Shared Action Hightlights – on NHAS in 2012 brought NHAS to our attention this week with a video discussion between Howard K. Koh, MD, MPH, Assistant Secretary for Health at the U.S. Department of Health and Human Services and Ronald O. Valdiserri, MD, MPH, Deputy Assistant Secretary for Health, Infectious Diseases, and Director of the Office of HIV/AIDS and Infectious Disease Policy. You can find the post here.

How has your agency changed with the release of NHAS? Did you know that Shared Action can offer free assistance with assessing your NHAS alignment and taking steps towards aligning with these future directions? Contact us for more information!

On the Road to an AIDS-Free Generation

Cross-posted from DipNote U.S. Department of State Official Blog.


2012 was an extraordinary year.

As of September 30, 2012, PEPFAR directly supported lifesaving antiretroviral treatment (ART) for nearly 5.1 million people — a nearly three-fold increase since 2008. PEPFAR also supported drugs to prevent mother-to-child transmission for nearly 750,000 HIV-positive women in 2012 alone, allowing approximately 230,000 infants to be born HIV-free, and HIV testing and counseling for more than 46.5 million people over the same time period.

These are not just statistics but they represent lives saved, and hope renewed for millions of families and communities. A decade ago, almost no one in Africa was receiving treatment. Today, over 8 million men, women, and children in developing countries are on ART, with the vast majority of them being in sub-Saharan Africa.

Every American should be profoundly proud of the United States’ role in supporting this progress. Both President Obama and Secretary Clinton have repeatedly reaffirmed America’s commitment to the global fight against AIDS through PEPFAR. In November 2011, the Secretary declared that the world is at the point where an AIDS-free generation is in sight. On World AIDS Day 2011, the President announced ambitious new PEPFAR prevention and treatment targets, which we are on track to reach by the end of 2013.

This past July, the 19th International AIDS Conference came to the U.S. for the first time since 1990. During the Conference, Secretary Clinton called on PEPFAR to develop a blueprint to inform the next Congress, the next Secretary of State, and all of our partners about all that we have learned, and how the U.S. will contribute to creating an AIDS-free generation moving forward. And in recognition of World AIDS Day 2012, the Secretary unveiled the PEPFAR Blueprint: Creating an AIDS-free Generation, which sends an unequivocal message that the U.S. commitment to the global AIDS response will remain strong, comprehensive, and driven by science.

Through the contributions of many partners, a new day has dawned in the global AIDS response. New HIV infections and AIDS-related deaths are on the decline, and national health systems have been strengthened to deliver a broader range of essential health services to the populations that they serve. Partner countries are increasingly assuming the central leadership in coordinating their AIDS response. Thankfully, long gone are the overcrowded medical wards that I witnessed as a clinician in San Francisco in the early 1980s, when we had little to offer patients beyond a more dignified death; or the time just a decade ago when AIDS was wiping out an entire generation in Africa. Today, while the fight is far from over, we are on the road to achieving an AIDS-free generation.

Now, we must redouble our efforts to get there. As outlined in the PEPFAR Blueprint, we will continue our focus on: saving lives by investing in proven HIV interventions; making smart investments by targeting interventions to populations at greatest risk; promoting sustainability, efficiency, and effectiveness across our programs to maximize the impact of each dollar we spend; partnering with countries in a joint move to country-led, managed, and implemented responses, and working closely with the Global Fund to Fight AIDS, Tuberculosis and Malaria and other partners around a shared global responsibility to reach more of those in need; and driving results with science by using the knowledge we already have, and supporting continued innovation.

As we enter the tenth year of PEPFAR, we do so filled with great hope for a future where an AIDS-free generation is, as Secretary Clinton stated, not just a rallying cry — it is a goal within our reach. And I am confident that 2013 can be another extraordinary year.

We Want to Hear From You

Cross-posted from White House Office of National AIDS Policy Blog

As we commemorated World AIDS Day earlier this month, the importance of addressing the needs of women and girls as part of the National HIV/AIDS Strategy was clear. While we have made tremendous progress in learning how to prevent and treat HIV, including among women and girls, much work remains.  Of the approximately 1.1 million people living with HIV/AIDS in the United States, about 290,000 are women and women account for 23 percent of new HIV infections.

This Administration has made combating the HIV/AIDS epidemic a priority. For women, that includes addressing gender-based violence and gender related health disparities.  This violence can increase the risks women and girls face of acquiring HIV while decreasing their ability to seek prevention, treatment, and health services.

