[Congressional Record Volume 168, Number 186 (Thursday, December 1, 2022)]
[Senate]
[Pages S6938-S6939]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
WORLD AIDS DAY 2022
Mr. CARDIN. Madam President, on December 1, we mark the 34th
anniversary of World AIDS Day. World AIDS Day calls on us to remember
those lost to AIDS and support those who live with HIV/AIDS-related
illnesses. On this day, we also raise awareness for the global health
crisis and redouble our efforts in the fight against HIV/AIDS.
Established in 1998, World AIDS Day marked the first international
day for global health. Since then, World AIDS Day has adopted targeted
themes to raise awareness and encourage international cooperation. This
year's theme, ``Equalize,'' focuses on addressing persisting
inequalities in the fight against AIDS. Vulnerable groups such as young
women, gay men, transgender people, people of color, and sex workers
struggle to access contraception, testing, treatment, and new
technologies. Criminalization, discrimination, and social stigmas
continue to target these vulnerable populations across the globe. The
2022 ``Equalize'' campaign reminds us that our fight cannot be won
until such inequalities are eliminated.
Since the first U.S. cases of AIDS were reported in June 1981, over
700,000 people in the U.S. have died from HIV-related illnesses. As of
2019, nearly 1.2 million people were living with HIV. In 2020, 30,635
people received an HIV diagnosis in the U.S. and dependent areas. My
home State of Maryland is not immune to this issue. As of 2021, over
32,000 Marylanders over 13 years old are living with HIV, with 773 new
diagnoses that same year. Furthermore, recent data shows that minority
populations remain disproportionately affected by HIV/AIDs. In 2020,
Black Americans accounted for 42 percent of HIV diagnoses, while
Hispanic/Latino Americans accounted for 27 percent of HIV diagnoses.
This is evidence of the persistent health challenge HIV/AIDS presents
Maryland and the U.S.
Fortunately, scientists have made significant strides in developing
antiretroviral therapies--ART--against HIV infections over recent
decades. Thanks to breakthroughs in the private and public sectors, the
U.S. Food and Drug Administration--FDA--has now approved more than 30
medicines
[[Page S6939]]
to treat HIV infection. These treatment regimens help extend and
stabilize the lives of those living with HIV while reducing further
risk of HIV transmission.
I particularly applaud Maryland's scientific community and academic
partners--including the National Institutes of Health--NIH--the Walter
Reed Army Institute of Infectious Disease Research, the Institute of
Human Virology at the University of Maryland, and Johns Hopkins
University--for their groundbreaking research initiatives. For example,
NIH-funded research, including clinical trials, to develop pre-exposure
prophylaxis--PrEP--medication designed to prevent high-risk individuals
from contracting HIV.
Thanks to cutting-edge advancements in treatment, Maryland has
reached significant milestones in reducing HIV case numbers. For the
first time in over three decades, Maryland reported fewer than 1,000
new cases in 2018 and continues to remain below the 1,000 new case
benchmark as of 2021. State-supported efforts such as safe-sex
education programs, condom distribution, and the expansion of
prophylactic medications have all mitigated HIV transmission. The
Maryland Department of Health's antiretroviral therapy campaign has
also contributed to viral suppression for 60 percent of the State's HIV
patients. Additionally, city and county needle exchange programs have
broadened efforts to reduce the circulation of unclean syringes,
provide testing for infectious diseases such as HIV, and extend
resources for substance abuse.
Thanks to the Affordable Care Act--ACA--Americans diagnosed with HIV
or at risk of transmission have more meaningful access to healthcare
coverage and health insurance. Today, Americans cannot be dropped or
denied coverage because of pre-existing health conditions such as HIV.
The ACA also gives States the option to expand Medicaid, the largest
payer for those who need HIV treatment in the country. The ACA's
investments in community health centers' Ending the HIV Epidemic
Initiative is an integral part of the National HIV/AIDS Strategy.
The ACA has also established new health plan standards or essential
health benefits that must be covered under certain health plans.
Benefits such as prescription drug services, hospital inpatient care,
lab tests, HIV screening, PrEP, and other preventive services aim to
preserve the health of those with HIV while mitigating further
transmission. Under the ACA, most health insurance plans must provide
preventative services, including HIV testing for those aged 15 to 65.
PrEP to inhibit HIV is also provided for HIV-negative adults at high
risk for contracting HIV. I am proud to cosponsor the PrEP Access and
Coverage Act of 2021, which would expand access to PrEP and work to
reduce disparities among those recommended and prescribed the
medication through multiple initiatives, including eliminating out-of-
pocket costs for the medication.
These investments in an infrastructure to test and treat HIV have
helped reduce the spread of HIV/AIDs, but have also been essential in
curbing the spread of mpox. It has provided natural points of care for
testing, access to treatment, and education to populations also
vulnerable to contracting mpox.
However, HIV/AIDS is not an issue the U.S. faces in isolation.
Outside the U.S., the global HIV/AIDs epidemic remains a grave public
health challenge. In 2021, approximately 38.4 million people lived with
HIV across the globe, including 1.7 million children between 0 and 14
years of age. Last year, roughly 1.5 million people contracted HIV.
Nevertheless, the international community has made significant process
in HIV testing and treatment over recent decades. By the end of 2021,
28.7 million people with HIV, about 75 percent, were receiving ART,
while approximately 68 percent of all people with HIV reached viral
suppression. In 2021, an estimated 650,000 people died from AIDS-
related illnesses worldwide, down from 2 million people in 2004 and 1.4
million in 2010.
Since its inception in 2003, the U.S. President's Emergency Plan for
AIDS Relief--PEPFAR--represents an extraordinary commitment to global
health, aiming to prevent, diagnose, and treat HIV infections. Over
nearly 20 years, the U.S. has invested more than $100 billion in the
global response to HIV/AIDS. Because of this, we have made significant
inroads in access to testing and ART.
In 2021, PEPFAR provided HIV testing services for more than 50
million people and supported ART for nearly 19 million people. As of
today, U.S. leadership through PEPFAR has saved an estimated 20 million
lives and prevented millions of HIV infections. PEPFAR now operates in
over 50 countries, training hundreds of thousands of healthcare workers
and providing critical support to healthcare systems. PEPFAR is a
powerful example of sincere, effective, and transparent U.S. global
health leadership and cooperation.
The COVID-19 pandemic produced a stark reminder that we must swiftly
respond to global health crises. It demonstrates that diseases cannot
be easily confined to national borders and regional spheres.
Additionally, the COVID-19 pandemic has disrupted HIV treatments and
prevention services, separating patients from healthcare providers.
Vulnerable populations have also been disconnected from educational and
counseling services while economic downturns exasperated social and
economic inequalities. Marginalized populations and now more
susceptible to HIV infection and less likely to access necessary
services than before the pandemic's onset. Our interconnected world
demands American vigilance, conscientiousness, and our strong
investment in global health systems.
Our battle against HIV is far from over. The U.S. must continue to
define global health leadership and facilitate cooperation with our
foreign partners and allies. I commend President Biden for his enduring
support for PEPFAR. I also recognize international partnerships,
including the Global Fund along with faith-based organizations and
civil society for their long-held commitment to eradicating HIV/AIDS.
Most importantly, I want to recognize those living with HIV/AIDS across
the globe. Your dignity, fortitude, and endurance testify to the
extraordinary power of the human spirit. And in accordance with that
drive and spirit, we will prevail in this fight.
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