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Bernie Sanders Lays Out His HIV Policy Plans

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HIV advocates have long requested that presidential candidates share their HIV policy plans, though they haven’t always gotten a response. But things have begun to change, and six of the top 2020 Democratic nominee hopefuls responded to an HIV-focused survey from ACT Now: End AIDS Coalition.

The survey was sent to every major presidential candidate, including President Trump. So far, responses have been returned from several Democratic candidates. A summary of responses can be found here. Here's what Bernie Sanders had to say.

Plus: ​Earlier this year, the Trump administration introduced their plan for ending the HIV epidemic in the United States by 2030. While the HIV community welcomes the increased financial resources and attention being paid to HIV by the administration, we also understand that to end the HIV epidemic we must address the social determinants of health and inequities that have led to a high-burden of transmission for HIV, STDs, and associated illnesses within vulnerable populations. Please describe what you would do to increase access to HIV prevention and treatment services, and outline your approach for addressing the social determinants of health and promoting racial justice. 

Bernie believes we can and must end the epidemic of HIV and AIDS in the United States and abroad. The government, using taxpayer funding, developed and patented the research that led to the use of the drug Truvada for PrEP in preventing HIV transmission. That drug is now being sold by the pharmaceutical giant Gilead for as much as $2,000 a month and generated $3 billion in sales for Gilead last year. This is unacceptable. Tens of thousands of individuals with HIV and AIDS are still uninsured or cannot afford their treatment. Sanders is the author of legislation that would give the federal government power to authorize generic versions of medicines if drug companies refuse to stop charging Americans higher prices than the do in other industrialized countries.

When Bernie is in the White House, he will enact Medicare for All, which will guarantee health care as a human right to everyone in America, free at the point of service. His plan will address the racial disparities we still see in the epidemic--people of color are disproportionately uninsured. We must work to make sure every person can get the care they need, including prevention and treatment for HIV/AIDS. Senator Sanders understands and will address the need for more black doctors, more black dentists, more black nurses, more black psychologists. We are talking about guaranteeing healthcare to all as a right, but at the same time ending the long-standing disparities which exist within the health care system. Under Medicare for All, he will strive to ensure we are putting health care providers and resources in every community in America.

He will also create a multi-billion dollar Prize Fund to reward medical researchers and developers of medicines who create lifesaving drugs for HIV and AIDS treatment and prevention based primarily upon the added therapeutic value a new treatment offers and the number of people it benefits — instead of a system where the market is manipulated to keep out all competition. Under Bernie’s plan, drugs would have generic competition immediately after FDA approval.

Bernie will also fight to expand the Housing Opportunities for Persons with HIV/AIDS (HOPWA) program that currently provides funding for housing assistance and related services for tens of thousands of low-income people living with HIV and their families and the Ryan White HIV/AIDS program which provides HIV-related services for those who do not have sufficient health care coverage or financial resources. He will expand efforts overseas for treatment and preventing transmission. We must strive toward a generation free of HIV and AIDS.

To address the social determinants of health, Bernie will guarantee all Americans economic rights. These include the right to a complete quality education, a decent job with good pay, affordable housing, quality health care, a clean environment, and a secure retirement. Bernie will raise the minimum wage to $15 an hour and guarantee a job to all Americans who want one to ensure everyone has a decent quality of life. He will protect, expand, and strengthen our existing safety net programs, not raid them. By taking health care, education, and other essential needs out of the control of the market and to the people, he believes we can create a country that works for all and provides everyone with dignity, security, and freedom.

And we will transform this country into a nation that affirms the value of its people of color, we must address the five central types of violence waged against black, brown and indigenous Americans: physical, political, legal, economic and environmental.

Whether it is a broken criminal justice system, or massive disparities in the availability of financial services, or health disparities, or environmental disparities, or educational disparities, our job is to — and we will — create a nation in which all people are treated equally. That is what we must do, and that is what we will do.

