Newsletter: Policy

Policy Updates: Hill Happenings and Administration Activities

Hill Happenings

FY2024 Appropriations 

Speaker Mike Johnson (R-LA-4) has proposed a two-step continuing resolution (CR) that would extend the current FY2024 continuing resolution (CR) until January 19 or February 2. While the measure doesn't have any of the policy riders that have stalled many of the GOP's appropriations measures, it also omits any supplemental funding for Israel or Ukraine. 

In the meantime, the House is continuing to move ahead on its remaining FY2024 spending bills, starting with Labor-HHS-Education and Commerce-Justice-Science, both of which are scheduled for floor votes this week.

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 Vital Signs: U.S. Syphilis Cases in Newborns Continue to Increase: A 10-Times Increase Over a Decade 

New Centers for Disease Control and Prevention (CDC) data reveal that more than 3,700 babies were born with syphilis in 2022, which was more than 10 times the number in 2012. The increase in newborn syphilis follows rising syphilis cases among women of reproductive age combined with social and economic factors that create barriers to high-quality prenatal care and ongoing declines in the prevention infrastructure and resources. 

CDC is recommending concerted action to stop the increase of newborn syphilis cases and continues to sound the alarm about the consequences of a rapidly accelerating epidemic of sexually transmitted infections in the United States. Syphilis during pregnancy can cause tragic outcomes, like miscarriage, stillbirth, infant death, and lifelong medical issues. Newborn syphilis occurs when mothers do not receive timely testing and treatment during pregnancy. 

GAO Report on Public Health Preparedness 

The Government Accountability Office (GAO) published a new report on building and maintaining the U.S. public health infrastructure beyond the COVID-19 pandemic. The report identified several challenges the CDC must embrace to be sufficiently prepared to respond to a public health threat. These challenges include funding challenges that come with a pattern of increased federal funding for an emergency response, followed by a decrease in funding after that emergency ends; the varying levels of funding different jurisdictions provide for preparedness and response; and the need to build a permanent public health workforce that is not disbanded after the emergency ends due to lack of long-term funding.


Webinar: Academic-Public Health Partnerships: Navigating Collaborations to Advance HIV/AIDS Public Health Programming and Research

Date: November 20, 2:00 – 3:00 PM ET 

Panelists will share experiences of academic-health department collaborations. Discussion will focus on the nature of these partnerships, how teams coordinate with each other, how collaborations are started, and more. The panel features people both from public health departments and universities. Please register here.   

Generic Daily HIV Prevention Pill for Young Men Who Have Sex with Men Could Save Lives, Lower Costs, NIH-funded Study Suggests 

“Compared to annual HIV screening alone, generic daily oral HIV pre-exposure prophylaxis (PrEP) with HIV screening every three months would result in fewer HIV acquisitions, longer life expectancy, and fewer HIV-associated costs among young men who have sex with men in the United States. Researchers applied an established simulation modelExit Disclaimer to better understand the costs and benefits associated with the PrEP strategy among young men considered at elevated risk of acquiring HIV. The study was primarily funded by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Additional support was provided by the National Institute on Drug Abuse and the National Institute of Allergy and Infectious Diseases. The findings appear in Clinical Infectious Diseases.” 

Geographic Variation in Qualified Health Plan Coverage and Prior Authorization Requirements for HIV Preexposure Prophylaxis 

McManus et al assessed commercial determinants of PrEP access within the health care sector from 2018 through 2020, including insurance coverage, prior authorization requirements, and specialty tiering of PrEP medications in qualified health plans (ie, those certified by the Patient Protection and Affordable Care Act (ACA) Health Insurance Marketplace). The authors investigated these policies for the two available formulations of oral PrEP. Emtricitabine/tenofovir disoproxil fumarate was approved for use as daily oral PrEP in 2012 in all populations; in 2019, emtricitabine/tenofovir alafenamide was approved for use as daily oral PrEP among men and transgender women who have sex with men, the only populations in which its efficacy was studied. The two medications were priced at over $20,000 annually per person during the study period, making coverage essential for those accessing PrEP through insurance plans.” 

Invited commentary on this research can be found here

2023 RWHAP Clinical Conference 

Dates: December 3-5, 2023 

Location: Portland, Oregon 

Registration for the 2023 RWHAP Clinical Conference is now open. This conference provides state-of-the-art research, care, and treatment updates for experienced clinical decision makers and those integral to medical care provision housed under the Ryan White HIV/AIDS Program (RWHAP) funded sites. Details on covered topics, venue descriptions, information about continuing education credits, and updates on registration and travel will be available on the IAS-USA website and the AETC National Coordinating Resource Center (NCRC) website

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.  

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, and 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

‘An extreme response': Republicans move to kill Trump’s HIV-fighting program 

“President Donald Trump convinced lawmakers it was possible to end AIDS in America — and to put hundreds of millions of dollars behind the effort. Four years later, House Republicans plan to slash the budget by 95 percent. When POLITICO asked Rep. Robert Aderholt (R-Ala.), the chair of the subcommittee overseeing the Department of Health and Human Services’ budget, about the reasoning behind the cut, he cited a need to prioritize. “It’s one of those things where it’s like, what do you have to have and what would be nice to have?” said Aderholt. “We had to get down to the bare bones of what we really had to have.” 

How a political battle is threatening a federal program that fights HIV 

“The federally funded President's Emergency Plan for AIDS Relief provides HIV prevention, treatment and education around the world. The program has seen broad bipartisan support on Capitol Hill for years, but now, a battle led by a small group of House Republicans is putting its future at risk. John Yang speaks with Jennifer Kates, director of global health and HIV policy at KFF, to learn more.” 

US to Cover HIV Prevention Drugs for Older Americans to Stem Spread of the Virus 

“A proposed federal policy aims to protect older Americans from contracting HIV by offering free preventive medication, the latest effort to catch up to much of Europe and Africa in stemming the spread of the virus. Under the plan from the Biden administration, Medicare would cover patients’ full cost of preexposure prophylaxis drugs, which prevent HIV transmission. The drugs, known by the shorthand “PrEP,” would be free in pill form and — for the first time — as long-acting injectables through the government insurance program designed for those 65 and older. Those 50 and over make up half of all people in the U.S. already living with HIV.” 

Syphilis cases in US newborns skyrocketed in 2022. Health officials suggest more testing 

“Alarmed by yet another jump in syphilis cases in newborns, U.S. health officials are calling for stepped-up prevention measures, including encouraging millions of women of childbearing age and their partners to get tested for the sexually transmitted disease. 

More than 3,700 babies were born with congenital syphilis in 2022 — 10 times more than a decade ago and a 32% increase from 2021, the Centers for Disease Control and Prevention said Tuesday. Syphilis caused 282 stillbirth and infant deaths, nearly 16 times more than the 2012 deaths.”