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Stanford expert says "hallelujah" over new Obama AIDS strategy

Eighteen months into his administration, President Obama has finally introduced a coordinated national AIDS strategy (.pdf) that has very laudable goals, though no new funding to support them.

The strategy calls for reducing the number of new HIV infections by 25 percent in five years and getting more people into treatment, particularly in the early stages after diagnosis.

“The first point to make is hallelujah that they have a national AIDS strategy. That is good,” Douglas Owens, MD, a professor of medicine and HIV specialist at Stanford, said earlier today. “But the question I would have is how much can we do without additional investments.”

More than 1.1 million Americans are living with HIV, the report notes, and an estimated 56,000 become newly infected every year. Clearly the strategy is intended to reinvigorate an effort that has been lagging.

“Public attention to the HIV epidemic has waned,” the report says. “Because HIV is treatable, many people now think it is no longer a public health emergency.”

Among the sobering challenges noted in the report is the fact that about one in five people living with HIV is unaware of his or her status. To identify more affected individuals, the strategy proposes to step up prevention and education efforts, particularly in high-risk groups, such as gay and bisexual men and African Americans. The report also notes that tens of thousands of Americans who are infected are not getting care, and it calls for greater access to treatment.

But the strategy doesn’t propose any new funding for these initiatives, noting the constraints on the federal budget. The United States currently spends $19 billion on AIDS prevention, treatment and research.

“We need to refocus the resources we’re spending to make sure we get more for the money, but it doesn’t really say how that will happen or that there is anything being done now that isn’t effective,” Owens told me.

The strategy is certainly an encouraging first step, but it remains to be seen whether agencies can effectively work together to accomplish what it sets out.

“These are all very important goals,” Owens said, “but the devil will be in the details.”

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