chief of staff to the White House drug policy office and is the managing director of 20K Strategies, a political operations and public policy strategy firm. He is a thought leader for addiction, mental health, and workforce development.