I am pleased to announce that Healthline Media selected NMAC as one of 2017’s top HIV organizations. To be honest, I’ve never placed much faith in these kinds of lists. It’s kind of silly to talk about the best when you are fighting an epidemic that is killing millions of women, men and children. However, this nice acknowledgement came at the end of NMAC’s 30th anniversary year and reminds me to say thank you and to brag about staff.

If NMAC is successful, it’s because of our staff, board, constituents, donors, community-based organizations, health departments, volunteers, people living with HIV, people on pre-exposure prophylaxis (PrEP), feds, national partners, researchers, activists and conference attendees. The only way to end this epidemic is to work together to change the world.

2017 was our 30th anniversary. I never thought we’d have to be here this long. It would be a mistake not to hold up our founders and Don Edwards, NMAC’s first executive director. Together, they laid the foundation for what would become one of the longest-surviving, Washington, DC–based national HIV organizations. That’s a lot of qualifiers, but people get very sensitive about adjectives. All I want to say is that we’ve been around a long time thanks to our founders and Don.

2018 will be a challenging year. We will have to closely monitor implementation of the new tax reform law. The loss of the health insurance mandate will destabilize the marketplace. Some states already have challenges keeping insurers. What happens when more healthy people exit the marketplace?

As Congress looks to the 2019 fiscal-year budget, lawmakers are already publicly talking about the need to balance the budget. Between tax reform implementation and existing federal expenses, we are around $1.4 trillion in debt. The House of Representatives is talking about cutting Medicaid, Medicare and other nondefense programs. Since expanded Medicaid provides health insurance for thousands of people living with HIV (PLWH), NMAC is very concerned about these actions.

Elections have consequences, and our work is in the crosshairs. The 2018 elections are extremely important. With the entire House and 34 Senate seats up for grabs, the results of these elections will determine the future of our work. Can we end the epidemic when people don’t have access to health care and medications? Can the Ryan White HIV/AIDS Program cover all the PLWH if expanded Medicaid gets cut? Hopefully, we will never have to figure this out. Going back to waiting lists for the AIDS Drug Assistance Program seems unimaginable.

Thank you for your support in 2017. We definitely need you in 2018, with a special shout-out to new and emerging leaders. You’re our movement’s future. Some of us are getting old, and we need to make sure the next generations of leaders are prepared to take the helm.

We were shouted down more times than I care to remember at the 2017 United States Conference on AIDS (USCA). Some folks were concerned. Personally, I embrace the shout-downs because our movement needs fighters. Over the next few years, we are going to be tested like we’ve never been tested. Our ability to save our communities depends on continued access to health care and medications, both for PLWH and people on PrEP. However, we must always prioritize people living with HIV.

It’s about time to stop using our 30th anniversary logo. I really liked this image. It’s a wonderful combination of the people and programs that make up NMAC. We remain committed to lead with race to end the HIV epidemic. 2018 is going to be tough, but it’s not like we haven’t faced difficult times before. Together we changed the world, and we can do it again.