The Time is Now: 2019 – 2020 Chair’s Challenge Update

At the 2019 NASTAD Annual Meeting in May, I launched my Chair’s Challenge – The Time is NOW: End the Epidemics. My goal is to build off of the successes of previous Chair’s Challenges to dramatically reduce new HIV and hepatitis transmissions through policies and public health grounded in science.

To achieve this goal, I called on NASTAD and its members to make progress in a variety of areas that are critical to ending the HIV and hepatitis epidemics. As we approach the midway point for the challenge, I’m pleased to provide some updates on our progress and success thus far.

Ending the HIV Epidemic

The federal initiative to end HIV by 2030 provides us with an opportunity to leverage approaches to ending the HIV epidemic that science tells us are effective. Over the past few years, several jurisdictions have developed “End the Epidemic (ETE)” plans that can serve as a basis for the national 2030 initiative. As such, I have called on NASTAD members to increase the number of jurisdictions by 50% that have a documented ETE plan, and we are making progress towards this goal. In May 2019, 14 members had plans in place. Currently, 16 members have plans and another 12 are in development.

I do recognize, however, that creating these plans can have its own inherent challenges. An important component of my challenge is to galvanize opportunities for peer support, learning, and mentorship. As such, on November 8, 2019, NASTAD and I hosted a meeting titled The Time is Now: Crafting Effective Plans to End the HIV Epidemic to bring together members from 20 health departments along with community representatives and federal partners to discuss the monumental opportunity in front of us, and to share experiences and resources.

As a next step, NASTAD will support strategic communication and policy activities, partnerships, data analyses, and technical assistance through the National Capacity Building component of PS19-1906. As part of this work, NASTAD will provide technical assistance in the development of local plans, and will establish, build, and maintain collaborative relationships with organizations to support the implementation of the local plans.

Undetectable = Untransmittable

Ending the HIV epidemic will require us to focus on evidence-based strategies, and one of our best tools is Undetectable = Untransmittable (U=U). As such, I’ve called for a 100% increase in the number of NASTAD members that have signed on to the U=U consensus statement. In May 2019, 15 members had signed on. Today, 20 members have signed on and five have indicated they are moving towards adopting U=U. In addition, NASTAD has launched a U=U map to highlight the various state, county, and local health departments that endorsed the U=U consensus statement.

PrEP Access

Prioritizing PrEP financing technical assistance and policy advocacy to ensure PrEP is accessible and affordable, particularly to populations with disproportionate access challenges, is another crucial element of my challenge. While there are numerous barriers to PrEP access, financing and affordability challenges have been a significant issue in many jurisdictions. The U.S. Preventive Services Task Force Grade A Recommendation for PrEP will help to alleviate some of the access and affordability challenges, particularly in the private insurance market, but only if it is fully implemented. To that end, NASTAD developed an implementation guidance letter on behalf of the HIV Health Care Access Working Group for state insurance regulators. I urge NASTAD members to contact your state insurance department and request that they issue guidance on USPSTF implementation.

Minority Leadership Program

I am a proud alumna of NASTAD’s Minority Leadership Program (MLP), so I had to include a call to support and grow the program in my challenge. MLP is a leadership development and investment program for persons of color working at various levels in state or CDC funded health department positions in HIV/AIDS or viral hepatitis programs. It is such an important program, and I am calling on all NASTAD members that are able to support MLP to do so through supplemental dues to the organization. At least 16 candidates will be accepted into the 2019 – 2020 cohort, and NASTAD is creating an Alumni Virtual Connection network to connect current and past cohorts. To date, there are 79 graduates.

Stigma Summits

Earlier this year, NASTAD launched a new microsite – Talking Points: The Resource Guide for Facilitating Stigma Conversations. This resource guide includes videos, tools and tips on how to implement conversations around stigma both internally within health departments and with communities we serve. I encourage all NASTAD members to host a stigma summit in their jurisdiction. If you have, please send a note to communications@NASTAD.org to let us know how it went. If not, please do review the microsite and let us know how we can help you begin planning for a summit.

Hepatitis Elimination

Finally, I am also calling on NASTAD members to be engaged in their state and local hepatitis elimination planning efforts if there are some, and if there are not, talk to your staff about opportunities to explore elimination planning moving forward.

NASTAD recently launched HepTAC, an online technical assistance and capacity building center for health department hepatitis programs to streamline resources and TA around the following topics:

• Hepatitis Program Infrastructure and Workforce;
• Community Engagement and Strategic Planning;
• Harm Reduction and Prevention;
• Epidemiology and Surveillance;
• Testing and Linkage to Care;
• Care and Treatment;
• Stigma and Health Equity; and
• Elimination

I urge all health departments to share HepTAC with staff to get them involved in accessing TA to strengthen their hepatitis infrastructure.

As you can see, there has been a lot of activity around the Chair’s Challenge. I encourage everyone – health departments and NASTAD staff – to keep up the great work as we approach the halfway mark. And to keep abreast of the Chair’s Challenge activities, please bookmark our new Chair’s Challenge microsite and success stories map.

Thank you, and remember, no opportunity waits. The Time is Now to End the Epidemics!