President Trump this week directed the acting Health and Human Services (HHS) secretary, Eric Hargan, to issue a Public Health Emergency Declaration (PHED) on the opioid epidemic. It was the first significant action the administration has taken to address the epidemic, coming after eleven weeks since his initial promise to do so at a press conference on Aug. 10. According to CDC data cited by the president’s Commission on Combating Drug Addiction and the Opioid Crisis, over 11,000 Americans are estimated to have died of a drug overdose in the period since the president said that he would take action on the epidemic.
Most experts within the HIV/AIDS and substance use fields had hoped the President would actually make a Presidential Declaration of Emergency rather than a Public Health Emergency Declaration. Though the terms are similar, their differences are significant. While the PHED does grant some of the same relief strategies as a Presidential Declaration of Emergency, the PHED is limited to existing funding. Consequently, there is cause for concern. Only $57,000 of new federal funding (from the Public Health Emergency Fund) will be made available as a result of the PHED, and the declaration allows HHS Secretary to redirect funds dedicated to HIV care and prevention to substance use treatment programs and efforts. This is of great concern since the PHED may not actually help Americans, especially those living with, affected by, or at risk for HIV/AIDS.
Significantly, the Office of National Drug Control Policy (ONDCP) —which would normally be integral to the implementation of the Declaration signed on Thursday—is still without a Director. The search for a new “drug czar,” as the ONDCP Director is informally called, stalled after a joint report from the Washington Post and 60 Minutes revealed that President Trump’s nominee, Representative Tom Marino (R-PA), had a leadership role in creating and passing a law backed by the drug industry. The law weakens the Drug Enforcement Agency’s (DEA) power to stop opioid flow to doctors or pharmacists who show suspicious drug-distribution patterns. Marino withdrew his name from consideration after the investigation, which reported that he had received about $100,000 in campaign donations for his support of the law. Several other names are being discussed as the next nominee. However, the seeming lack of urgency in filling this position along with the delayed response in declaring the PHED led Maria McFarland Sánchez-Moreno, the executive director of the Drug Policy Alliance, to observe that Trump’s “statements and policies so far give every reason to believe that [his supporters’] health is not his chief concern.”
AIDS United urges the administration to ensure that the responses to the PHED take into account the connections between the HIV and opioid epidemics and opposes simply substituting funding from one public health emergency to the other. We will continue to work in coalition with other communities and organizations suffering from the opioid epidemic to urge Congress to appropriate permanent, substantial, new funding for substance use disorder treatment that does not come at the cost of HIV care and prevention. See our official statement on the matter here.