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America's vision of ending the AIDS epidemic in 10 years is facing many challenges

via:CnBeta     time:2019/2/16 12:31:40     readed:182

In an explanatory article, the U.S. Department of Health and Human Services said the U.S. government's plan is to reduce new HIV infections by 75% in the next five years and 90% in the next 10 years. There are three reasons for this goal: first, antiretroviral drugs can make infected people live longer and healthier, and effectively avoid the risk of transmitting HIV to their partners through sexual behavior; secondly, pre-exposure preventive drugs can reduce the risk of HIV transmission by up to 97%; thirdly, new laboratory and epidemiological technologies help lock in the need for more prevention and control. Resource areas.

The article also points out that since the 1980s, the United States has made tremendous progress in the fight against AIDS. The U.S. government directly invests more than $20 billion annually in AIDS prevention and control, which has led to the lowest number of new HIV infections in the United States, about 40,000 people a year.

In addition, the Food and Drug Administration of the United States approved three new anti-AIDS drugs last year, and at least one broad-spectrum AIDS vaccine in clinical trials, which are good news for the Trump Administration's "ten-year anti-AIDS" program.

But the relevant institutions and people believe that even in the advanced medical level of the United States, there are many difficulties to achieve this goal.

The first is the issue of funds. Despite Trump's statement that the anti-AIDS agenda will be reflected in the budget for fiscal year 2020, the budget for fiscal year 2019 proposes a reduction of $43 million in domestic AIDS spending and is committed to repealing the Affordable Medical Act, known as the Obama Health Reform.

Data from the Kaiser Family Foundation, a non-partisan health policy research organization, show that Medicaid is the largest program to fund people living with HIV, but Trump encourages States to cut funding for this program.

The Trump administration also proposed at the end of last year to change the "prescription drug insurance" part of the Federal Medicare for the elderly and the disabled, possibly excluding some "lifesaving drugs" from reimbursement.

Because of this, more than 20 non-profit organizations, such as the United States AIDS Alliance, issued a joint statement saying that they "cautiously welcome" Trump's anti-AIDS vision, because "actions speak louder than words, and so far this administration has led us in the wrong direction". The statement argues that Trump's crackdown on the Affordable Medical Act and his proposal to cut non-defense autonomous spending may have a negative impact on efforts to combat AIDS.

Second, as the U.S. Department of Health and Human Services says, not all Americans benefit equally from scientific progress. In the United States, new HIV infections are mainly concentrated in minorities such as gay men and Afro-descendants; regional distribution is uneven, and the problem of AIDS in the south is more serious. At the same time, the stigmatization of AIDS has been a persistent problem, which has hindered the access of people living with HIV and high-risk groups to relevant prevention and treatment services.

Relevant US government data also show that progress in reducing new HIV infections in the United States has stalled. Moreover, there are some new threats to this progress, the most notable of which is the Opium crisis, because one in 10 new HIV infections is a drug injector.

Observers also noted that the Trump administration has not shown any obvious signs of its commitment to play an effective role in anti-AIDS work for two years. Trump's budget proposal for fiscal year 2018 had proposed cuts in funding for AIDS prevention and control research. In 2018, the Presidential Advisory Committee on AIDS in the United States did not hold a meeting. Trump has not appointed a new candidate since January 2017, when the director of the White House National AIDS Policy Office resigned under the Obama administration.

The joint statement of non-profit organizations such as Joint AIDS Agency wrote: "The real evidence will appear in the President's budget proposal for fiscal year 2020 next month." (Xinhua News Agency reporter Zhou Zhou Zhou)

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