The United Nations convened a high-level meeting this week to review progress over the past five years since world leaders adopted strategies to eliminate HIV / AIDS as a public health threat by 2030 .

Healio spoke with Carl Schmid, MBA, executive director of the HIV + Hepatitis Policy Institute and co-chair of the Presidential Advisory Council on HIV / AIDS, on the meeting and the future of the fight against HIV / AIDS.

Healio: What are the main achievements and setbacks in the effort to end the HIV / AIDS epidemic by 2030?

Schmid: The biggest accomplishments have been the focus and leadership needed to end HIV, of course, as well as the funding. Over the past 2 years, we’ve been able to get $ 400 million more for HIV programs, get more people on treatment, get more people tested, get more people on PrEP. I think the most important thing is to get the attention, the leadership and the resources and, of course, to get people talking about HIV.

The first thing the plan did was force jurisdictions to develop plans to end the HIV epidemic. The high priority districts, where 50% of all cases are in the United States, were the ones that needed to do it and it was done by their governments, but they had to do it with community input which resulted in got people to focus.

It is important to talk about HIV in the South, where half of all HIV cases occur and where there is a lot of stigma. We’ve had a lot of issues with the Trump administration’s healthcare policies, causing issues of discrimination among LGBTQ + and transgender communities and creating roadblocks, but at least they’ve put us on the right track. . Now, the Biden administration continues its efforts to end HIV, which is wonderful. It puts great people, just announcing recently Harold Philips as director of the White House’s Office of National AIDS Policy, and he increases the budget by $ 216 million. The Trump administration had offered more money than Congress gave us last year, so what Biden is doing brings it almost to the level Trump proposed last year.

In addition, there is the Ryan White program, which provides treatment and support services to low-income people living with HIV. They received additional money, and with that money, about 6,500 new people entered the program and about 3,500 people were rehired.

Overall I think there has been a lot of progress but then COVID-19 happened and it really impacted the effort despite rehab. For example, instead of getting tested for HIV, they did a lot of self-testing for HIV and the CDC provided funds to jurisdictions to send out kits, and telehealth was adopted more as well. We are continuing these efforts now. So we may have had a few setbacks with COVID-19, but I think there is hope on the horizon, new technology, and hopefully a vaccine.

Healio: What new recommendations, if any, were made at the UN high-level meeting?

Schmid: They made a statement. What happened is that Russia tried to stop focusing on special populations, sex education, all those things, and it lost. The United States and several other countries have spoken out against it. The declaration reiterates its commitment to end HIV and to focus on the right populations and human rights, which is very important. They also focus on inequalities, and that’s a great thing. There are a lot of different global inequalities that you can’t compare Africa with the United States, for example; we have our own injustices and this is largely due to poverty and race. We need to make sure we focus on communities facing these inequalities, as we have so much higher rates of HIV among blacks, African Americans and Latinos than among whites, which is true in the gay community and in women as well.

The group also spoke about leadership and fundraising commitments. It is good that the world is re-engaging and refocusing on the HIV epidemic after 40 years.

Healio: What do patients hope to see from such meetings? Was this meeting on their radar?

Schmid: UNAIDS tries to keep us informed. I don’t know if all people living with HIV were aware of the meeting, but the advocacy community and the activist community were certainly aware and involved. They had representatives there, and there were people living with HIV from the United States who were invited to attend. I think it’s more of a government meeting than a patient meeting, but there is an opportunity for people living with HIV around the world to participate, not just the United States.

Healio: What do you think clinicians hope to see from this high level meeting?

Schmid: I think we have to continue to put people on treatment, get more people into prevention and PrEP, but also make sure it is done in a way that respects the communities that are affected. I think that’s a hindrance especially here in the US

Healio: We reported that the pandemic-related disruption could have a negative effect on HIV in the United States.S. and also globally . There is also hope that the research that has focused on the development of messenger RNA vaccines – which has been aided by HIV vaccine research – could be reversed and give us more information about vaccines. against HIV. What will be the net effect of this pandemic on HIV / AIDS in the United States?

Schmid: First of all, you are absolutely right. Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, says all the time without HIV, we wouldn’t have been as good at the COVID-19 response. And it’s just not the science thing, it’s the health care system and the public health infrastructure. Now I think there is a big difference between COVID-19 and HIV. The reason they were able to develop a vaccine so quickly is, yes, the new technology, but also COVID-19 does not replicate as quickly as HIV.

You also asked for the net impact. I hope more people are aware of HIV because of COVID-19. At the start, at each press briefing that Deborah Birx, MD, Fauci, former president Donald J. Trump and former director of the CDC Robert R. Redfield, MD, instead, HIV was mentioned. The biggest problem with HIV is the stigma these days and so, it is hoped that talking about it has made people more aware of HIV and infectious diseases because of COVID-19. People are no longer dying from HIV like they used to, and maybe it is no longer central to people’s minds as it was in the past.