2. ​U.S. HIV research investments have saved millions of lives, prevented countless new transmissions of the virus and placed us on a potential path to end the HIV epidemic. Do you support increasing dedicated HIV research funding to promote treatment advances, prevention efforts, and attempts to identify a vaccine and a cure? What, if any, changes to the current HIV prevention and research funding levels would you propose? 

Yes. First, we need to make significant investments in health research, including robust HIV research funding. I strongly support additional funding for the NIH. I also believe that a comprehensive health research agenda should include not just the necessary financial support for disease-specific research, but must also consider our long-term investments in science education and how we can broadly support the next generation of scientists tackling some of the greatest medical challenges of our time.

I have introduced legislation in the past to create a prize model to spur innovation for new HIV/AIDS medications. Essentially, a company bringing a truly innovative HIV/AIDS treatment to market would receive a cash prize instead of patent protection; the treatment would then be placed in the public domain, allowing generic versions to come onto the market quickly. This ensures companies are still compensated for their research and development, while keeping drug prices affordable for all patients. We have seen absolutely incredible advancements in HIV/AIDS treatment over the last thirty years, but the disease can only be managed if patients can afford their medications.

4. The Ryan White HIV/AIDS Program provides care and treatment for people living with HIV in the United States who are uninsured or underinsured and has demonstrated its success at linking and retaining people in care, improving both individual health outcomes for enrollees, and a reduction in new HIV transmissions. Do you support increased funding for the Ryan White Program and for networks of people living with HIV that provide peer support and combat stigma? What changes, if any, would you make to the program and its funding? 

Yes, we must increase funding for this vitally important program. Bernie supports expanding the highly successful Ryan White HIV/AIDS program which provides HIV-related services for those who do not have sufficient health care coverage or financial resources. It was unacceptable that at the height of the Wall Street crash, many states had long waiting lists for the AIDS Drug Assistance Program. Especially when so many people were losing their jobs and their life savings, people should not have had to wait for the life-saving treatment they needed.

5. Although millions of individuals have been insured through the implementation of Medicaid expansion and the Affordable Care Act, lack of access to healthcare is still a major driver of the HIV epidemic. If elected, how will you ensure that all people living with and affected by HIV have access to affordable healthcare? Please state your position on the ACA, and outline your views on the best ways to extend high-quality, low-cost healthcare to everyone, regardless of age, income, immigration status, or pre-existing condition--including in states that have not expanded Medicaid. 

Bernie believes it is a national disgrace that we are the only major industrialized country not to guarantee health care to all people, especially to those living with and affected by HIV. In order to ensure all people have access to affordable comprehensive health care, the United States must join every other major country on Earth and guarantee health care to all people as a right, not a privilege, through a Medicare-for-all program.

And he will ensure that every community has the providers and health care infrastructure needed to address this epidemic. He secured $11 billion for Community Health Centers in the Affordable Care Act, which serve 28 million patients a year in underserved communities. He also secured funding for the National Health Service Corps in the Affordable Care Act to bring more health care providers to underserved communities.

He is working with Rep. Clyburn of South Carolina to fight to expand Community Health Centers and the National Health Service Corps so that more underserved communities can get the health care they need.

Today, the United States remains the only major country on Earth that does not guarantee health care to all people as a right. And despite the gains accomplished by the Affordable Care Act, we still have tens of millions of Americans who lack health insurance and millions more who are underinsured. Bernie has fought against every Republican-led attempt to throw millions off of their insurance. But let’s be clear, the time is long overdue for the United States to guarantee health care to all people as a right, not a privilege, through a Medicare-for-all program. Health care is not a commodity. It is a human right. The goal of a sane health care system should be to keep people well, not to make stockholders rich. That is why we need Medicare for All. Bernie’s Medicare for All program would provide comprehensive health coverage to all regardless of income, immigration status, age, or pre-existing condition with no premiums, deductibles, copayments, or surprise bills.

