The United States needs a National AIDS Strategy

It sounds simple enough, doesn’t it? It may come as a surprise that more than a quarter of a century into the epidemic there has never been a comprehensive plan to address HIV/AIDS in the United States. Moreover, our government committed to having a national strategy when it signed the United Nations General Assembly Special Session Declaration of Commitment on HIV/AIDS in 2001 and yet there has been no action. The U.S. President’s Emergency Plan for AIDS Relief’s (PEPFAR) web site states that “the heart of PEPFAR is to work shoulder to shoulder with partners in host nations in support of the national strategy in each country”. Yet the United States has no national strategy of its own. Shouldn’t the United States government be held to the same standard that we set for other nations?

The new HIV infection figures by the Centers for Disease Control and Prevention (CDC) increase the estimate of new HIV infections in 2006 from 40,000 to 56,300. Though the agency says the one-year revision does not necessarily indicate an ongoing increase in the annual estimated infection rate, the new estimate demonstrates that HIV infection rate is not falling and may very possibly be increasing significantly.

The US epidemic demands a more effective, strategic approach to reducing the number of new infections and extending the lives of people living with HIV/AIDS. Many federal HIV/AIDS programs have proven highly effective. But in many ways, the US response to HIV/AIDS is a patchwork of uncoordinated programs. Numerous government and private studies have pointed to the need for better planning of HIV/AIDS policy. The country needs to move from a response that is often bureaucratic to a strategic plan of action that is well coordinated, evidence-based, outcomes-oriented, and appropriately funded.

In order to be effective, a national strategy has to be “owned” by a variety of stakeholders and draw on the expertise of the public, private, and non-profit sectors. The strategy must be developed with the involvement of people living with HIV/AIDS, individuals from groups at elevated risk, public health leaders in and out of government, researchers, health providers, and representatives from faith based, civil rights, business and other communities.

While a range of groups need to be engaged, the federal government should have the responsibility to implement the strategy and report annually on progress towards defined targets. The federal government manages the vast majority of HIV/AIDS prevention and treatment programming and resources. While the government response to HIV/AIDS has often fallen short, it will not be possible to substantially improve national prevention and treatment outcomes unless we hold federal policy and programming to a higher standard.

The bottom line is that federal, state, local and community resources must be marshaled far more effectively to tackle HIV/AIDS in the US. Our government has a responsibility to lead a national response to HIV/AIDS that brings HIV infection rates down, increases access to HIV/AIDS-related care, and dramatically reduces racial disparities in health.

Through the remainder of the year we want to build overwhelming support for a national AIDS strategy and refine the concept of how a strategy should be developed and implemented. By the time the next President takes the oath of office on January 20th 2009, there should be broad based support for a national AIDS strategy.

You can be part of the call for a National AIDS strategy and help make it a reality. You can endorse the Call to Action for a National AIDS Strategy at the National AIDS Strategy Website. As a signer you’ll receive periodic updates on the strategy effort including recommended action items, sample media statements, and shared activities. As of August 2008, over 250 organizations and hundreds of individuals had endorsed the Call to Action.