At 10 am on November 30, 2020, the day before World AIDS Day, the End AIDS New York Community Coalition joined with members of Governor Andrew Cuomo’s New York State Ending the HIV/AIDS Epidemic (EtE)Task Force, and members of the NYS AIDS Advisory Council (AAC) and its AAC EtE Subcommittee, to convene a press conference demanding that Governor Cuomo make good on his commitment to end AIDS as an epidemic in New York State, in a full and equitable manner that eliminates persistent HIV health disparities based on race, poverty, and marginalized identities.Despite years of collaborative government and community effort that has produced significant overall progress, the Governor now appears to be abandoning his 2014 commitment to Ending the Epidemic—by stripping away essential resources that are key to sustaining progress and reaching our EtE goals. In the midst of a pandemic that disproportionately affects the same communities of Black and Latinx/Hispanic New Yorkers who also experience HIV health disparities, the State has imposed a 20% across the board withhold of funding for critical HIV prevention and care programs, and has plans to undermine the fiscal stability of and services provided by the safety-net providers that care for the State’s most vulnerable populations living with or vulnerable to HIV/AIDS.
In June 2014, Gov. Cuomo announced a historic commitment to end AIDS as an epidemic in NYS by 2020, and appointed a 64-member Task Force to develop a Blueprint to meet this goal. The Governor formally accepted the Blueprint in April, 2015, endorsing and calling for full implementation of each of its recommendations. Since that time, the End AIDS NY Community Coalition, ETE Task Force members, the AAC, and others have worked with the Governor’s Office, the NYS Legislature, and the New York City Mayor and City Council to implement major elements of the plan.
Despite repeated promises to fully implement the Blueprint, Governor Cuomo has refused to date to fulfill key Ending the HIV/AIDS Epidemic (ETE) Blueprint recommendations that are essential to address health disparities. These Blueprint recommendations (BPRs) include efforts to improve housing for people living with HIV/AIDS (PWHA) outside of NYC (BPR #’s 8,9 &16), expand overdose prevention efforts (including overdose prevention centers) to address the opioid crisis and prevent new HIV and Hepatitis C (HCV) infections (BPR #15 and Getting to
Zero recommendation #3), and to eliminate HIV/HCV co-infection by identifying and treating HCV among PWHA (BPR #26).
The State’s 20% withhold of funding for HIV prevention and care services is undermining evidence-based work on EtE recommendations that have been implemented, threatening to undo our EtE progress to date. These cuts are compounding the already serious barriers to effective HIV prevention and care created by the COVID-19 pandemic—barriers acknowledged by the Governor and Department of Health, but not addressed—including a statewide shortage of syringes and other harm reduction supplies and decreased access to HIV testing and care, leading to new HIV infections such as a cluster of new HIV cases in Monroe County.
Most harmful is the current plan by the NYS Department of Health (DOH) to strip away millions of dollars in "340B" savings that provide fundamental fiscal support for the community health centers and Ryan White HIV clinics that deliver HIV prevention and care to medically underserved communities and populations. NYS safety net providers use 340B savings to increase health care capacity, and to fund otherwise uncompensated or underfunded “wrap-around” comprehensive patient care services recommended in the EtE Blueprint as essential in order to address long-standing inequities in HIV prevention and care. 340B funded services have increased access to PrEP, and enabled people with HIV to achieve and maintain the HIV viral suppression key to ending our NYS HIV epidemic by sustaining the health of PWHA and stopping new infections.
The planned DOH pharmacy “carve-out” plan will strip away over $56M in pharmacy rebates from just 15 of the hundreds of AIDS health care, prevention and service safety net providers across the State; all of whom will be deeply affected. Without these funds, many Ending the Epidemic interventions will have to be terminated, and New York State will see major service reductions and dozens of clinic closures in neighborhoods with the highest levels of poor HIV health outcomes.
This World AIDS Day, leaders from across New York State demand that Governor Cuomo take immediate action to keep his promise on Ending the HIV/AIDS Epidemic and to cease the Department of Health’s attack on the safety net, which is so vital to the health and survival of people living with and affected by HIV.
“Our work to achieve the goals laid out in the Ending the Epidemic Blueprint will be undermined should there be a drastic reduction in savings from the 340B program. This program has provided access to quality care, especially affordable drugs for some of the most marginalized people living with HIV/AIDS and those who are at high risk of contracting the virus. Reversing the 340B carve out strengthens Apicha Community Health Center and other 340B providers' ability to maintain services that create enduring success in our fight to end AIDS.” – Therese Rodriguez, Chief Executive Officer, Apicha Community Health Center
“We have a promising blueprint to end the HIV/AIDS epidemic by this year, which was loudly backed by Governor Cuomo. However, in the last few years, his administration has wavered in its commitment by pushing back on the implementation of evidence-based strategies to curtail the epidemic such as the establishment of overdose prevention centers and threatening funding from HIV providers by stripping away 340B savings. On the eve of World AIDS Day, it is critical that this administration takes the necessary actions to reposition New York in our previous path to end the epidemic in our State."
