Dr. Jonathan Mermin

CDC

Atlanta, GA

Dear Jono,

As you know, HIV/AIDS sits at the intersection of so much that divides America. What happens when core HIV prevention funding gets pulled? We are about to find out. Tennessee (TN) decided that as of May 31, 2023, the state will no longer accept 1802 and EHE HIV prevention dollars. This decision has the potential to create chaos across multiple systems.

All of this is happening when TN is in the news because of the killing of Tyre Nichols. There are multiple political agendas and HIV is caught in the crossfire. Governor Lee took these steps without consulting the health department, CDC, the White House, or the local community. We are still not clear as to the motive, and I don’t think his office will be very forthcoming. Given the make-up of the state legislature, there is little hope for a local solution.

Not only is 1802 and EHE funding at risk, but so is 340B support. Without core funding for HIV prevention, how will PrEP programs happen? 1802 also give agencies without pharmacies access to PrEP and 340B support. No 1802/EHE means limited PrEP outreach. That results in decreased 340B funding. People will lose their jobs, some agencies will close, and, ultimately, more folks will get HIV.

CDC could do a work around by directly funding the local United Way. The TN health department already uses them to distribute and monitor 1802 and EHE funding. Can the federal government shift by the May 31st deadline? How the administration responds could impact our work in other deep red states.

Disease prevention should never be a political pawn. This fight is not about our work, it’s about who we serve. The amount of chaos, money, jobs, and people’s lives that could be impacted are so much bigger than most people realize. I urge the CDC to move quickly and stealthy. This is not a war that any of us wants, but we will fight.

Yours in the struggle,

Paul Kawata