6. The Housing Opportunities for Persons with HIV/AIDS (HOPWA) program is the sole dedicated funding source for housing assistance and related supportive services for low-income people living with HIV and their families. Currently, HOPWA remains chronically underfunded despite the fact that housing has a greater impact on health outcomes for people living with HIV than any other factor, including demographics, substance use, mental health, or access to social services. Do you support increased funding for the HOPWA program and other programs that provide housing for people living with HIV?

Yes, it is unacceptable that so many people with HIV/AIDS are at risk of homelessness. Bernie believes we must increase funding for this woefully underfunded program and make accessible affordable housing a right to all people in this country. Bernie would also aggressively defend and promote the legal protections of fair housing, and make sure that no one is denied housing based on race, color of their skin, national origin, religion, gender, sexuality, disability, or HIV/AIDS status.

7. What will you do to prohibit discrimination based on sexual orientation, racial and gender identity in housing, healthcare, the workplace, the legal system, privately-owned businesses, and access to federal benefits? 

Bernie believes it should not be a radical idea to guarantee everyone — regardless of sexuality or gender identity - equal protection under the law and that we must end discrimination in all forms. As President, he will:

● Pass the Equality Act, which would expand the defined prohibited types of discrimination to include sexual orientation and gender identity.

● Pass the Every Child Deserves a Family Act and other bills to prohibit discrimination against LGBTQ+ people.

● Strongly oppose any legislation that falsely purports to “protect” religious liberty at the expense of others’ rights.

● Ensure LGBTQ+ people have comprehensive health care without discrimination or discrimination from providers.

● Protect the rights of LGBTQ+ people around the world by ensuring that written into the core text of all global trade agreements, are strong and binding human rights standards and strengthening the Special Envoy for LGBTQ+ Rights within the Dept. of the State.

● Advance policies to ensure students can attend school without fear of bullying, and work to substantially reduce suicides.

● Support police departments that adopt policies to ensure fairer interactions with transgender people, especially transgender women of color who are often targeted by police unfairly, and by instituting training programs to promote compliance with fair policies.

● Fight against discrimination against LGBTQ+ people by creditors and banks so that people will not be unfairly denied mortgages, credit cards, or student loans.

● Bernie would also aggressively defend and promote the legal protections of fair housing, and make sure that no one is denied housing based on race, color of their skin, national origin, religion, gender, sexuality, disability, or HIV/AIDs status.

● Repeal the Trump Administration’s bigoted ban on transgender people from serving in the U.S. military.

● Make it easier for LGBTQ+ workers to form a union so they can collectively bargain for fair wages and safe working conditions.

8. Americans living with HIV continue to be subject to stigma and discrimination, and many are subject to outdated and stigmatizing criminal laws where they are susceptible to enhanced sentencing based upon their HIV status. These laws violate the human rights of people with HIV, sometimes imposing extremely severe punishments on people with no intent to harm and behaviors that pose no risk of HIV transmission. Moreover, these statutes discourage those at risk from learning their HIV status and subsequently beginning treatment to extend their longevity and quality of life. Will you work to pass a law that ends the criminalization of HIV status? Will you work to extend federal protection from discrimination based on HIV status? What other steps, if any would you take to help reduce HIV/AIDS stigma and discrimination in the United States? 

Bernie believes we must ensure that health providers, social services, law enforcement, and all other entities have proper resources and training to handle the varying needs of the communities they serve — especially the community living with and affected by HIV/AIDS — without discrimination. Schools must give students age-appropriate, comprehensive sex education and all Americans should have access to scientifically-accurate information regarding HIV/AIDS infections. We must also appoint people living with HIV, community and public health experts and government officials to the HIV/AIDS Task Force to develop specific recommendations on how to successfully accomplish this goal.

9. Given the advances in medical treatment available to all servicemembers for over two decades, do you support lifting unnecessary restrictions that prevent individuals living with HIV from enlisting, being commissioned as an officer, or deploying in the Armed Forces of the United States? 

Yes. 

