Strategies to Improve Viral Hepatitis Prevention, Care and Treatment through Appropriations. Emily McCloskey USCA October 3, 2014

Transcription

1 Strategies to Improve Viral Hepatitis Prevention, Care and Treatment through Appropriations Emily McCloskey USCA October 3, 2014

2 About NASTAD NASTAD is an international non-profit association of U.S. state health department HIV/AIDS program directors who administer HIV/AIDS and viral hepatitis programs funded by U.S. state and federal governments. NASTAD was established in 1992 as the voice of the states. NASTAD is governed by a 20 member, elected Executive Committee charged with making policy and program decisions on behalf of the full membership. NASTAD has a Washington, DC headquarters with 38 staff and field offices/programs in Bahamas, Botswana, Ethiopia, Guyana, Haiti, Trinidad, South Africa and Zambia with 65 staff.

3 About NASTAD Mission NASTAD strengthens state and territory-based leadership, expertise and advocacy and brings them to bear on reducing the incidence of HIV and viral hepatitis infections and on providing care and support to all who live with HIV/AIDS and viral hepatitis. Vision NASTAD s vision is a world free of HIV/AIDS and viral hepatitis.

4 Viral Hepatitis Overview Viral Hepatitis at CDC Viral Hepatitis Funding Needs Looking Forward Questions and Answers

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6 Viral Hepatitis Overview 5.3 million people are living with hepatitis B (HBV) and/or hepatitis C (HCV) in the U.S. Up to 75% of chronic viral hepatitis cases are undiagnosed Viral hepatitis can be asymptomatic for decades, leading to late-testing and late diagnoses Viral hepatitis can lead to liver disease and claims the lives of 15,000 people annually Baby boomers have the highest rates of HCV-related mortality New reports indicate an increase in acute HCV infection among young persons who use/inject drugs who began by using prescription opioids and transitioned to injection

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8 Division of Viral Hepatitis (DVH) DVH is currently funded at $31.4 million This funding is used to identify those most at risk for viral hepatitis and monitor the impact of the viral hepatitis epidemic CDC funds health departments to have a Viral Hepatitis Prevention Coordinator (VHPC) in 52 jurisdictions. Coordinate prevention and surveillance efforts Provide the basic, core public health services to combat viral hepatitis with no federal funding for programming VHPC program has been and remains the only national program dedicated to the prevention and control of the viral hepatitis epidemics.

9 Division of Viral Hepatitis (DVH) (cont.) In order to reduce viral hepatitis-related illness and death, CDC seeks to: Conduct hepatitis surveillance and detect outbreaks Support targeted implementation of one-time testing for Asian- Americans, persons born during , and others at risk for viral hepatitis and linkage of infected individuals to preventive care and treatment services Link those persons found to be living with viral hepatitis to appropriate medical care and treatment Develop interventions to prevent HCV transmission among adolescent and young adult persons who inject drugs. Update CDC recommendations for hepatitis A and hepatitis B vaccination to reduce the incidence of hepatitis A and hepatitis B Increase and improve case management of infants born to hepatitis B virus (HBV)-infected mothers, infants who are at highest risk for developing chronic HBV infections. Raise awareness about viral hepatitis among at-risk persons and educate healthcare providers about viral hepatitis prevention, care and treatment.

10 Funding Needs

11 FY2014 Funding In FY2014, the Division of Viral Hepatitis (DVH) was funded at $31.4 million Less than 15% ($5.3 million) of DVH s budget goes to the VHPC program

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13 Funding Needs Viral hepatitis prevention at CDC is not adequately funded to meet the prevention, screening and education needs of the millions living with and vulnerable to viral hepatitis. Need at least $47.8 million for DVH to expand prevention programs Funding must support HHS in strengthening the federal response to viral hepatitis in line with CDC testing guidelines for baby boomers, the Viral Hepatitis Action Plan, IOM viral hepatitis report and CDC PJ

14 Funding Needs (cont.) There is currently no funding for a national surveillance system to monitor trends in chronic viral hepatitis. Without such a system, stakeholders have limited information on which to base a hepatitis response and respond to outbreaks.

15 Funding Needs (cont.) There are untapped opportunities to reach persons who use drugs who are vulnerable to hepatitis C infection through the Substance Abuse and Mental Health Services Administration (SAMHSA) SAMHSA announced a one-year FY2013 initiative to link overdose treatment programs to HCV care. Sustained gains will require a long-term funding commitment Congress must direct resources and funding to SAMHSA to create linkages to viral hepatitis care

16 Funding Needs (cont.) Scientific research has shown that access to sterile syringes is an evidence-based and cost-effective means of lowering rates of HIV and viral hepatitis. Syringe services programs reduce the use of illicit drugs and helps connect people to medical treatment, including substance use treatment. Congress must lift the ban on the use of federal funds for the purchase of syringes.

17 Funding Needs (cont.) Effective hepatitis C treatments with high cure rates are now available and more are coming The only way that cure can be an effective public health strategy is if these new hepatitis C treatments are both affordable and accessible Identifying and linking patients to these new treatments will rely on investments in health department infrastructure.

18 Congressional Outlook

19 Congressional Outlook The 113 th Congress has grown increasingly partisan, resulting in very little accomplishment. Congress has the lowest level of productivity in many years Congress New Laws Enacted 113 th ( ) th ( ) th ( ) th ( ) 260 (as of July 2013) In the 107 th Congress ( ), the Senate and House were controlled by different parties and still managed to enact 200 new laws.

20 Elections Outlook

21 FY2015 Funding The Bipartisan Budget Act of 2013 established spending caps and reduced sequestration for FY2015 The FY b allocations for the Labor, Health and Human Services bill are similar to FY2014, however there are increasing funding needs for other programs The debt ceiling will expire in March 2015

22 FY2015 Funding (cont.) President Obama s budget included flat funding for the DVH The Senate LHHS Subcommittee also DVH The House Democrats released a bill that appropriated flat funding for the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention The breakdown by division is not available

23 FY2015 Funding (cont.) The Continuing Resolution funds the government through December 11, 2014 Across-the-board rescission of 0.054% for programs for the length of the CR Awards will potentially be partially allocated Chance of another continuing resolution into 2015

24 FY2016 Funding President Obama s last full fiscal year in office Potential changes in House and Senate Sequestration will impact FY2016 funding Budget cap for non-defense discretionary funding is $494 billion, an increase of $1.6 billion from FY2015 Appropriators will have to allocate funding at this level to avoid across-the-board cuts Low chance of another grand bargain

25 Questions and Answers

26 Contact Information Emily McCloskey Manager, Policy and Legislative Affairs