– Senator Gustavo Rivera, Chair of New York State Senate Committee on Health
“New York cannot afford to take our focus off of HIV. Our communities have been hard-hit by HIV and COVID-19 – in particular people of color, older adults, and especially trans women of color—and we cannot afford the resurgence of one epidemic while we battle the other.” – Kelsey Louie, CEO, GMHC
"There may be competing priorities but there are not competing communities. Black, Brown, poor, and otherwise disenfranchised persons are disproportionately contracting HIV and contracting COVID. Effective public health cannot be delivered in a silo. In NYS, we can do better." – Marjorie Hill, Co-chair, NYS AIDS Advisory Council
“The same community health organizations who collaborated with Governor Cuomo’s administration to create the EtE Blueprint are now in an impossible, untenable position. The Governor is making moves to destroy the very safety net that must be preserved to get us to truly ending the epidemic in New York State and refuses to implement key interventions that require a proven, harm reduction approach. We call upon him at this crucial juncture to make good on his promises, trust the experts, and do everything within his power to continue funding the hundreds of providers that will be irrevocably harmed by the proposed 340B cuts.” – Charles King, Co-Founder and CEO, Housing Works
“For Ryan White clinics, the proposal would result in a significant step backward in the NYS fight to end the HIV/AIDS epidemic. The reduction of 340B savings would threaten comprehensive services for our patients living with HIV, and prevention work in our community to stop the spread of the virus. It will also undermine our success in addressing health disparities, particularly within communities of color. And the timing couldn’t be any worse, as COVID-19 has disproportionately affected the vulnerable communities that we serve. We ask the governor to reverse his decision so we may continue to provide the highest quality of care and services to end the HIV epidemic, as we fight the pandemic of COVID-19.” – Andrea DeMeo, President and CEO, Trillium Health
“We need to protect the 340B funding. Any changes will hurt organizations most responsible for fighting the HIV epidemic. These organizations serve communities who are already impacted by health inequities in our State and the U.S. We need to focus on ensuring that communities have access to healthcare and supportive services. We need to work together to fully implement NYS’s Blueprint to End the HIV Epidemic in NYS. We call on the Federal Government and Congress to approve relief to States and U.S. Territories to handle the fiscal stress that put at risk critical services to our communities due to the COVID19 pandemic.” – Guillermo Chacon, President, Latino Commission on AIDS and Founder of the Hispanic Health Network.
“As a member of the original Ending the Epidemic Task Force and a person with AIDS, I am truly frightened that the Department of Health and Governor, who have been longtime champions of those in need, are destroying our safety net resources at a time when we need them the most. We also do not have rental assistance promised outside of NYC, which is critical for people with HIV and AIDS to survive. We understand COVID has brought many revenue challenges, but we cannot start with cutting services to those who are most vulnerable and predominately from Black and brown communities in NYS.” – Perry James Junjulas, Executive Director, Albany Damien Center
“As a longtime HIV-positive resident of Upstate NY, I am ashamed that adequate and stable housing is an issue. The Governor’s broken promise to end HIV by 2020 has cost the lives of so many of my peers. HIV housing saves lives. How many lives need to be lost for that to be understood by the Governor?”