10. Despite the existence of antiretroviral medications that can render the viral load of a person living with HIV undetectable (and therefore untransmittable), and prevent transmission of the virus through pre-exposure prophylaxis (PrEP) many people in need of such medications cannot access them because of their high cost. In other instances, our insurance premiums go up, and/or taxpayers are stuck holding huge costs. If elected, how will you reduce excessive drug prices in the United States, through executive action, as well as legislation? Will your plan make use of government purchasing power to negotiate lower prices and work towards policies similar to all other developed countries to limit abuses of the patent monopoly system? 

We pay the highest prices in the world for prescription drugs. It does not have to be that way. If the pharmaceutical industry will not end its greed, which is literally killing Americans, then we will end it for them. What does this mean for people with prescriptions? Medicare for All will cover your prescription drugs.

The plan will require drug prices to be negotiated by the Secretary of Health and Human Services.

Bernie also introduced the Prescription Drug Price Relief Act, which will index the price of prescription drugs in the U.S. to the median price of the same drug in five other major countries. His legislation would give the federal government power to break patents on expense brand name drugs and authorize generic versions of medicines if drug companies refuse to stop charging Americans higher prices than they do in other industrialized countries. He has also introduced the Affordable and Safe Prescription Drug Importation Act, which would allow the importation from Canada and other major countries. He will use executive authority to reinstate the reasonable pricing clause to require "reasonable pricing" on drugs and other products developed in cooperation between the Government and industry. And if needed, he will direct federal agencies to use Bayh-Dole march-in rights.

Bernie’s Medicare for All plan will require drug prices to be negotiated by the Secretary of Health and Human Services. He will also create a multi-billion dollar Prize Fund to reward medical researchers and developers of medicines like lifesaving drugs for HIV and AIDS treatment and prevention, based primarily upon the added therapeutic value a new treatment offers and the number of people it benefits — instead of a system where the market is manipulated to keep out all competition. And Bernie will pass the Prescription Drug Price Relief Act, which will index the price of prescription drugs in the U.S. to the median price of the same drug in five other major countries, and the Affordable and Safe Prescription Drug Importation Act, which would allow the importation of prescription drugs from Canada and other major countries.

11. According to the CDC, an estimated 14% of transgender women are living with HIV, with an estimated 44% identifying as Black/African-American, 26% Hispanic/Latinx, and 7% White. The number of transgender people who received a new HIV diagnosis was 3 times the national average. If elected, would you support a reinterpretation of Section 1557 of the ACA as covering transgender people and champion the passage of the Equality Act? How would you protect the rights, well-being, and lives of transgender people living in this country, while ensuring that they receive the healthcare and housing necessary to be virally suppressed? 

Yes. Bernie is a proud cosponsor of the Equality Act, and will sign it into law as President to prohibit discrimination against LGBTQ+ people nationwide. Bernie Sanders’ Medicare for All would not only confront the massive health disparities faced by the LGBTQ+ community, it would also cover gender-affirming surgeries, increase access to PrEP, remove barriers to mental health care and bolster suicide prevention efforts. Bernie’s plan clearly states that LGBTQ+ people cannot be discriminated against by providers or denied health benefits. It’s a truly intersectional plan that would establish health care as right to every single person in America, no matter who they are or who they love.

Bernie believes it should not be a radical idea to guarantee everyone — regardless of sexuality or gender identity — equal protection under the law and that we must end discrimination in all forms. As President, he will:

● Pass the Equality Act, which would expand the defined prohibited types of discrimination to include sexual orientation and gender identity.

● Pass the Every Child Deserves a Family Act and other bills to prohibit discrimination against LGBTQ+ people.

● Strongly oppose any legislation that falsely purports to “protect” religious liberty at the expense of others’ rights.

● Ensure LGBTQ+ people have comprehensive health care without discrimination or discrimination from providers.

● Protect the rights of LGBTQ+ people around the world by ensuring that written into the core text of all global trade agreements, are strong and binding human rights standards and strengthening the Special Envoy for LGBTQ+ Rights within the Dept. of the State.

