Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
FY2025 Appropriations
Congress has adjourned for the August recess through September 9, pausing a flurry of activity on the fiscal year 2025 (FY2025) spending bills in July. On August 1, the Senate Appropriations Committee marked up and approved the Labor, Health and Human Services, Education, and Related Agencies (LHHS) Subcommittee spending bill for FY2025, which starts on October 1, 2024. The Senate’s LHHS bill avoids deep spending cuts proposed by the House of Representatives, maintaining investments in core health programs, but many health programs at the Centers for Disease Control and Prevention (CDC) National Center for HIV, Viral Hepatitis, STIs, and TB Prevention were flat-funded, including the HIV and viral hepatitis prevention programs and the infectious disease and opioids program. The Senate’s overall LHHS package includes a higher total than the House bill, teeing up a fall showdown on budget negotiations ahead of the November election.
On July 10, the House Appropriations Committee (HAC) approved the lower chamber’s LHHS spending bill and released an accompanying report for FY2025. The House bill proposes major cuts to health programs across the Department of Health and Human Services (HHS), totaling a decrease of 7% compared to fiscal year 2024 enacted levels. The cuts include the elimination of the CDC component of the Ending the HIV Epidemic Initiative (EHE) and a $190 million cut to the Health Resources and Services (HRSA) Ryan White HIV/AIDS Program (RWHAP). Notably, the subcommittee proposed a $10 million increase for the CDC hepatitis program and a $6.1 million increase for the infectious disease and opioids program.
NASTAD will continue to monitor the congressional appropriations process and advocate for the highest possible funding for HIV, hepatitis, and drug user health programs.
Administration Activities
CDC Issues Supplemental NOFO to Scale Up PrEP Access in Key Jurisdictions
On August 6, CDC issues a notice of funding opportunity (NOFO) titled High-Impact HIV Prevention and Surveillance Programs for Health Departments: Accelerating Pre-Exposure Prophylaxis (PrEP) Uptake for Ending the HIV Epidemic in the United States. The competitive supplemental funding opportunity is offered to the 32 state, local and territorial health departments currently receiving Ending the HIV Epidemic in the U.S. (EHE) funding under NOFO PS24-0047: High-Impact HIV Prevention and Surveillance Programs for Health Departments. CDC will award $7 million to jurisdictions with greater need for PrEP and lower uptake among priority populations disproportionately affected by HIV and low PrEP prescriptions (i.e., Black and Latino gay, bisexual, and other men who have sex with men (MSM), and Black cisgender and transgender women) to accelerate PrEP uptake through patient navigation/case management services and improve access to and utilization of existing PrEP services not covered by other financial resources. Applications are due by August 31, 2024.
HRSA HAB Issues RWHAP Programmatic Guidance for Doxy PEP and STIs
On August 7, the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB) released a new program letter on the role of the Ryan White HIV/AIDS Program (RWHAP) in addressing sexually transmitted infections (STIs) and mpox. The letter provides information on the CDC’s new clinical guidelines on the use of doxycycline post-exposure prophylaxis (doxy PEP) for prevention of bacterial STIs, and calls on programs to use RWHAP funds to purchase doxy PEP for eligible clients and Part B AIDS Drug Assistance Programs to add doxycycline to their formularies to ensure access and coverage. HRSA also calls on programs and jurisdictions to remain aware of mpox vaccination and testing recommendations, particularly for people living with HIV.
FDA Approves First Nalmefene-based Opioid Reversal Auto-Injector Product
On August 7, the US Food & Drug Administration (FDA) approved Purdue Pharma’s Zurnai, the first nalmefene hydrochloride auto-injector to reverse opioid overdose. The approval of the auto-injector formulation follows the FDA’s approval of the first nasal nalmefene spray product in May 2023. Nalmefene-based opioid reversal products are potent, longer-acting opioid antagonists compared to naloxone, which may lead to more precipitated withdrawals and push people away from care. In 2023, the American College of Medical Toxicology and American Academy of Clinical Toxicology issued a position statement recommending naloxone products over nalmefene sprays as the preferred first-line agent to reverse opioid overdoses.
