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Interview: Monique Tula on the National HIV/AIDS Strategy Launch

The National HIV/AIDS Strategy for the United States: Updated to 2020 was presented at a day long symposium style gathering at Atlanta’s Morehouse School of Medicine on Thursday July 30, 2015. As we discussed last week, the updated strategy reinforces the goals of its predecessor while incorporating scientific developments of the past 4 years. The four pillars of the updated strategy are:

1. widespread testing and linkage to comprehensive care,

2. broad support for treatment adherence for people with HIV,

3. universal viral suppression, and

4. full access to PrEP.

The latter two pillars reflect the efficacy of and support for antiretroviral medications as an integral component of our comprehensive national strategy to combat HIV.

AIDS United’s Director of Capacity Building, Monique Tula, presented at the symposium and took the time to reflect on the event with the Policy Department.

What was the key takeaway from the NHAS launch?

MT: The thing that struck me the most was the focus on PrEP. I appreciate that the White House acknowledged that PrEP, along with treatment as prevention are probably the strongest tools we have in our prevention arsenal apart from access to sterile syringes. Despite criticism of PrEP, the White House stood up and said: “This works. It should be a best practice and it should be a standard.”

That’s really heartening.

We now see that people inside the White House really get it. And it validates the work that community organizations have been doing to make PrEP an accessible prevention resource.

Who showed up and who didn’t?

MT: There were no surprises. All the usual suspects. I really liked that Obama was there in spirit. I like that he took the time to be recorded and kicked off the day for us.

And there was the noticeable absence of protesters, which could likely mean that the strategy is a good thing and it’s something the community wants and needs. As advocates, it stood out how different of a place we are in 20, 30 years into the movement. We now have the Office of National AIDS Policy – that is responsive to communities most affected by HIV/AIDS and is led by an HIV positive black gay man. They get it. And this really speaks to how far we have come.

Tell us about your panel.

MT: The NHAS goals— Widespread testing and linkage to comprehensive care; Broad support for treatment adherence for people living with HIV; Universal viral suppression; Full access to PrEP—can’t be accomplished without a strong infrastructure that supports innovative collaboration between public, private, and nonprofit sectors to meet the complex needs of people impacted by HIV.

AIDS United believes that healthy organizations make for health communities. Whether through our grantmaking, capacity building, or public policy and advocacy initiatives, AU is committed to ensuring people living with or affected by HIV have access to high quality medical care, support services, and the most effective prevention tools available.

For the past few years, there’s been a growing uncertainty about grant-based funding to support these important programs, prompting many ASOs to develop aggressive strategies to diversify revenue streams and heighten their ability to maximize the impact of each dollar. So the question becomes: how do community-based HIV organizations respond to the changing health care landscape? And this is what my talk explored.

Was there something special about hosting the launch at Morehouse School of Medicine?

MT: While the location, a Historically Black College and University (HBCU), certainly called attention and focused conversation on health disparities – particularly those faced by young Black men, and their over representation in HIV incidence rates across the country – the language of the strategy didn’t actually emphasize and enumerate the ways the issue would be addressed. There was some talk about it, but I felt like the substance of the strategy didn’t directly address it. However, I must say that much of the strategy’s implementation is still being developed so this remains to be seen. There certainly was emphasis on the part of the panel on special communities

The fact that geographically speaking, the nexus of the epidemic is in the south and the event took place at a HBCU, demonstrated an increasing interest and awareness that the strategy needs to be taken out of the bureaucracy and into the communities most affected. It also sent the message that leadership needs to come from these communities too.

The former Surgeon General, David Satcher, who is now a professor at Morehouse, also is the Founding Director of The Satcher Health Leadership Institute which aims “to develop a diverse group of public health leaders, foster and support leadership strategies, and influence policies toward the reduction and ultimate elimination of disparities in health.”

The connection for me, and a passion of mine, is ensuring that our workforce in the field has all the tools that we need, not just to do our jobs well but to ensure that we have strong leadership and people in line to take on these leadership positions in the future. If we are truly to see an end to HIV in the US, we need to do everything we can to make sure rising leaders have the skills and resources they need to continue the momentum achieved over the past 35 years. 

How do you think the Updated NHAS will advance us towards ending the HIV epidemic in the U.S.?

MT: I think it speaks to the fact that we have tools now that we didn’t have even five years ago. The biomedical advances we've had within the past 30 years puts the end within our reach. Somebody asked me the other day if we were going to see a cure. And I said “Yes, I think we will in my lifetime.” Even though I believe that, I also believe that unless we address HIV-related stigma, we will have missed the opportunity to achieve health equity. Michael Johnson’s sentence of 30 years for HIV exposure and transmission in Missouri is the latest example of the continued criminalization of HIV and evidence of arcane laws that further stigmatize people living with HIV. Finding a cure is not the end game. At the end of the day, it’s about health and social justice for all. The advances we’ve made in 30 years are huge. I really believe that we’re going to get there.

This article first appeared in the AIDS United Policy Action Center. Learn more: 

Posted By: AIDS United Policy Department - Friday, August 07, 2015

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