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HRSA AIDS Advisory Committee Meeting
I am delighted to speak to this joint meeting of the HRSA AIDS Advisory Committee and the CDC Advisory Committee on HIV and STD Prevention. This is a wonderful opportunity for us to exchange information and broaden our collaboration. It is absolutely essential that we improve ways to link care and prevention, and HRSA and CDC have been working together on this goal for many years. HRSA and CDC are natural partners. We share many concerns about the quality of health care in America. By coming together in joint sessions like these, we can transcend boundaries to make sure that our programs work together more efficiently and effectively. Your leadership and experience will help us move even more aggressively to address the needs of the millions of people in the U.S. and around the globe who are living with HIV/AIDS. Our ability to meet new challenges...to expand our efforts to meet emerging needs...and to plan for new developments will in large part depend upon the quality of consultation and advice we receive from people on the front lines – people like those of you who serve on these two advisory committees. I also want to take a moment to pay tribute to Belynda Dunn, a member of HRSA’s AIDS Advisory Committee, who passed away in March. She made many contributions, not only to the work of the Committee, but to the ongoing struggle against this terrible disease. She will be sorely missed. Again, I am delighted that HRSA and CDC have come together to explore areas of mutual interests and concerns. No doubt your deliberations here today will be productive and even strengthen what is already a strong working relationship. In the short time I have today, I want to give you an update on some HRSA priorities, discuss briefly our progress on CARE Act reauthorization implementation and take a look at our Global AIDS initiative. The past year has been a period of change and reorganization for me, the HIV/AIDS Bureau, and for all of HRSA. Upon taking office last year, HHS Secretary Thompson ordered HRSA to make sure that more of our funds go to pay for direct medical services for the people we serve. To do that, we have taken decisive steps to streamline operations and increase efficiency. We have restructured programs, bureaus and offices, cut travel, and curtailed speaking engagements. Communications and legislative offices have been centralized from across HRSA to cut waste and duplication and improve the way they serve the agency as a whole. Next, we are turning our focus to HRSA’s grants management process. Changes will be announced soon. I can’t share details with you today, because there are still some things to be worked out. But I can tell you that these changes will reflect our renewed emphasis on efficiency, on using scarce resources more wisely, and on professional organization and streamlined operations. As I said earlier, President Bush and Health and Human Services Secretary Tommy Thompson are both convinced that the best way to boost access to care and eliminate health disparities is to get more direct health care to the people who need it most. HRSA plays a central role in that strategy. The President and the Secretary decided to focus on HRSA safety-net programs that have a proven track record and use them to gradually and persistently expand access to care. In the President’s fiscal year 2002 budget, HRSA-supported health centers received an increase of $175 million, to a total of more than $1.34 billion. These additional funds represent a down payment on the President’s five-year plan to create new or expand health center sites in 1,200 communities and increase the number of patients served annually to more than 16 million. His 2003 proposed budget would raise the health center funding total to $1.5 billion, a $114 million increase. The President also plans a big boost for the National Health Service Corps. The President’s 2003 budget proposal would give the Corps a $44 million increase to $191.5 million. The added funds would provide scholarships or loan assistance to about 1,800 professionals practicing in underserved areas - an increase of about 560 participants. In addition, President Bush’s fiscal year 2003 budget proposes a total of $15 million, nearly a 50 percent increase above last year’s funding, to expand the Nursing Education Loan Repayment program. This will help address the Nation’s growing need for nursing professionals. The increase will support 800 new nursing education loan repayment agreements. The program repays a substantial portion of the education loans of nurses who agree to work for two years in designated public or nonprofit health facilities. HRSA also has responsibility for the new $20 million Healthy Communities Innovation Initiative. This is an effort to bring together community-wide resources to help prevent diabetes, asthma and obesity. It will fund demonstrations in five communities to enhance services, encourage behavioral changes and improve overall community health. As a part of this initiative, HRSA will continue its partnerships with other DHHS agencies, especially CDC and the Centers for Medicare