Overview of Ending the Epidemic Initiatives: Objectives, Organizing, Outcomes

Transcription

1 Overview of Ending the Epidemic Initiatives: Objectives, Organizing, Outcomes

2 About Treatment Action Group Treatment Action Group is an independent research and policy think tank focused on activism to accelerate research, treatment, access, and community information to prevent, treat, and cure HIV and its most common coinfections, hepatitis C virus (HCV) and tuberculosis (TB).

3 Introductions Name Organization (if any) Where you re from In one or two words: what would ending the epidemic mean to you?

4 TAG s Southern EtE Work TAG has been funded by the Elton John AIDS Foundation, MAC AIDS Fund, Ford, Gilead, and ViiV to assist EtE development in Southern jurisdictions In May 2017, TAG, the Southern AIDS Coalition, the Southern AIDS Strategic Initiative, NASTAD, Sisterlove, and AIDS Alabama convened 45 advocates and public health officials from the Deep South for a discussion in Atlanta. Looked at key opportunities and challenges and identified jurisdictions that are ready to move forward with an EtE plan. TAG has been working closely with advocates in Nashville, TN; Alabama, and Louisiana to begin EtE planning.

5 What does it mean to end the epidemic? For the first time ever, we have evidence-based tools in HIV treatment and prevention that are so effective that they could conceivably end epidemics. Bending the curve and bringing new infections below epidemic levels Implementing policies and programs to address structural and social drivers. Ending the epidemic while continuing to demand a cure and vaccine for HIV/AIDS Improving outcomes for people living with HIV

6 Comparison to Other Targets Getting to Zero Gives us an ambitious target on our way to this ultimate vision Frequently part of EtE targets, but misses out on HIV negative individuals National HIV/AIDS Strategy Targets Still very useful, but we want to be even more ambitious

7 Key EtE Advantages CBO and Community Driven/Led Statewide/Citywide Can work synergistically with existing plans Focus on vulnerable HIV negative individuals

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13 Where are EtE Initiatives Happening? In 2014 New York became the first jurisdiction in the world to announce an EtE plan. Now, several other cities, counties, and states around the US have made similar announcements. Cities/Counties Houston Pittsburgh Washington D.C. Fulton County, GA (Atlanta Metro Region) Miami-Dade County San Francisco Hennepin County, MN States Arizona Colorado Massachusetts New York Washington Oregon

14 What Does an EtE Initiative Look Like? No one-size-fits-all approach Successful planning usually involves partnership and shared leadership between community leaders, activists, service providers, representatives from academic institutions, and public health officials Key steps: community mobilization, action planning, developing a written EtE plan, implementation, monitoring/evaluation Bottom up and top down document: not another integrated care, treatment, and prevention plan

15 EtE Plans Most plans contain some common elements. Defined, quantifiable targets for Ending the Epidemic in your city/county/state. Specific recommendations/objectives for: HIV Prevention Access to Care and Treatment Surveillance and Data Addressing Structural and Social Barriers Strategies for implementing the plan Cost savings/cost modeling The plan serves as a blueprint or roadmap for achieving drastic cuts in new infections in your jurisdiction.

16 A community proposal: Five pillars for a plan to end AIDS in NYS 1 Use 21 st century surveillance strategies to know the epidemic and guide responses 2 Ramp up evidence-based combination prevention (biometrical, behavioral & structural) for both HIV+ and HIV- persons 3 Fill gaps in the continuum of care to maximize the number of people able to rapidly suppress viral load after HIV diagnosis 4 Ensure access to housing and supportive services needed to support health, prevention and retention in care for all 5 Garner the commitment of political leaders and all communities to leadership and ownership of the plan to end AIDS Supported with smart, strategic & sustained public investments

17 17 Social and Structural Barriers Medicaid Expansion Adapting to A Changing Landscape Culturally competent providers Stigma and Discrimination Health Disparities

18 Timeline and Steps for a Plan: Houston November 2015: Legacy Community Health received a $50,000 Southern REACH grant from AIDS United for EtE work. March 29-30, 2016: Community leaders attended an invitation-only kickoff meeting and divided up into work groups focused on five broad subject areas related to the plan. April - July 2016: Co-chairs for the working groups convened monthly meetings to develop recommendations for ending the epidemic. September 2016: A second community meeting was held to review and provide feedback on a draft plan. December 1, 2016: Officially launched the final plan. The plan reflects the input of over 150 community members.

19 Who Do We Need at the Table? Diverse community representation Pharmaceutical companies Academia Public health officials Ryan White Planning councils Elected officials Non-traditional partners Service providers and healthcare administrators Sororities/Fraternities Police Departments Faith-based institutions

20 Key Opportunities in the South Trailblazers: existing EtE initiatives in Fulton County, GA and Houston Political allies in key jurisdictions Passionate, experienced advocates Increased attention to funding disparities Innovative use of HIV surveillance Budget savings: every new HIV infection costs almost $444,000 in health spending

21 Small Group Discussions (20 minutes) Is your jurisdiction already participating in EtE work? If yes, how did that work start and what benefits/challenges do you see? If no, would EtE planning help further your work? How so? How do we best include Latino communities in planning and implementation? Why is it important for healthcare workers and social workers to be engaged in these discussions?

22 EtE Resources TAG EtE Website NASTAD EtE Tools TAG Prevention Advocacy Modules Act Now End AIDS Coalition