Resources
OIDP NOFO: Supporting Vaccine Confidence
Deadline: August 21, 2024 at 6:00 PM ET
This initiative seeks to expand, plan, implement, and evaluate promising practices and develop novel approaches to increase vaccine confidence in local communities, particularly partnerships with organizations that work with populations with low vaccination rates (e.g., African Americans and residents in rural communities). Practical solutions at local levels are needed to help support vaccination efforts in communities by healthcare providers, immunization program managers, immunization advocates, vaccine manufacturers, and other stakeholders. OIDP anticipates the availability of approximately $1,000,000 for this funding opportunity to support four awards ranging from $250,000 to $115,000 per year for up to three years. OIDP and ORHO will support activities by public health departments, community organizations, academic institutions, professional or trade organizations, and immunization coalitions, among others, that work with populations with low vaccination rates.
NIH NOFO: High Priority HIV and Substance Use Research
“The purpose of this notice of funding opportunity (NOFO) is to support high priority research at the intersection of HIV and substance use. This NOFO invites research projects with the potential to open new areas of HIV/AIDS research and/or lead to new avenues for prevention, treatment and cure of HIV among people who use addictive substances.”
Job Opportunities
Director, HIV Prevention -- Tennessee Department of Health
This role is responsible for overseeing and administering the entire portfolio of HIV Prevention activities supported by TDH and our community-based organization partners statewide. In addition to leading an internal team of eleven direct and shared staff, this role will also be responsible for maintaining strong relationships with a wide variety of external stakeholders, including our CBO partners, metro Health Department leadership, and the United Way of Middle TN.Top of Form
Communicable Disease Epidemiologist – Cheyenne, Wyoming
This position will serve as the Communicable Disease AIDS Drug Assistance Program (ADAP) Coordinator, Wyoming TB Controller, and Disease Intervention Specialist (DIS) for the Communicable Disease (CD) Treatment Program. Assist in outbreak response to ensure the safety of Wyoming residents; by interviewing cases for exposure information, updating news outlets on the progress of outbreak control, analyzing exposure data utilizing epidemiological and statistical methods.
Open Positions – New York State
The New York State Department of Health, in partnership with Health Research, Inc, has various job openings, including some within the AIDS Institute. Please visit this link to learn about their current opportunities.
News Bulletin
Harris’ running mate, Minnesota Governor Tim Walz, boasts progressive health care record
“With Minnesota Gov. Tim Walz as her running mate, Vice President Kamala Harris has tapped a fiery advocate for public health and abortion rights. Harris chose Walz as her vice presidential pick Tuesday morning. The pair have less than 100 days before Election Day to rally voters to the new Democratic ticket. Walz emerged as a frontrunner for the role in part due to his record of defending abortion access, gender-affirming care, and the national Covid-19 response.”
Native American Public Health Officials Are Stuck in Data Blind Spot
“It’s not easy to make public health decisions without access to good data. And epidemiologists and public health workers for Native American communities say they’re often in the dark because state and federal agencies restrict their access to the latest numbers. The 2010 reauthorization of the Indian Health Care Improvement Act gave tribal epidemiology centers public health authority and requires the federal Department of Health and Human Services to grant them access to and use of data and other protected health information that’s regularly distributed to state and local officials. But tribal epidemiology center workers have told government investigators that’s not often the case.”
Democrats call on administration to enforce ‘march-in rights’ to counter high drug prices
“A trio of lawmakers who caucus as Democrats are calling on the Biden administration to bolster and finalize a federal rule utilizing the government’s legal authority to seize taxpayer-funded patents in order to combat the high price of drugs, despite Republicans arguing recent Supreme Court rulings supersede such powers.”