2020 Hopefuls Highlight Medicare for All, PrEP in Plans to Combat HIV/AIDS

Democratic presidential candidates from left: Sen. Elizabeth Warren (D-Mass.), Sen. Kamala Harris (D-Calif.), Sen. Bernie Sanders (I-Vt.) and Mayor Pete Buttigieg (D-South Bend, Ind.) (Washington Blade file photos by Michael Key)

(WB) The reinvigoration of the White House Office of HIV/AIDS, access to generic PrEP and the award of cash gifts for HIV/AIDS innovations as opposed to U.S. patents were just three ideas 2020 hopefuls articulated in responses to a survey conducted by HIV/AIDS advocacy groups.

The candidates expressed those ideas in a survey conducted by AIDS United, which composed its questions in conjunction with a coalition of HIV/AIDS groups and made the responses public Monday.

William McColl, director of health policy at AIDS United, said in an interview with the Washington Blade his organization undertook the survey because elected leaders need the “political will…to actually commit to ending the HIV epidemic, including [making] the significant investments in the programs and services that are needed.”

“Basically, the people who are running for president in 2020 have a really unique opportunity to work toward the end of the epidemic in the United States,” McColl said. “It’s really an amazing time for HIV, and what that means for the epidemic. The fact of the matter is we have an ability and the technologies right now — with a great deal of work — even to end the epidemic.”

Seven candidates vying for the Democratic nomination — Elizabeth WarrenBernie SandersKamala HarrisPete ButtigiegCory BookerBeto O’Rourke and Kirsten Gillibrand — returned responses. (Gillibrand has since dropped out of the presidential primary.) Read a summary of their responses here.

McColl said his coalition submitted the survey questions to every candidate running for president — Democratic, Republican and Libertarian — but thus far has received only those seven replies.

Asked whether the coalition is satisfied with the responses, McColl said they would let them speak for themselves. (AIDS United is a 501(c)(3) and unable to endorse political candidates.)

“I think that what we’re going to do is just put the responses up for people to see themselves and they’ll have the opportunity to decide, who, I think, has the most convincing plans,” McColl said. “We’re not taking a position on them.”

For Warren, whose mantra is pharmaceutical companies are taking advantage of the American people, the plan for HIV/AIDS consists of Medicare for All, expanding HIV research and treatment and repeal of HIV criminalization laws. 

Buttigieg calls for reinvigorating the White House Office of HIV/AIDS, which has gone dormant in the Trump administration, and addressing substance abuse.

Other candidates who are U.S. senators tout legislation they’ve introduced. Harris points to the PrEP Access and Coverage Act, which requires insurers to cover PrEP, Sanders points to legislation to award cash prizes for HIV/AIDS innovations as opposed to patents and Booker points to the Real Education for Healthy Youth Act, which would require comprehensive sex education.

Drew Gibson, policy manager for AIDS United, said the survey responses are “a first step” for candidates, which he hopes is followed by in-person meetings.

“While we’re very happy with the answers they provided — for the candidates who provided the answers — this is just an opening salvo of trying to start a dialogue with these candidates and ensure that issues related to HIV are an essential part of their campaigns,” Gibson said.

McColl said the 2020 election isn’t the first time AIDS United collected survey responses from presidential candidates. The group has conducted the survey with presidential candidates every four years since at least 2012. 

For congressional candidates, AIDS United has conducted surveys in presidential years and in 2016 and 2018. For this cycle, the group is focused first on presidential candidates, but has plans to reach out to congressional candidates later.

Asked if anything jumped out in any of the candidates’ responses, McColl identified acknowledging no single strategy can beat HIV/AIDS and the need to use every tool available, including PrEP.

“I really should note that some of the candidates were very specific about speaking about the opioid epidemic,” McColl said. “I think that that was particularly useful.”

McColl also commended candidates for identifying state laws criminalizing the transfer of HIV as stigmatic and an “impediment to ending the epidemic.” As of 2018, 26 states had laws criminalizing at some level exposure to HIV, according to the Centers for Disease Control.

Also noteworthy, however, are the candidates who didn’t respond to the HIV/AIDS questionnaire. 

Among them are President Trump, whose administration has articulated a plan to beat the HIV/AIDS epidemic by 2030, and former Vice President Joseph Biden, who’s the front-runner for the Democratic nomination.

Erin Perrine, a Trump campaign spokesperson, said the Trump campaign doesn’t fill out candidate surveys as a general practice because his policies emanate from the White House, but added the incumbent president “has a strong record of taking bold action to eradicate the HIV/AIDS epidemic in United States within the next 10 years.”

“During this year’s State of the Union address, President Trump announced the Ending the HIV Epidemic: A Plan for America, which will use data, innovative tools, and medical research to tackle the epidemic head on,” Perinne said. “President Trump’s approach is one that faces the HIV/AIDS epidemic in a way that has never been done before.”

In his fiscal year 2020 budget request, Trump called on Congress to appropriate an additional $300 million to fight HIV/AIDS on the domestic front, although it also proposing slashing contributions to global programs like PEPFAR and the Global Fund.

The Biden campaign didn’t respond by the Blade’s deadline to comment on why the campaign didn’t return a survey response to AIDS United. Last month, however, Biden pledged to beat HIV/AIDS by 2025, which would cut in half the goal set by the Trump administration, in response to a question at a New Hampshire town hall from a health care worker.

McColl said the Biden campaign signaled they intended to provide a response and will continue to collect responses beyond their deadline, which was Monday. McColl added Biden’s 2020 commitment at the town hall was “significant.”

The Democratic candidates’ plans as a whole, McColl said, contrast with the Trump administration plan by focusing on the importance of insurance coverage, such as Medicare for All.

“Some of those things, potentially, are different from the focus of the administration plan, which basically takes the current health care structure and assumes that it will stay in place,” McColl said. “I think that a lot of the Democratic plans look at different ways to take a look at either insurance or ensuring access to treatment and care.”

McColl expressed confidence the future administration — Democrat or Republican — will be able to combat and potentially defeat HIV/AIDS, saying it has “remained a bipartisan issue.”

“We believe that there is now a floor in place, that there will be a commitment to working to end the epidemic and, I think, that there just needs to be this much greater awareness that there is really an opportunity to do this,” McColl said.

The Act Now: End AIDS Coalition consists of AIDS United, the New York-based Gay Men’s Health Crisis, Health GAP, Housing Works, the International Association of Providers of AIDS Care, Lambda Legal, Positive Women’s Network-USA, Sero Project, the San Francisco-based Transgender Law Center, the U.S. People Living With HIV Caucus and 41 other community based organizations.


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