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Overview of Ending the Epidemic Initiatives: Objectives, Organizing, Outcomes
Overview of Ending the Epidemic Initiatives:
Objectives, Organizing, Outcomes
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).
www.treatmentactiongroup.org
Introductions
Name
Organization (if any)
Where you’re from
In one or two words: what would ending the epidemic mean to you?
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.
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
Comparison to Other Targets
Getting to Zero
Gives us an ambitious target on our way to this ultimate vision
90-90-90
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
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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Where are EtE Initiatives Happening?
Cities/Counties States
HoustonPittsburgh
Washington D.C.Fulton County, GA (Atlanta
Metro Region)Miami-Dade County
San Francisco Hennepin County, MN
ArizonaColorado
MassachusettsNew York
Washington Oregon
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.
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
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 newinfections in your jurisdiction.
A community proposal: Five pillars for a plan to end AIDS in NYS
① Use 21st 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
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Health Disparities
Social and Structural Barriers
Culturally competent providers
Stigma and Discrimination
Adapting to A Changing Landscape
Medicaid Expansion
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.
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
Key Opportunities in the South
Trailblazers: existing EtEinitiatives 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
Small Group Discussions (20 minutes)
Is your jurisdiction already participating in EtEwork? If yes, how did that work start and what benefits/challenges do you see? If no, would EtEplanning 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?
EtE Resources
TAG EtE Website
NASTAD EtE Tools
TAG Prevention Advocacy Modules
Act Now End AIDS Coalition
