We cannot be the generation that cuts funding to fight HIV/AIDS

Last week, a top Trump administration official announced plans to significantly cut foreign aid. A cut to foreign aid could mean a death sentence for millions of people who are supported by lifesaving global health programs. Two of which are, President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to fight AIDS, Tuberculosis, and Malaria.

In 2003, President George Bush initiated PEPFAR to fund research, prevention and treatment of HIV/AIDS around the world. Today, PEPFAR supports 11.5 million people on life-saving antiretroviral treatment. In addition, through U.S. investments in Global Fund and global partnerships, the incidence rate of Tuberculosis has fallen 1.5 percent annually over the past 15 years.

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However, Tuberculosis is still the leading infectious killer and one-third of the world’s population is infected with TB, and on AIDS we’re still 20 million people short of full coverage with AIDS medications. Failure to increase AIDS funding would translate to an additional 17.6 million HIV infections globally and an additional 10.8 million AIDS-related deaths globally between 2016 and 2030.

Foreign aid funding is 1 percent of the U.S. budget and of that one percent, one quarter of it goes to global health. Sens. Charles SchumerCharles (Chuck) Ellis SchumerTrump, GOP regain edge in Kavanaugh battle READ: President Trump’s exclusive interview with Hill.TV The Hill's 12:30 Report — Trump slams Sessions in exclusive Hill.TV interview | Kavanaugh accuser wants FBI investigation MORE (D-N.Y.) and Kirsten GillibrandKirsten Elizabeth GillibrandGillibrand calls for Kavanaugh nomination to be withdrawn Teen girls pen open letter supporting Kavanaugh accuser: We imagine you at that party and 'see ourselves' Poll: Most Massachusetts voters don't think Warren should run for president in 2020 MORE (D-N.Y.) are both supporters of global health funding and I commend them on their efforts to increase investments in global health. As a New York constituent I ask that Schumer and Gillibrand oppose PEPFAR and Global Fund federal appropriations cuts for the Fiscal Year 2018 budget.

From Melissa Chacko, New York, N.Y.


How to improve healthcare for all

ObamaCare and whatever will modify or replace it are both attacking the wrong culprit. The major problem with healthcare is that it’s not a system. Therefore, its efficiency and effectiveness are severely suboptimized. We need to formulate the goals related to access, quality and cost. Then design the strategies that will accomplish these critical goals.

The responsive strategies include things like triage, telehealth, self-care and a personal health record (PHR). Triage maximizes the likelihood that patients will receive care at the right time and from the right source. Telehealth enables near-immediate clinical guidance for the many medical conditions that don’t actually require a time-consuming and expensive visit to a doctor’s office. Some conditions can be successfully managed via self-care, with guidance from the triage nurse. The PHR facilitates this self-care as well as ensuring that clinicians are aware of all relevant medical history, in order to be endowed with the requisite data for smart decisionmaking.

Let’s not forget wellness, because incenting healthy lifestyle is the best way to minimize the need for healthcare. There are other strategies that can contribute to optimizing population health, including the outcomes analysis of clinical encounters nationwide — so that we can finally learn from experience how to more accurately diagnose and effectively treat the plethora of patient problems. We should bring together the preeminent minds in this industry to design a system that will make healthcare all that it can be. Then it will be much easier and far less expensive to provide full-coverage insurance for all — or at least for all who are perceptively willing to be served by an intelligently designed healthcare system. 

From Joe Weber, Palm Beach Gardens, Fla.