David MunarOn Tuesday, November 6, the United States will not only be electing people to represent us in Congress, as well as at the state and local levels, but perhaps most importantly we will be electing our next president.

The next big steps before Election Day will be the presidential nominating conventions. The Republicans will hold their convention August 27 to 30 in Tampa, Florida. The Democrats will hold their convention September 3 to 6 in Charlotte, North Carolina.

In addition to choosing its nominees for president and vice president, the parties also adopt platforms at the conventions that outline the beliefs and goals of each party. The platforms include planks that specify details. 

Recently, much news was made about the Democratic Party including marriage equality for same-sex couples as a plank in its platform. However, there has not yet been any news about the inclusion of an HIV-specific plank.

To that end, David Ernesto Munar, president and CEO of the AIDS Foundation of Chicago, testified in front of the committee currently drafting the Democratic National Committee (DNC) platform.

These are the detailed recommendations submitted by Munar to the DNC:

Policy to Achieve an AIDS-Free Generation
President Obama and the Democratic Administration have committed the United States government to pursue an AIDS-free generation at home and abroad. To achieve an AIDS-free generation domestically, the DNC supports federal policy development and increased federal investments necessary to achieve or exceed the National HIV/AIDS Strategy targets by 2015. In addition, DNC supports development of a new 2016-2020 National HIV/AIDS Strategy; full implementation of the Affordable Care Act, including efforts to promote Medicaid expansion in every state to individuals with incomes up to 133 percent of federal poverty; and sustained support for domestic initiatives in HIV-related prevention, care and treatment, housing, support services, research, stigma/discrimination mitigation and protection of civil and human rights. The White House Office on National AIDS Policy will continue to champion continuation of signature HIV programs such as the Ryan White CARE Act, Housing Opportunities for People with AIDS, Medicare/Medicaid, and NIH Office of AIDS Research, and coordinate the HIV-related activities of the federal departments of Health and Human Services, Housing and Urban Development, Defense, Veteran Affairs, State, Justice, Education, Labor, Agriculture and Homeland Security to achieve maximum results.

Better Public Health Outcomes in the U.S.
The 2010 National HIV/AIDS Strategy sets ambitious targets to (1) decrease new HIV infections; (2) increase the number of HIV-positive people who gain access to continuous high-quality clinical care, housing and support services; (3) reduce HIV-related health disparities among African-Americans, Latinos and men who have sex with men of all races/ethnicities, and (4) increase inter-governmental coordination and collaboration to maximize results with scarce resources. To achieve and exceed specific targets in each area, and establish a stronger foundation for the 2016-2020 National HIV/AIDS Strategy, the DNC supports the following:

- Robust research on the most effective ways to implement new prevention strategies as well as the continued prioritization of research toward a preventive HIV vaccine and a cure.
- Substantial increased investments in domestic HIV prevention services to assist an estimated 250,000 Americans unaware of the HIV-positive status and millions of other men, women, and adolescents at risk of infection. Proven-effective HIV prevention services save money and lives, yet they comprise only 4 percent of the federal HIV/AIDS budget. By 2016, HIV prevention will comprise 8 percent of all federal HIV-related spending. The federal government will also develop HIV prevention and care quality measures, including routine screening for HIV, as part of federal guidelines for state-based Medicaid expansion and design and implementation of insurance exchanges.

Access to Care
- Reauthorization of the Ryan White CARE Act and an increase in its appropriations by 25 percent by 2016; reauthorization of the Housing Opportunities for People with AIDS Act and a 50 percent appropriations increase by 2015.
- Assistance for states to implement health reform provisions in ways that maximize benefits for people with and at risk for HIV and that save money and lives. The Centers for Medicare and Medicaid (CMS) will appoint a senior official to work with the Health Resources Services Administration and states on HIV-related health reform implementation. In addition, CMS will develop a federal model benefits package to guide states in adhering to federal HIV treatment guidelines and the National HIV/AIDS Strategy.