– Pedro Benitez, VOCAL-NY Leader, Rochester
“The pharmacy carve-out and the continuation of the 20% holdback will decimate the safety net system at a time when the system is in even more demand. Communities that remain most impacted by HIV are the very communities that are now hardest hit by the COVID-19 pandemic. The very programs and services that have allowed us to make progress in ending the epidemic and are critical to continuing that progress are the ones that will be lost. The very providers who have been, and remain, on the front lines of caring for those living with and most at risk for HIV, and now COVID-19, are the ones that will be forced to reduce services or close their doors altogether. The State cannot balance the budget on the backs of the safety net system and the communities that rely on it.” – Jacquelyn Kilmer, Chief Executive Officer, Harlem United
"Six years have passed since Governor Cuomo made a promise to end AIDS as an epidemic in New York State. But his refusal to fund his own End AIDS Taskforce priorities have shown those of us living with AIDS what good a Cuomo promise is. He has refused to fund housing for HIV+ New Yorkers, and lacks the courage to even allow a pilot program for Overdose Prevention Centers. Instead of ending AIDS, he is promoting austerity that allows harm reduction providers to go unpaid for their services." – Reginald Brown, a VOCAL-NY Board Member and formerly homeless HIV+ New Yorker
“At a time when our State and City are focused on overcoming the COVID-19 pandemic, our Governor and Health Department have made drastic changes to the 340B program that will plug its budget gap on the backs of low-income New Yorkers with chronic health conditions. We reinvest in services to ensure that people living with HIV, hepatitis, and other chronic conditions have access to lifesaving medications and care. New York has made significant strides toward ending the AIDS epidemic, but this financial shell game will set us back. We urge Governor Cuomo to reconsider this ill-timed decision.” – Sharen I. Duke, CEO, Alliance for Positive Change
“The plan to ‘carve-out’ the Medicaid pharmacy benefit from managed care to fee-for-service will stall – if not reverse – our progress to end AIDS in New York. Access to low-cost HIV treatments including PrEP, the ability to help patients navigate care, support for STI screenings and sexual health – will be lost to communities who already face significant barriers to care. Further, this plan will exacerbate health inequities laid painfully bare by the COVID-19 pandemic. Finally, analysis after analysis demonstrates that the carve-out will cost - not save - the state money. New York must not divest from the safety net nor abandon its commitment to end AIDS.” – Kimberleigh Joy Smith, Senior Director for Community Health Planning and Policy, Callen-Lorde Community Health Center
“As an EtE task force member who specifically worked on HIV prevention recommendations, I'm very concerned about what we will lose in terms of PrEP accessibility if these cuts happen. If we are ever to fully realize ending the epidemic, we absolutely can not afford to lose $56M in pharmacy rebates from HIV health care, prevention and service providers. We've come too far in connecting people to PrEP services and I would hate for us to not reach the ultimate goal of making sure that every New Yorker who needs PrEP gets PrEP.” – Terri L. Wilder, MSW
“The years-long effort to end the AIDS epidemic in New York State has been a significant achievement. New HIV infections have dropped dramatically and the lives of people living with HIV have improved. In 2020 a new viral pandemic, COVID-19, has understandably galvanized public attention. But it would be indefensibly foolish if New York State allowed a new pandemic to distract us from finishing the job of ending the last pandemic, AIDS. Instead, we should recognize that full funding of initiatives to end the AIDS epidemic is an integral part of public health efforts in the era of COVID-19.”
– Jim Eigo, HIV/AIDS Activist
"As an inaugural member of New York State's 'Ending the Epidemic' coalition, Legal Action Center (LAC) knows the aims are achievable. But not when basic community health supports are reduced to such levels that stymie their effectiveness. Cutting health and human services funding - in particular for HIV prevention and suppression, addiction treatment, and transitional reentry care - during a pandemic that is disproportionately impacting the individuals who need these services goes against all logic. This is a classic case of penny wise and pound foolish. If we don't prioritize community health and harm reduction, we risk losing significant gains made - and in fact, it's sadly already happening in Rochester as we watch new HIV transmissions increase in Monroe County. We must restore and increase funding immediately to reverse this trend and ensure all New York State residents can access the care and supportive services they need." – Tracie Gardner, Director of Policy, Legal Action Center (LAC)
"Governor Cuomo also seems to have forgotten his 2018 promise to end the hepatitis C epidemic: the number of people treated annually by Medicaid fell 10% from 2018 to 2019, and the recommendations of his expert statewide Task Force are sitting on a shelf, unreleased. Real leaders stay focused until the job is done." – Annette Gaudino, Director of Policy Strategy, Treatment Action Group
"Governor Cuomo is failing us every day he does not sign off on Overdose Prevention Centers (OPCs). COVID-19 combined with NYS budget cuts to service providers and drug user health hubs continue to exacerbate the Overdose Crisis and are leading to preventable deaths every single day. People who use drugs and people living with HIV/AIDS are suffering at the hands of the government as they continue to use COVID and money as their excuse for not taking action. Not having OPCs on top of these cuts to providers also contributes to increased rates of HIV and he is supposed to be ending the epidemic! Evidence based research shows that OPCs keep people alive and they provide the sterile equipment people need to inject safely. This isn't rocket science. Governor Cuomo: Open the OPCs and stop making excuses. We are losing people every day you stall on what we already know is the answer to ending the overdose crisis and stopping the spread of HIV among people who use drugs." – Wayne Anderson, VOCAL-NY Leader, Capital Region
"It is troubling for those of us who are old enough to remember the governor as a fierce advocate for people living with AIDS to watch his policies become so regressive, so quickly on this issue. The withdrawal of support for New York State's End the Epidemic initiative coupled with the confiscation of 340B funds will guarantee that the governor will seize defeat from the jaws of victory as regards the end of AIDS in New York. It is an odd feeling to know that one is living through an experience that will one day appear in public health texts as an example of how not to combat an epidemic.” – John Barry, LMSW, Executive Director, Southern Tier AIDS Program