and Medicaid Services. Our telehealth program, now housed in the HIV/AIDS Bureau, is also a vital and growing part of HRSA’s outreach efforts. The Secretary and I intend to ensure that telehealth consultation and distance-learning remain innovative grant programs in their own right as well as becoming vital parts of other HRSA services. We want to use telehealth technologies to fill the gaps for people and communities who might otherwise go without critical health care. This is especially important since September 11, with our new focus on public health preparedness. The President’s budget priorities and the Department’s new concerns with confronting bioterrorist threats make telehealth an important part of our response. Building public health systems that can respond to emergencies that result from terrorism is another critical area where HRSA and CDC are working together. Secretary Thompson wants to ensure that we are ready no matter what happens. We are helping states to develop comprehensive bioterrorism preparedness plans, upgrade infectious disease surveillance and investigation, enhance the readiness of hospital systems to deal with large numbers of casualities, expand public health laboratory and communication capacities, and improve collaboration among hospitals, and state and local health departments to enhance disease reporting. HRSA also has been hard at work implementing some of the key changes mandated by the 2000 CARE Act reauthorization. We’re making progress on a number of fronts. We’re bringing people into care earlier, especially those who know their HIV status and are not in care. We’re making life-prolonging antiretroviral therapies more readily available in states with limited resources, and we’re helping communities where the epidemic is increasing to build and improve their HIV health care infrastructure. And, of course, we are making every effort to better target services to women, children, youth and families. Through our administration of the CARE Act over the last decade, we have gained enormous practical experience in treatment and care delivery, drug distribution, clinician and caregiver training, community health care organization and development, and program measurement and assessment. We believe that our programs have established approaches that will be useful for any country looking to extend clinical and support services to HIV-infected individuals. We’ve learned that education is a key to stopping the spread of HIV/AIDS… that when people are tested and receive appropriate treatment, their long-term health and well-being are enhanced. We have seen dramatic breakthroughs in AIDS research in recent years, such as new drug therapies that are making it possible for many to enjoy long and productive lives. Our experience has taught us that these themes are valid and important whether we’re talking about treatment for women and children with HIV in Jacksonville, Florida or in Kingston, Jamaica. We now want to build on this experience by expanding our focus beyond the borders of the United States. In the last 20 years, AIDS has claimed the lives of nearly 25 million people. Last year, 40 million people around the world were living with HIV/AIDS, the vast majority in Africa and South East Asia. In the Caribbean alone, we estimate that nearly 400,000 people are living with HIV. This is no time to let our guard down. With HRSA’s Global AIDS Initiative, we will work to support development and implementation of training activities; support implementation of clinical guidelines; help expand palliative, home and community-based care programs; and support the monitoring and evaluation of treatment and care programs. For example, we have recently formed a partnership with the Pan American Health Organization and others to strengthen the U.S.-Caribbean collaboration on HIV/AIDS care and treatment. Through this effort, we will:
As you can see, partnerships are key to much of what we do. To reach our goals, we work with other governmental agencies, such as USAID, the Defense Department, State Department and departments of Labor, Commerce and Treasury, as well as nonprofit organizations like the Salvation Army and various foundations. That’s why our going partnership with you folks at CDC is so important. Only by working together do we have a chance to prevent new infections and provide compassionate care for those who are already living with HIV/AIDS. Looking ahead, we face an era of many new challenges and shifting priorities. And, while our long term sights must be set on preventing disability and death for all affected, we have an urgent need to intervene on behalf of the poor, the uninsured, and the racial and ethnic minorities who continue to bear a disproportionate share of the burden of this disease. We are committed to working with you to create a coordinated continuum of care that is accessible to everyone who is living with or at risk for HIV. Again, I thank each of you for sharing with us your time and talent. Your dedication and commitment have brought us even closer to the goal we all share -- quality health care for all those living with HIV/AIDS. |
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