● Advance policies to ensure students can attend school without fear of bullying, and work to substantially reduce suicides.

● Support police departments that adopt policies to ensure fairer interactions with transgender people, especially transgender women of color who are often targeted by police unfairly, and by instituting training programs to promote compliance with fair policies.

● Fight against discrimination against LGBTQ+ people by creditors and banks so that people will not be unfairly denied mortgages, credit cards, or student loans.

● Repeal the Trump Administration’s bigoted ban on transgender people from serving in the U.S. military.

● Make it easier for LGBTQ+ workers to form a union so they can collectively bargain for fair wages and safe working conditions.

12. Many documented and undocumented immigrants living with and affected by HIV are refraining from seeking out HIV and general medical care due to fear of deportation or denial of citizenship. Please state how you would encourage this population to be screened for HIV and initiate treatment if diagnosed, and how to ensure healthcare spaces are safe spaces for immigrants and health providers from immigration enforcement? What are your views on potential changes to the “public charge” rule that would make any use of a very wide range of benefits (including healthcare programs such as the Affordable Care Act marketplace subsidies, Children’s Health Insurance Program and potentially some Medicaid benefits) detrimental to an immigrant’s chances at becoming a U.S. citizen?

Medicare for All means guaranteeing health care as a right for everyone in the United States, regardless of their immigration status. Bernie wholeheartedly rejects the “The Great Sanctuary City Slander” as the politics of fear, and supports enacting community trust policies to ensure all people, especially immigrants, feel safe to seek medical attention. These policies will strengthen relationships between community members and local law enforcement, respect the constitutional rights of immigrants, and prohibit racial profiling and the criminalization of communities of color.

Should this president implement a so-called “public charge” rule to deny help and benefits to people based on their immigration status, Bernie will immediately rescind that rule. Bernie is a firm supporter of a family-based immigration system grounded in civil and human rights. We should not let corporate America pick and choose who they want to come into our country or who they deem “worthy” of public benefits.

13. The escalating pace of the introduction and passage of federal and state bills that restrict legally protected health care services, including abortion and some forms of contraception, is already having adverse effects on young people, women, and people living with HIV. How will you ensure people of childbearing potential that, regardless of income, geography, or any other stigmatizing restriction, they will have unfettered access to all of their needed sexual and reproductive health services? Additionally, how will you communicate the government's full support of sexual and reproductive health, rights, and justice of all people living with HIV and those who may be vulnerable to contracting HIV?

Despite major advances in civil and political rights, our country still has a long way to go in addressing the issues of gender inequality and reproductive freedom. Right now, extreme forces on the right are launching political attacks and passing draconian laws at both the state and national level with the goal of ending the right to choose and rolling back protections for LGBTQ+ individuals. We must fight back together, and defend the right to control your own body and ensure LGBTQ+ people are free from discrimination by providers. When we are in the White House, we will:

● Guarantee health care as a human right. Under his Medicare for All program, the Hyde Amendment is fully repealed, and comprehensive reproductive health coverage is provided to all, free at the point of service.

● Fully fund Planned Parenthood, Title X, and other initiatives that protect health, access to contraception, and the availability of a safe and legal abortion.

● Black women are three and a half times more likely to die from pregnancy than white women. The research is clear: to solve our maternal mortality crisis, we need to address uninsurance. Nearly 14 percent of black women are uninsured, compared to 8 percent of white women. To address this crisis, Bernie will guarantee health care to all as a right.

● Oppose all efforts to undermine or overturn Roe v. Wade, and appoint federal judges who will uphold the constitutional right to an abortion.

I believe we must ensure that health providers, social services, law enforcement, and all other entities have proper resources and training to handle the varying needs of the communities they serve — especially the community living with and affected by HIV/AIDS — without discrimination.