Health Disparities
- Recognizing that HIV disproportionately affects vulnerable communities, effective HIV responses must address social determinants of health. The federal government must pursue efforts to reduce rates of poverty, unemployment, un-insurance, unstable housing and homelessness, food insecurity, disproportionate incarceration of people of color, low educational attainment, domestic violence, drug dependence, untreated mental illness, bullying, hate crimes, homophobia, xenophobia, sexism, ageism, homophobia, and transphobia. Science shows that these socio-economic inequalities and marginalization help fuel the HIV epidemic in America.
- Aggressively confronting and countering the war on women is instrumental to reduce the impact of HIV/AIDS among women and girls, particularly women of color.
- The federal government must lead efforts to repeal stigmatizing state criminalization laws, which serve no public health benefit and discourage acceptance of HIV testing and care services. In addition, efforts to build the resiliency of individuals from marginalized groups—including HIV-positive individuals—must be a focus of federal research and public health interventions in the U.S.

Coordination and Public Health Leadership
- Creation of a National HIV/AIDS Strategy implementation fund—with financing from a 1 percent tap on federal HIV appropriations—to help achieve the Strategy’s goals.
- Initiatives by the President, his Cabinet and federal departments and agencies to increase the proportion of Americans with accurate HIV/AIDS knowledge, measurably reduce stigmatizing attitudes and beliefs toward HIV-positive people, and increase utilization of HIV testing and care services.
- Enactment and appropriations for the Ending the AIDS Epidemic Act (Rep. Lee).
- Federal public health leadership to increase local and state technical capacity and expertise to implement evidence-informed public health strategies and healthcare reform strategies.

Global Health
The newest science shows that putting HIV-positive people on antiretroviral therapy keeps them alive and healthy and, with a combination of prevention efforts, can halt new infections and reverse the global HIV/AIDS epidemic. In the period ahead, the U.S. must support an AIDS-free generation around the world by leveraging its bilateraland multilateral agreements and its global public health leadership and diplomacy. In particular, the U.S. will:

- Affirm its global commitment to achieve universal voluntary treatment on demand for all people in low and middle-income countries.
- Invest $50 billion in the President’s Emergency Plan for AIDS Relief and the Global Fund for AIDS, Tuberculosis and Malaria over a five-year period.
- Expand access to male and female condoms, lubricants, harm reduction tools, male circumcision, sexual and reproductive healthcare and rights, primary education, HIV prevention services, HIV testing, and other strategies designed to curb rates of new HIV infections in the developing world.
- Expand and protect the rights of low and middle-income nations to enact laws that allow manufacturing and procurement of generic antiretroviral medications as part of an effective global response to HIV.
- Support for the civil and human rights of LGBT people, women and girls, school-age children and orphans, sex workers, and drug users in order to ensure they gain access to the help, services and legal protections they need to lead healthy, productive lives.
- Support a financial transaction tax of less than half of 1 percent for global and domestic health and services.

American Values
Pursuit of an AIDS-free generation is among the most emblematic examples of America’s compassion, generosity and global leadership. Globally, in 2011, there were an estimated 34.2 million individuals living with HIV, 2.5 million new HIV infections (including 330,000 children), and 1.7 million deaths from AIDS-related causes. In the U.S., an estimated 1.2 million people live with HIV. Despite substantial progress, 1 in 2 HIV-diagnosed Americans is not receiving clinical care or life-saving treatments that can increase longevity and curb new infections. As a result, every year 50,000 individuals become infected and 16,000 deaths occur among people with HIV/AIDS. By transmission category, the largest number of new HIV infections currently occurs among men who have sex with men (MSM) of all races/ethnicities, followed by African-American heterosexual women. By race/ethnicity overall, African Americans are the most heavily affected, followed by Latinos. The most recent data from CDC show that between 2006 and 2009, a growing number of new HIV infections occurred among young gay and bisexual men—due in large part to an alarming 48 percent increase among young, black MSM.