As directed by the National HIV/AIDS Strategy, federal agencies are collaborating and coordinating in an unprecedented manner to decrease new HIV/AIDS infections, improve HIV-related outcomes, and reduce HIV-related disparities.  To continue this collaborative approach, President Obama issued a Presidential Memorandum in March 2012, establishing an interagency working group on the intersection of HIV/AIDS, violence against women and girls, and gender-related health disparities.

The working group includes representatives from the Departments of Justice, Interior, Health and Human Services, Education, Homeland Security, Veterans Affairs, Housing and Urban Development, and the Office of Management and Budget. We are also tapping into the wealth of expertise and experience of members of the Presidential Advisory Council on HIV/AIDS as well as our global Federal partners from the Department of State, the United States Agency for International Development, and the Gender Technical Working Group from the President’s Emergency Plan for AIDS Relief (PEPFAR).

The interagency group is charged with developing recommendations that focus on increasing public awareness of the intersection of HIV/AIDS, violence against women and girls, and gender related health disparities; sharing best practices and gender specific strategies aimed at addressing women’s risks and vulnerability to HIV/AIDS and violence; and prioritizing the needs of women of color who make up the majority of women living with and at risk of HIV infection in the United States.

Since June 2012, working group members have met regularly to pursue this mission of interagency coordination and the development of recommendations. We believe that it is critical to obtain input from as many stakeholders as possible regarding the issues the working group is addressing.  So we want to hear from you.

From December 202012 to January 202013 you will be able to submit your individual stories, experiences, and comments to the working group by completing this online form. While we welcome any comments salient to the issue, we also ask that you consider the following questions:

1) How can we best address both violence and HIV among women and girls?
2) What are model programs and promising practices in addressing the intersection of HIV/AIDS and violence against women and girls?
3) What are barriers to reaching women and girls affected by HIV and violence?
4) What are the most effective strategies to reach women and girls who are living with violence and with HIV?

We would appreciate if you could keep you submission to under 500 words.

We are extremely grateful for your input. Your experiences and recommendations will inform our work, and we will be sure to keep you informed as we move forward.

Dr. Grant Colfax is Director of the Office of National AIDS Policy and Lynn Rosenthal is the White House Advisor on Violence Against Women.

States Moving Forward to Implement the Health Care Law

Cross-posted from HealthCare Blog


Starting in 2014, consumers and small businesses in every state will have access to quality, affordable health insurance ­­– known as qualified health plans – offered through an Exchange – a marketplace where consumers can choose a private health insurance plan that fits their health needs.  The marketplace will provide consumers and small businesses one stop shopping for health insurance with better information about plan benefits, quality and cost­­ – simplifying the process for buying health insurance.

Last week marked a milestone for states setting up their own marketplace – it was the deadline to submit their Blueprint applications to run a type of marketplace called a State-based Exchange.  We have received State-based Exchange Blueprint applications from the following states: California, Hawaii, Idaho, Minnesota, Mississippi, Nevada, New Mexico, Rhode Island, Vermont, and Utah. We look forward to reviewing these applications, as well as working with other states as they continue to develop a marketplace that best meets the needs of their residents.

On Friday, we also announced that the District of ColumbiaKentucky, and New York have made significant progress setting up their marketplaces, and conditionally approved their plans.  These states are on track to meet all exchange deadlines and be ready for open enrollment in ten months.  Previously, HHS conditionally approved ColoradoConnecticutMassachusettsMarylandOregon, and Washington.

We know that some states will need more time before being ready to run their own marketplace or want to run part but not all of the exchange in 2014.  These states can choose to enter into a State Partnership Exchange in which the State assumes responsibility for plan management and/or consumer assistance.  A partnership exchange allows states to make key decisions and tailor the marketplace to local needs and market conditions.  States have until February 15, 2013 to choose a state partnership exchange.

Many states have received planning and establishment grant awards to help them modernize and develop IT systems and the business systems needed for exchange establishment.  We recently released the Health Insurance Market RulesEssential Health Benefits Rules, and Payment Parameters Notice to ensure states have more information to continue their work.  We will continue to provide states with as much support and guidance as they need.

