Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
FY2024 Appropriations
Congress approved a second continuing resolution (H.R.6363) that extends fiscal year 2023 (FY2023) funding just days shy of the November 17 funding deadline. House Democrats worked with new House Speaker Mike Johnson (R-LA-04) to pass a “clean” continuing resolution on November 14 that avoids partisan policy riders, ensuring that it could pass both chambers on a bipartisan basis and become law. President Biden signed the CR into law on November 17, officially extending funding for health programs in a “laddered” timeline: some federal agencies and programs face a January 19 funding deadline, but larger agencies, including those funded through the Labor, Health and Human Services, Education, and Related Agencies (LHHS) bill, will face a February 2 deadline.
Having obtained no policy concessions from Democrats in the CR, Republicans on the House Rules Committee moved to advance their LHHS spending bill on November 14. The bill includes right-wing policy riders that target stigmatized health care services, such as HIV programs, abortion, and LGBTQ health. Although the LHHS bill was teed up for floor consideration, the final vote was postponed until after the Thanksgiving recess due to disagreements on controversial spending cuts, like cutting the majority of funding for the Ending the HIV Epidemic Initiative, and other right-wing amendments that were proposed during floor consideration of the bill. Notably, Democrats and moderate Republicans defeated an amendment that would eliminate funding for the Minority HIV/AIDS Fund and HOPWA. Congress resumes session on November 27.
NASTAD will continue to monitor the congressional appropriations process and advocate for the highest possible funding for HIV, hepatitis, and drug user health programs.
Senate Confirms New Director of the National Institutes of Health, Dr. Monica Bertagnolli
On November 7, the Senate voted to confirm Dr. Monica Bertagnolli to lead the National Institutes of Health (NIH), the nation’s medical research agency, filling the vacant Director role after nearly two years. Bertagnolli formerly led the NIH National Cancer Institute (NCI) since October of 2022 and will now oversee NIH programs and activities across all of its 27 Institutes and Centers, including the Office of AIDS Research (OAR).
Administration Activities
FDA Grants Marketing Authorization for First At-Home Diagnostic Test for Chlamydia and Gonorrhea
On November 15, the US Food and Drug Administration (FDA) granted marketing authorization for the first-ever self-test diagnostic for chlamydia and gonorrhea. The test, Simple 2 Test manufactured by LetsGetChecked, is an over-the-counter diagnostic that can detect chlamydia and gonorrhea bacteria using vaginal swabs or urine specimens in an at-home setting. Notably, the FDA is leveraging the Simple 2 Test approval to establish a new regulatory classification under the FDA 510(k) premarket review process, simplifying the marketing approval process for subsequent devices of the same type with the same intended use.
Resources
GAPP/FAPP: World AIDS Day Event
Date: Thursday, November 30 at 3.30 PM ET
Location: Rayburn House Office, Washington DC
The Global AIDS Policy Partnership and the Federal AIDS Policy Partnership will host a World AIDS Day event celebrating the 2023 recipients of the Award for Excellence in HIV/AIDS. Space is limited.
JAMA:
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“In the US, the prevalence of HCV is higher in people who are Black than in people who are not Black. Point-of-care HCV tests, patient navigation, electronic health record prompts, and unrestricted access to HCV treatment in community-based settings have potential to increase diagnosis and treatment of HCV and improve outcomes in people who are Black.”
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“HDV infection affects approximately 12 million to 72 million people worldwide and is associated with more rapid progression to cirrhosis and liver failure and higher rates of hepatocellular carcinoma than infection with HBV alone. Bulevirtide was recently approved for HDV in Europe, whereas pegylated interferon alfa is the only treatment available in most countries.”
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Overdose Prevention Centers, Crime, and Disorder in New York City
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“In this difference-in-differences cohort study, the first 2 government-sanctioned OPCs in the US were not associated with significant changes in measures of crime or disorder. These observations suggest the expansion of OPCs can be managed without negative crime or disorder outcomes.”
CDC MMWR: Vital Signs: Missed Opportunities for Preventing Congenital Syphilis — United States, 2022
“In 2022, lack of timely testing and adequate treatment contributed to almost 90% of congenital syphilis cases in the United States, including substantial proportions of congenital syphilis cases in all U.S. Census Bureau regions and among all racial and ethnic groups. Implementing tailored strategies addressing missed opportunities at the local and national levels could improve timeliness of testing and appropriateness of treatment for syphilis during pregnancy and thereby reduce the incidence of congenital syphilis and complications of syphilis during pregnancy.”
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, 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
From testing to dental care, HIV programs in the crosshairs
“Maryland’s largest city was one of 57 jurisdictions picked in 2019 for an initiative started under former President Trump to end the HIV epidemic by 2030. The program started with these locations because they accounted for more than half of new diagnoses in 2016 and 2017. The goal was to bring resources to the jurisdictions to increase diagnosis, treatment, and viral suppression. But these dollars could be stripped away under the House funding bill for the Health and Human Services Department that could go to the floor this week. And with the country trying to combat other health problems, like rising cases of syphilis and the opioid crisis, Agwu said slashing dollars could strain public health.”
How CDC’s new director is trying to regain trust shattered by covid
“Installed at the CDC by the White House in July, Cohen is tasked with restoring staff morale and public credibility at a time of extreme political divisions and fading trust in government — and in science. The 12,000-person Atlanta-based agency has become a target in Congress and on the campaign trail: Republican presidential candidates such as Florida Gov. Ron DeSantis and Vivek Ramaswamy have vowed to gut the CDC if elected next year, insisting that the agency’s covid-19 guidance was too cautious and led to unreasonably long school shutdowns, rising mental health woes and other social problems.”
Manchin won’t seek reelection in West Virginia
“Sen. Joe Manchin (D-W.Va.) announced Thursday that he will not seek reelection to the Senate in 2024, almost certainly handing Republicans a seat in next year’s elections in a deep red state…Manchin’s decision leaves a major void in the center of the Senate. He has been at the center of bipartisan negotiations of many stripes in recent years and has been widely considered the most moderate member of the Senate Democratic caucus, with questions persisting throughout whether he could leave the party, especially after Sen. Kyrsten Sinema (I-Ariz.) did so late last year.”
New AMA policies focus on GLP-1 coverage, resisting corporate medicine
“The association called for an elimination of buprenorphine treatment dose limits for patients with opioid use disorder, arguing that the nation’s worsening opioid overdose epidemic necessitates prescribing flexibility. Current dose limits are out of date and don’t keep pace with fentanyl addictions, which require higher dosages of buprenorphine to treat, according to the AMA. Presently, physicians abide by strict dose limits set by payers based on drug labels approved by the FDA.”