Imagine if we had a treatment for COVID-19 that works nearly 100% of the time, or a cure, and we did not provide it to the people. That is what we are doing today when it comes to HIV and hepatitis C.
As a nation, we must do better, and the president and Congress can ensure it happens.
We already have much of the science we need to eradicate these two viruses. But to end them, we will need many of the same scientific tools needed to address COVID-19, along with governmental leadership, a strong state and local public health infrastructure, and sufficient funding. While we have many of the scientific advancements to end HIV and hepatitis C, some of these other ingredients are still needed to end these two infectious diseases.
There are approximately 1.2 million people living with HIV in the United States and 38,000 new infections annually. Hepatitis C affects 2.4 million people in the nation, with 53,000 new infections in 2018. In the last 10 years, new cases have quadrupled, mainly due to the opioid epidemic. Despite testing technologies, 1 in 7 people living with HIV and 4 in 10 people with hepatitis C are unaware of their infection.
While there are significant differences among the coronavirus, HIV, and hepatitis C, there are also many similarities. To attack each of them, you need testing, medications for treatment, prevention methods, and, ultimately, a vaccine. In fact, it is due to the years of research on HIV and hepatitis C that we are able to respond quickly to COVID-19.
After decades of research, we have highly effective anti-retroviral drugs that, if taken daily, allow people with HIV to live long and healthy lives. They work so well that they suppress the virus, making transmission of HIV to another person impossible. There are even drugs called PrEP, which people can take to prevent HIV. Pharmaceutical companies are working on even better drugs for treatment and prevention. Although they still are searching for vaccines for HIV and hepatitis C, we do have drugs that cure hepatitis C in a matter of eight to 12 weeks.
People can only take advantage of these scientific advancements if they have access to healthcare, the public health infrastructure is in place, there is government leadership, and sustained, sufficient funding is available.
The Trump administration has made ending the HIV epidemic in the U.S. a priority. Announced during the 2019 State of the Union, the Ending the HIV Epidemic initiative seeks to reduce new HIV infections by 90 percent in ten years by ramping up testing, access to treatment, PrEP, and other prevention efforts. This focused approach initially targets 57 hardest-hit areas and communities, including gay men, black people, Latinos, and injection drug users.
The president proposed an ambitious budget for year one, and Congress responded in a bipartisan basis by providing over $300 million. To ramp up efforts for year two, the president has proposed another $450 million. This is a type of sustained investment needed to end an infectious disease and save thousands of lives and billions of dollars in future treatment costs.
While our government has invested resources to create prevention and treatment programs for HIV, the same cannot be said for hepatitis C. Despite the growing number of cases, there are minimal resources to conduct outreach and testing, conduct surveillance, and provide people with curative medications. The limited dollars also must be divided up to address new cases and outbreaks of hepatitis A and B.
America is learning about the costly impact of infectious diseases in terms of human and economic suffering and the important role of science, along with the value of a public health infrastructure. Our government is responding by dedicating billions of dollars for COVID-19 and building up a public health workforce.
Republicans and Democrats are also sounding the alarm that we cannot be caught ill-equipped during the next public health emergency. We must rebuild our public health infrastructure now and sustain it so that communities are prepared for the future. We can utilize the emerging infrastructure responding to COVID-19 and leverage it with strengthened infectious disease response efforts for HIV and hepatitis. This will require funding that some are smartly suggesting should not be subject to congressional budget caps, very much like we do during wars.
Our nation’s response to COVID-19 has greatly benefited by years spent battling HIV and hepatitis. But those wars are not over. Now, we must use what we are learning in battling COVID-19 with a similar sense of urgency to end these two other infectious diseases that we already have the scientific evidence and tools to defeat.
Carl Schmid is the executive director of the HIV+Hepatitis Policy Institute and co-chairman of the Presidential Advisory Council of HIV/AIDS.