We continually strive to give states the resources, flexibility and guidance to design and build a marketplace that meets the needs of their state.  While last week was one milestone, we are not taking an “all or nothing” approach to exchanges.  Many states are making impressive progress and we are committed to working with all states as we approach open enrollment in October 2013.  We’re looking forward to January 1, 2014 when consumers and small businesses will be enrolled through the Exchanges in private health insurance plans and millions more Americans will have the coverage they need and deserve.

Strengthening Global Health by Elevating Policy

Cross-posted from DipNote U.S. Department of State Official Blog


I was honored to be asked by Secretary Clinton to lead the new Office of Global Health Diplomacy. I am proud to serve my country in this capacity while also remaining the U.S. Global AIDS Coordinator. I am equally delighted that a skilled and seasoned diplomat like Ambassador Leslie Rowe has agreed to join me in establishing the new Global Health Diplomacy Office in the State Department. We have seen first-hand in countries around the world that America’s investments in global health not only improve and save lives, they build stronger families, communities and nations and contribute to economic growth. And stronger and more stable nations abroad mean a stronger and more stable America.

Increasingly, our investments are also enabling countries to build the health systems they need to provide care for their own people. A goal of this Administration has been to ensure that we are not only investing in saving lives, but that we are helping partner countries eventually take on this responsibility themselves. Country ownership is a central objective of the U.S. government and it challenges our own government, partner and other donor countries alike to work tirelessly to create sustainable health systems that are eventually owned, managed and operated by the partner nation and their people. As Secretary Clinton said in June in Oslo, country ownership will take considerable time, patience, investment and persistence — but it is an end state that we can achieve together.

The task of the Office of Global Health Diplomacy is to guide diplomatic efforts to advance the United States’ global health mission to improve and save lives and foster sustainability through a shared global responsibility. In doing so, our office will focus on providing diplomatic support in implementing the Global Health Initiative’s principles and goals.

The U.S. government is a leading contributor to global health efforts, with foreign assistance investments in approximately 80 countries. The Presidential Policy Directive on Development (PPD) and the State Department’s first-ever Quadrennial Diplomacy and Development Review (QDDR) identify supporting global health as a top foreign policy priority. The QDDR states that “we invest in global health to strengthen fragile and failing states, to promote social and economic progress, to protect America’s security, as tools of public diplomacy, and as an expression of our compassion.”

The new office will bring the full force of U.S. diplomacy to advancing our global health goals. Specifically, it will:

Support our ambassadors on the ground, where our investments are translated into lives saved. As called for in the QDDR and as described in Secretary Clinton’s call promoting “smart power,” the role of ambassadors in the global health arena will be elevated as they pursue diplomatic strategies and partnerships within countries to foster better health outcomes. We will provide ambassadors with expertise, support and tools to help them effectively work with partner country officials on global health issues affecting their people.

Strengthen sustainability of health programs by supporting partner countries as they work to meet the health care needs of their own people and eventually achieve country ownership. We will work with ambassadors to build political will in countries, in pursuit of sustainable health systems without barriers to care.

Foster shared responsibility by supporting countries to coordinate donor nations, multilateral institutions, civil society, the private sector, faith-based organizations, foundations, and community members. Stronger coordination and alignment will strengthen overall investments in global health, bring more donors to the table and better leverage U.S. investments. We will convene and work with U.S. government agencies representing our interests in multilateral organizations to advance our global health priorities and improve and save more lives.

The Obama Administration is committed to continued smart stewardship of the funds that Congress and the American people entrust to us to improve global health. And the results have been notable:

• Nearly 5.1 million people are receiving life-saving HIV treatment as of September 2012, an increase of 3.8 million since 2008.

• 58 million individuals were reached with malaria prevention measures in 2011, an increase of 33 million people since 2008.

• 1.3 million TB cases were treated in 28 countries in 2011

• 696 million treatments were delivered to individuals at risk of contracting neglected tropical diseases in 20 countries from 2008-2011

• There has been a 15 percent reduction in the maternal mortality rate in U.S. government-assisted countries since 2008, and we’re on track to reduce the maternal mortality rate by 26 percent by 2013.

To ensure sustained impact, we also know that we can’t go it alone. It is through our diplomatic efforts that we will forge deep partnerships and shared responsibility for improved health across the globe. Our new office will play an important supportive role to Ambassadors and health teams on the ground, fortifying high-level diplomatic engagement to strengthen the capacity and political will required to build strong, country-owned health systems. Our country Ambassadors are our arms and legs — and hearts and minds — in driving the hands-on implementation of America’s global health strategy. We are committed to doing everything we can to support their efforts.