From National to Local: Prioritizing Getting to Zero

By Aisha Davis, Manager of Policy & Advocacy

On February 2, Politico reported that the upcoming State of the Union address will include a new pledge from the President – a promise to reduce HIV transmissions by 2030. However, last night, the President’s address included very little information of substance, lacked any substantive plan, and made no vow to end HIV transmission. The anticipated statement was nowhere to be found in the State of the Union, and the Trump administration’s current trajectory does not bode well for getting to zero by 2030.

The president spared a mere six sentences to talk about an epidemic that has affected millions of lives in the decades since discovery. In those short sentences, the President alluded to bipartisan collaboration to pass a budget that will, effectively, commit funds to eliminating HIV transmission in the United States. Given the contentious budget negotiations that recently led to the longest federal government shutdown in the United States, this soft commitment lacks the teeth or momentum to inspire any hope that the administration will be successful.

Furthermore, the President mentioned no desire to work with advocates in the field, no acknowledgement of communities that are disproportionately affected by HIV, and no appreciation of what his administration has done to set the movement to end the HIV epidemic back. To date, the Trump administration’s positions on healthcare have been devastating – for people living with HIV both in the United States and abroad. In the two years since his inauguration, it has taken aim at family planning (including denying money to family planning providers that offer abortion services), refused to defend the Affordable Care Act, and reinstated the global gag rule on global funding that supports international HIV/AIDS-related healthcare. Given this history, a pledge in support of reducing or eliminating HIV transmission is at best, a simple acknowledgement of the tireless, ground-level work already done by coalitions such as Getting to Zero Illinois. At worst, it aims to take credit for work accomplished despite the administration’s hostile policies and does not guarantee that movement will actually take place.

To be successful, national efforts to end new HIV transmissions must necessarily engage the community members, advocates, and organizations that have – for decades – been on the front lines of the HIV epidemic. These individuals and groups have long worked to increase scientific development, reduce stigma, and engage with community. This hard work already has the potential to dismantle the barriers preventing education, scientific advancement, and access to resources. Countless activists across the country have made progress in achieving this goal, and if the Trump administration aims to support this work, it would need to be done in collaboration with existing, local community efforts.

Locally, on Friday, February 1, Governor Pritzker signed Executive Order 2019-08, entitled “Executive Order Strengthening the State’s Commitment to Ending the HIV Epidemic.” This executive order includes two important actions and reaffirms Governor Pritzker’s historical commitment to ensuring the rights of LGBTQ people – who are disproportionately affected by the HIV epidemic. The first act commits to working with stakeholders on both public health initiatives and supporting Illinoisans living with HIV. This includes investing in agencies, programs, and services working to end the HIV epidemic, such as Getting to Zero.

The second action item is for the IL Departments of Public Health and Healthcare and Family Services to work with Medicaid Managed Care Organizations (MMCOs) to deliver a report detailing the plan delineating how the agencies and MMCOs will share information to monitor viral load metrics. This continues vital work following by acknowledging that people living with HIV, who are in care and have an undetectable viral load, cannot sexually transmit the virus to someone else. In monitoring viral load metrics, Governor Pritzker intends to ensure that Illinoisans living with HIV are able to access the lifesaving healthcare they need.

This executive order is an important step for the State of Illinois – it demonstrates an intentional move toward protecting marginalized communities and guaranteeing access to healthcare for some of our most vulnerable community members. This move is particularly bold and exciting because it combines the work undertaken by MMCOs and the Getting to Zero coalition to utilize a metric that will help Illinois achieve undetectable viral loads for Medicaid beneficiaries.

We stand ready to support any national or local efforts taken to ensure that resources, medical care, or funding are used to improve the health outcomes for people living with HIV. As one of the many organizations with Getting to Zero in Chicago, Howard Brown Health recognizes the great potential in Governor Pritzker’s executive order for Illinoisans living with HIV. In a similar vein, we will look to the Trump administration for their tangible next steps in significantly reducing HIV transmission by 2030. Howard Brown will continue to work with our patients to improve the health outcomes of all people living with HIV, and we look forward to succeeding in this lifesaving work with new allies, locally and nationally.

Aisha Davis is an avid student of intersectionality. She has worked on civil and human rights issues throughout her legal career, including work with Amnesty International, the Human Rights Foundation, Columbia Law School’s Center for Intersectionality and Social Policy Studies, and the African American Policy Forum.


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