Governor Cuomo Makes History by Committing New York State to Ending AIDS
By Charles King, Co-founder, President, and CEO, Housing Works; and Mark Harrington, Executive Director, Treatment Action Group
Today New York Governor Andrew Cuomo made history by committing New York State to ending AIDS as an epidemic within the next decade.
New York – which has been the epicenter of the nation’s HIV epidemic since the beginning, now becomes the first jurisdiction anywhere in the world to launch an effort to end our AIDS epidemic, even without a cure, by stopping deaths from HIV disease and eliminating new HIV infections.
The Governor’s announcement builds on recent scientific findings that early HIV treatment can reduce new transmissions of the virus by 96% and that two anti-HIV drugs given together, when taken daily as prevention, can reduce new infections by over 90%.
Over the past six months, New York State successfully negotiated substantial rebates on HIV treatments from companies manufacturing drugs that make up 73% of the market in the state.
We call on the holdout companies – representing 27% of the market, but making important treatments – to expeditiously come to agreement with the state on their participation in the plan.
New York has the people, institutions, resources, and tools needed to end AIDS as an epidemic and Governor Cuomo’s announcement today shows the way forward for other jurisdictions around the country and around the world.
A little over a year ago—in June 2013—a remarkable coalition of over 30 New York organizations, among them LGBT and AIDS groups, asked Governor Cuomo to be as progressive regarding AIDS as he is in other arenas such as marriage equality and housing for people with HIV. We asked the Governor to publicly declare an end to AIDS in New York by the year 2020 and to appoint a high-level State Task Force to develop the strategic roadmap and plan to get us there.
The goal is ambitious, but grounded in reality. NYS has always been a leader and center of innovation in the fight against AIDS. We have seen an almost 40% decrease in new HIV diagnoses in the last decade, with fewer new infections each year, while nationally there has been no decline in the number of new HIV infections diagnosed each year. Now Affordable Care Act (ACA) implementation and New York’s incredibly successful Medicaid reform give us unprecedented momentum, putting more people, especially those at risk, into primary care and freeing up funds for support services vital to HIV treatment adherence.
We also have the science—from new prevention and testingtechnologies to highly effective antiretroviral treatments (that dramatically reduce the level of detectable virus in the blood). An HIV+ person on treatment that renders the virus “undetectable” is not only healthy but also virtually unable to transmit HIV to others. Add in new HIV prevention tools beyond condoms—PrEP, a daily pill for people who are HIV-negative but at high risk, and PEP, in which individuals go on HIV meds within 72 hours of possible exposure to prevent infection.
With these advancements we can end AIDS if we have the resolve, even while critical research continues towards a cure and a vaccine.
Over the struggles of the past three decades, we’ve learned that any effective plan to address AIDS requires shared commitment: the political will of government, coordination between state and city health agencies, and the energy and dedication of AIDS activists, doctors, researchers, and service providers.Getting all HIV-positive New Yorkers who need HIV treatment into care – and those highly at-risk who need access to HIV testing, pre-exposure and post-exposure prophylaxis, substance use treatment, and housing – will certainly increase the overall costs of New York’s HIV programs, so the state entered in negotiations with HIV pharmaceutical makers to join in the effort by offering the NYS Medicaid program discounts. In March, Gilead, the company that represents 53% of the HIV treatment market, signed on to the plan, agreeing to let the State purchase HIV treatments in bulk at reduced cost.Similar commitments are in the offing from most of the other major HIV drug makers—with over 73% of the market now on board.
Other breakthroughs over the past year include the historic agreement on an affordable housing protection for disabled people with HIV by Governor Cuomo and Mayor de Blasio and new HIV testing laws that will increase our ability to diagnose HIV early in the course of infection, get positive persons into care while they’re still healthy and help all persons at risk of and living with HIV in NYS benefit from new therapies.
Now that Governor Cuomo is throwing his full weight behind this initiative with confidence, we have the political leadership as well as the science, momentum, community support, and the social protections required to make the end of AIDS in New York a reality.
It’s not only the right choice, it’s also cost-effective. We simply can’t afford a status-quo approach to HIV. Our current “stable” NYS epidemic is expensive—in human lives and public spending. In New York, “stability” means about 130,000 New Yorkers living with HIV and 3,000 new HIV infections annually. The cost of these 3,000 new infections adds at least $36 million in HIV medicine costs alone every year.
Every averted HIV infection saves the State over $400,000 in lifetime medical costs. Current HIV prevention and care efforts save NYS $1 billion every year through improved health outcomes and prevented infections. A State Plan to End AIDS will more than double those savings, freeing funds that could be re-allocated to address other health issues.
We have work to do. Although new infections are dropping in almost every other demographic, HIV is rising dramatically among young men who have sex with men and transgendered women, who together account for nearly two-thirds of new infections in NYS. Our Governor led the way nationally by redesigning Medicaid to improve health outcomes and save the state $8 billion. Applying the latest scientific evidence in the context of universal health coverage New York State can also show the way for all to end AIDS.
“We have won when we’re one” is NYC Pride 2014’s theme, the idea being that the marriage equality fight isn’t over until the LGBT community worldwide enjoys its protections.That theme also echoes a longstanding theme of the AIDS movement:
The AIDS epidemic isn't over until it's over for everyone.
Since Governor Cuomo successfully led New York State to marriage equality, a dozen other states have followed suit. By launching New York State on a sustainable path to ending AIDS, Governor Cuomo once again lays down a challenge for other states to follow.
Governor Cuomo has chosen to make history by committing the full resources of New York State to ending AIDS in the next decade. We salute him for his leadership and vow to work with him and all New Yorkers to making this commitment a reality.