The Honorable Donald J. Trump

The White House

1600 Pennsylvania Ave, NW

Washington, DC 20502

Dear President Trump,

As co-chairs of the bipartisan and bi-cameral Congressional HIV/AIDS Caucus, we write to encourage you to continue the longstanding American commitment to the fight against HIV/AIDS, both here at home and abroad. We’d also like to express our eagerness to work with your administration on this important issue. According to the Centers for Disease Control and Prevention (CDC) there were 1.2 million individuals living with HIV and nearly 40,000 people diagnosed in the United States in 2015. Globally for the same year, nearly 37 million people were living with HIV and an estimated 2.1. million individuals had become newly infected.

Over the last two decades, because of strong bipartisan support in Congress, strong leadership from the executive branch, and the tireless work of advocates we have made tremendous progress towards our ultimate goal of ending AIDS once and for all. In the last five years, the number of people on lifesaving antiretroviral treatment worldwide has doubled to 18.2 million — nearly 11.5 million due to the President’s Emergency Plan for AIDS Relief (PEPFAR). Because of PEPFAR’s commitment to reach pregnant women with HIV, more than 2 million new infections have been averted in children born to infected mothers.

The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) has also played a significant role in reducing the number of deaths due to AIDS by 45 percent in the countries where it has a presence since the peak of the crisis in 2005. Additionally, as of mid 2016, Global Fund programs provided important care and treatments to 3.8 million HIV-positive pregnant women as part of efforts to prevent mother-to-child transmission. Furthermore, the partnership between PEPFAR and the Global Fund goes far beyond ending HIV in the countries where they work, it has also significantly improved the health systems and economies of these nations.

Significant advances in science and treatment have transformed HIV from a fatal epidemic to a treatable chronic disease. A February 2017 CDC report showed an 18 percent decline in the number of HIV infections between 2008 and 2014 in the United States. The estimated number of new HIV infections also fell from 45,700 in 2008 to 37,600 in 2014. These encouraging numbers are due to the ability of caretakers, including those in the Ryan White program, to achieve viral suppression in patients. Viral suppression allows people to live longer, healthier lives, and lowers the risk of transmission of HIV to near zero. By ensuring all people living with HIV achieve viral suppression, we could end the epidemic and reduce health care costs by billions of dollars. We know that this is not an unobtainable dream, as in 2015 the Ryan White program successfully achieved viral suppression among 83 percent of its clients versus 55 percent of people diagnosed with HIV nationwide.

However, despite the considerable scientific and epidemiological advances we have achieved, there is still more work to be done. We still face significant risk of surpassing the infamous mark of a cumulative 100 million HIV infections by 2030. Every week, 40,000 people around the world are infected with HIV. While HIV incidence in sub-Saharan Africa has declined by 50 percent since its peak, the population has increased by 340 million during the same period. And each day, another 1,900 young people ages 15 to 24 become infected. In the United States alone, an estimated 55 percent of those living with HIV are virally suppressed, but 13 percent of those infected are not aware of their status. Given these trends, we need your assistance to keep and expand our progress.

We urge you to ensure that HIV/AIDS remains a critical public health priority during your administration, as it has been for many presidents before you. We hope you will consider the following actions:

  • Support critical and timely investments in global health programs, in particular the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund)
    • PEPFAR and the Global Fund work hand in hand to ensure those infected and affected by HIV have access to critical and oftentimes lifesaving services. Without these investments progress stalls, and worse still previous gains could be lost.
  • Support continued and robust funding for HIV/AIDS research, prevention and treatment programs, including for the Ryan White HIV/AIDS Program
    • The Ryan White HIV/AIDS Program has provided critical funding to cities, states, clinics, and local community-based organizations for more than 25 years. The program serves more than 500,000 people and guarantees that more than 50 percent of people living with HIV in the United States are in ongoing care.
  • Continue the implementation of the National HIV/AIDS Strategy (NHAS)
    • Initially developed in 2010, the NHAS is a clear roadmap for harnessing public and private sector resources to combat HIV in the United States. The National HIV/AIDS Strategy: Updated to 2020 includes key goals with quantifiable targets developed with input from multiple stakeholders to measure progress.
  • Maintain the Office of National AIDS Policy (ONAP) and the Presidential Advisory Council on HIV/AIDS (PACHA)
    • The White House Office of National AIDS Policy (ONAP), within the Domestic Policy Council, is tasked with coordinating governmental efforts to reduce the number of HIV infections across the United States. ONAP has been instrumental in ensuring accountability, continuity and consistency between all sectors of government and the NHAS goals.
    • The Presidential Advisory Council on HIV/AIDS (PACHA) — which has been in existence since 1995 — provides critical expert advice, information and recommendations to the secretary of health and human services regarding programs, policies and research to promote effective treatment, prevention and cure of HIV/AIDS.

Because of these indispensable federal programs and advancements in treatment and prevention, we are on track to significantly reduce the number of new infections and eventually end the HIV epidemic. However, our progress is dependent on continued federal support and coordination that we can continue caring for patients and preventing new infections. We cannot afford to take a step back.

Under your presidency, we could end AIDS in the United States and around the world. We look forward to working with your administration to achieve these goals.

Sincerely,

Rep. Barbara Lee (D–Calif.)

Rep. Ileana Ros-Lehtinen (R–Fla.)

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