Schools must give students age-appropriate, comprehensive sex education and all Americans should have access to scientifically-accurate information regarding HIV/AIDS infections. We must also appoint people living with HIV, community and public health experts and government officials to the HIV/AIDS Task Force to develop specific recommendations on how to successfully accomplish this goal. 

14. In recent years, the need for comprehensive prison and justice system reforms that focus on rehabilitation and the wellbeing of those who are incarcerated rather than punishment has become clearer than ever. What will you do to ensure that incarcerated people living with HIV and those who may be vulnerable to contracting HIV receive uninterrupted, unfettered and fully funded access to healthcare and medications for treatment both while they are in prison or jail, and when they are released for re-entry into their communities? 

We are spending $80 billion a year to lock up 2.2 million people, hundreds of thousands of whom have not been convicted of a crime and are solely in jail because they can't afford their bail. We are criminalizing poverty. And because of the historical legacy of racism in this country, we are disproportionately criminalizing African Americans, Latinos and Native Americans.

With increased detention of immigrants under the Trump Administration, private prisons are becoming more widespread and more profitable. We need real, comprehensive criminal justice reform now. When Bernie is in the White House we will:

○ End, once and for all, the destructive “war on drugs,” including legalizing marijuana.

○ Eliminate private prisons and detention centers

○ End cash bail

○ Abolish the death penalty

○ End all mandatory minimums and reinstate the federal system of parole

○ Seriously reform civil asset forfeitures

○ Bring about major police department reform

○ Prevent employers from discriminating against applicants based on criminal history by “banning the box.”

○ Support police departments that adopt policies to ensure fairer interactions with transgender people, especially transgender women of color who are often targeted by police unfairly, and by instituting training programs to promote compliance with fair policies.

○ Ensure all people have comprehensive health care without discrimination or discrimination from providers — especially for incarcerated individuals living with and affected by HIV/AIDS.

○ And as part of our comprehensive criminal justice reform, we will ensure that people who interacted with the justice system are still able to get the rehabilitation services they need and are able to find housing and employment.

15. Ending the HIV epidemic in the United States is also dependent on ending the HIV epidemic across the globe. Traditionally, the US has taken a leadership role in funding for both PEPFAR and The Global Fund, but recent years have been characterized by flat-funding and the threats of massive cuts in funding for fighting these pandemics. Would you commit to launch a stepped up effort to end the deadliest pandemics, including AIDS, and prepare for and prevent epidemic threats of the future with expanded results-oriented programming, doubled US investment in fighting pandemics, and US leadership to rally the world to join us in this effort? 

Bernie believes America has a responsibility to lead the international community in solving the health crises we have seen arise globally and establish efficient emergency systems for future epidemics. Taking steps back and cutting funding for critical programs like PEPFAR and the Global Fund are an abdication of American leadership and an international disgrace.

At this moment, we must do everything we can to end the HIV and AIDS epidemic. The good news is that San Francisco, New York and other urban areas are making significant progress in combating HIV and AIDS.

The bad news is that nationally we have not seen an improvement in the nearly 40,000 avoidable HIV infections that are taking place each and every year. Tragically, in some regions of the country, the epidemic has gotten even worse. And globally we are not doing better. It was estimated globally in 2017, 1.8 million individuals became newly infected with HIV and nearly 25 percent of people living with HIV are not aware and lack testing services. In the year 2019, we have got to do much better than that.

We now have all of the tools we need to end AIDS deaths and HIV transmissions. Now, we need the political will to do it.

We must set a national goal of ending the HIV epidemic in the U.S. by the year 2025 so that HIV is no longer a public health threat to any community in the U.S. and that people with HIV are able to live long, healthy lives.

We must also appoint people living with HIV, community and public health experts and government officials to the HIV/AIDS Task Force to develop specific recommendations on how to successfully accomplish this goal.

We must support the CDC and ensure the CDC has the tools and resources needed to combat this epidemic.

We must also join the international community in committing to make large changes in our country to ensure the HIV epidemic and other epidemics are treated with urgency and adequate resources are allocated to end them.

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