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Partnership between health department leadership and community advocates is integral to the success of EtE initiatives. The advent of TasP and PrEP was a significant part of the first call to end HIV as an epidemic in New York. However, it was a renewed spirit of cooperation between the New York City Department of Health and Mental Hygiene, the New York State Department of Health, and community advocates that provided the opportunity to turn hopeful science into an implementable reality.

Aligning the priorities of state and city health departments with the priorities of the communities they serve is an essential part of the EtE process. In order to achieve this, jurisdictions must find ways to level the playing field between community and public health leaders; developing common language and establishing mechanisms for meaningful and productive dialog every step of the way. Many times, this means being cognizant of power dynamics and ensuring that community is involved in a formalized leadership capacity. We recommend that health departments partnering on EtE initiatives remain aware of who is driving the process, who is facilitating, who is developing meeting agendas, and who is following up on next steps.

Across the country, innovative health department leaders are stepping up to the challenge. In May 2016, NASTAD Board Chair DeAnn Gruber of Louisiana announced her Chair’s Challenge calling on health departments to accelerate the end of the HIV and hepatitis epidemics in the United States. In support of this challenge, NASTAD assessed state health departments across fourteen core competencies, highlighting strengths and identifying areas for improvement. The assessment was designed to determine the minimum program and policy building blocks, or core competencies, that must be in place to support highly effective HIV prevention and care programs, and assess where health departments land on the core competencies continuum.

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