Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
FY2024 Appropriations
Partisan disagreements on federal spending proposals for Fiscal Year 2024 (FY2024) continue to delay the appropriations process, threatening a partial government shutdown on January 19. On January 7, a bipartisan group of senior appropriators reached an agreement on topline spending levels for FY2024, kickstarting negotiations on programmatic spending levels with less than a month to approve a spending package. However, lawmakers from the right-wing Freedom Caucus in the House of Representatives have blocked all legislative action in the lower chamber in opposition to the bipartisan deal forged by House Speaker Mike Johnson (R-LA-04). As a result, Speaker Johnson will need more time to build approval for the deal within the Republican caucus or renegotiate topline numbers with Democrats, necessitating another continuing resolution (CR) by the first funding deadline on January 19.
The current CR (H.R.6363) established separate deadlines for FY2024 spending bills. As a result, some federal agencies and programs face a January 19 deadline, but larger agencies, including those funded through the Labor, Health and Human Services, Education, and Related Agencies (LHHS) bill, face a February 2 deadline. If another CR is passed, lawmakers are expected to extend current funding levels through early March. On January 14, Senate Appropriations Chair Patty Murray (D-WA) released text of a bipartisan CR that extends the laddered funding deadlines to March 1 and March 8.
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
HHS Finalizes Nondiscrimination in Healthcare Regulation
On January 9, the Department of Health and Human Services (HHS) released a final rule that restores longstanding processes to address conscientious objections and religious discrimination in healthcare settings. The updated rule rescinds much of a 2019 rule promulgated by the Trump Administration that expanded the ability of healthcare professionals to refuse care based on conscientious or religious objections, including HIV and STI services, gender-affirming care, and abortions. Although the Trump-era changes never went into effect due to legal challenges, the updated rule will restore a 2011 framework for handling and enforcing conscientious objections and aims to strike a balance between safeguarding religious and moral rights while protecting access to care. The updated rule will go into effect on March 11, 2024.
FDA Approves Importation of Syphilis Drug
On January 10, the US Food and Drug Administration (FDA) announced that it temporarily approved importation of Extencilline, an antibiotic used to treat syphilis manufactured by Laboratoires Delbert, in order to address Bicillin L-A shortages in the US. Extencilline contains the same antibiotic agent as Pfizer’s Bicillin L-A and is available globally, but it has not been approved by the FDA in the US. Notably, Bicillin L-A is the only syphilis treatment available to pregnant people in the US. After Pfizer reported supply shortages impacting production of Bicillin L-A in April of 2023, many health systems were forced to ration syphilis treatment, exacerbating a dramatic spike in new syphilis infections among pregnant people and perinatal transmission to newborns. Advocates applauded FDA for taking action to address the critical treatment shortage. NASTAD is monitoring this and will continue to provide updates on the implementation.
Resources
NASTAD Podcast: Southern Steep: Brewing Stronger Community
NASTAD is excited to announce the release of the fourth season of its podcast, Southern Steep: Brewing Stronger Community. Southern Steep is a public health and social justice podcast that centers the voices of community leaders in the southern United States. Conversations highlight innovative approaches to unapologetic leadership, meaningful partnerships and thriving communities.
CDC: 2024 Immunization Schedules for Clinicians
The 2024 immunization schedule includes new risk-based mpox recommendations for children, adolescents, and adults.
Job Postings
Viral Hepatitis Prevention Coordinator – Austin, TX
Under direction of the Prevention Unit, provides highly advanced, senior-level consultative services and technical assistance as the DSHS viral hepatitis prevention coordinator. Oversees implementation and maintenance of viral hepatitis prevention efforts by identifying ways to integrate viral hepatitis prevention, vaccination, testing, and linkage to care into existing public health, clinical care, and community settings. Responsible for developing a DSHS viral hepatitis prevention plan as well as legislatively-mandated plans, including working with branch staff to solicit input from the public, including experts on Hepatitis, on the tenets of the plan. Apply by April 23.
Program Content and Training Specialist, Supporting Harm Reduction Programs (SHaRP) – University of Washington
This position is part of a cooperative agreement award from the Centers for Disease Control and Prevention to provide technical assistance about monitoring and evaluation to syringe services programs (SSPs) as part of the National Harm Reduction Technical Assistance Center. One of the primary projects of this award is to provide technical assistance (TA) to SSPs for monitoring and evaluation activities. The University of Washington is working in collaboration with the CDC, SAMHSA, NASTAD, the National Harm Reduction Coalition, and other TA partners to provide a suite of technical assistance support to individual programs.
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
Gilead Sciences Must Face Consumer Claims Over Older, Lower-Quality Drugs, Court Rules
“Gilead Sciences must face thousands of claimants in court who allege the company deliberately delayed development of safer drugs to maximize profits on older drugs, California’s First District Court of Appeal ruled Tuesday. The claims allege that the drugmaker’s tenofovir, an antiretroviral used in Gilead’s older HIV drugs, caused kidney, tooth, or bone damage to patients, and that Gilead knew its tenofovir-based drugs which were still in development, were safer. They further allege that Gilead deliberately paused the development of those new, safer drugs in order to maximize its profits from both types.”
The FDA just cleared the way for drug importation. What now?
“The FDA’s decision to allow states to import prescription drugs from Canada may not help President Joe Biden’s reelection campaign — or Americans’ pocketbooks.
That’s because Florida’s drug importation plan, which the Food and Drug Administration greenlit on Friday, has a long way to go before Americans end up saving money on their prescriptions, if they ever do.”
How History Has Shaped Racial and Ethnic Health Disparities
“This timeline offers a historical view of significant U.S. federal policies and events spanning the early 1800s to today that have influenced present-day health disparities. It covers policies that directly impacted health coverage and access to care, relevant events in medicine, social and economic policies and developments that influence health, and efforts to tackle inequalities.”