February 7, 2024

On the Policy Horizon in 2024

Welcome back to the Academy’s bi-weekly policy and advocacy newsletter for Academy members, which was on hiatus for a few months. At the beginning of this new year–another presidential election year in the U.S.–we embark with excitement on the policy work of the Academy. Last year, much of our important policy focus occurred in collaboration with several community-based coalitions. Collaborative relationships were critical in 2023 as the landscape of HIV policy and appropriations was threatened like never before. We’ll continue to foster these relationships to make the greatest impact in 2024.

Funding and Resources 

Earlier this year, it was announced that Harold Phillips, who had been admirably serving since 2021, would be stepping down from his role as Director of the White House Office of National AIDS Policy (ONAP). The Academy joined the AIDS United Public Policy Council in sending a joint letter to the White House Domestic Policy Council outlining the community’s appreciation for the service of Mr. Phillips and his sizeable contributions to the Ending the HIV Epidemic (EHE) initiative. The letter also asked for a re-prioritization of the role as it selects a new director as well as supporting it with more resources within the Administration. The letter may be viewed here.

In addition to various critical federal and local elections in 2024, House Republicans will likely continue their efforts to gut domestic funding intended to eliminate HIV, as we saw with the GOP’s budget blueprint announced in September 2023. Further cuts to already stretched federal programs could significantly damage medical providers’ efforts to deliver comprehensive HIV care and prevention in their communities, as well as severely set back EHE goals. We will need our members’ grassroots advocacy at various points over the next year during budget and appropriations battles in Congress.

Protecting the Patient-Provider Relationship

One of the new strategic innovations of 2023 centered discussions around a new policy priority that focuses on leveraging and upholding the sanctity of the patient-provider relationship. To illustrate the importance of this principle, the Academy’s Public Policy Committee has proposed an amendment to the policy platform on patient-provider sanctity that reads, in part: “As an organization of front-line clinicians dedicated to providing excellent HIV and sexual health care, we believe the best determination of appropriate medical treatment occurs within the relationship between the patient and provider. This relationship, based on shared decision-making, evidence-based care, and open, respectful and confidential communication, should be fiercely protected.”

Never was this relationship more under attack than by the ruling in the recent Braidwood Management, Inc. v Becerra case, which is currently being appealed in the Fifth Circuit Court of Appeals. Voice readers will recall in the original ruling in Braidwood the court denied the authority of the U.S. Preventive Services Task Force (USPSTF) to mandate no-cost insurance coverage of PrEP, one of the most important biomedical successes in recent memory. The court also ruled that the USPSTF’s PrEP mandate violates the plaintiffs’ rights under the Religious Freedom Restoration Act. With the 2030 deadline for ending the epidemic approaching, we could not disagree more strongly.

Meeting the Challenge

Because our membership is already stretched with the demands of medical practice, our resources are limited, but our voices are mighty. The Academy’s Public Policy Committee is comprised of several longstanding members, most of whom are physicians on the East Coast. However, if we are to rise to meet the challenges of this political season it will require all–diverse and many–hands to be on deck.

For a perfect example, we need only to look to our recent collaboration on the West Coast. The Academy was invited to join advocates in California in supporting a bill to expand access to PrEP and PEP for Californians. This collaborative work was only possible because of the work and dedication of the California and Hawaii Chapter, who brought this matter to our attention. Yesterday, Governor Newsom signed the bill into law. You can read the Academy’s letter here.

It is imperative that the policy work of the Academy shift to meet the novel challenges of the day. The practice and effectiveness of HIV medicine must respond with all the creativity, expertise and innovation of our entire membership. Our practice demands an expression of advocacy that is geographically, ethnically and clinically diverse.

To that end, we are exploring new innovations in advocacy and engagement in 2024 that will be discussed here in future Voice newsletters and other communications from the Academy. It is imperative that we consider all opportunities to uplift the interplay of policy and practice. These new opportunities are meant to diversify our response to the challenges on the horizon.

View the latest Policy Update here.