PIEN HUANG, HOST:
During his first term, President Trump laid out a bold proposal during a State of the Union address.
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PRESIDENT DONALD TRUMP: My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years. We have made incredible strides, incredible.
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HUANG: The Trump administration's goal of eliminating HIV in the U.S. led to a swell of research and funding to study the virus. But in the opening months of his second term, the Trump administration slashed thousands of Public Health jobs and gutted funding for scientific research, including grants and funds for HIV and AIDS research. What does this mean for the future of HIV research in the U.S.? Dr. John Brooks is the former chief medical officer to the CDC's division of HIV prevention, and he joins me now. Dr. Brooks, welcome to ALL THINGS CONSIDERED.
JOHN BROOKS: Well, Pien, thank you. It's a pleasure to be here, and I appreciate your attention to this issue.
HUANG: So first of all, can you give us a sense of where HIV research stood before these cuts?
BROOKS: Well, you know, HIV research has been in place since the discovery of the virus as the cause of advanced HIV disease, which we used to call AIDS. And it's, you know, made incredible strides. We are now at a place, due to consistent funding through mostly federal support, that's discovered amazing drugs that can help us both treat HIV to keep a person healthy but also to prevent HIV.
HUANG: Were there any treatments that we were sort of - you know, you're talking about treatments that have been developed and are out there working for people. Was there anything also that was in the works that we haven't quite gotten to yet?
BROOKS: Yeah, so a couple of very important things. First of all, there has been a decadeslong pursuit of an HIV vaccine, and that research, as well as research for an HIV cure, appears to have been canceled. That was mostly research funded by the NIH. A vaccine would be incredible if we could have it - enormous public health impact, gigantic economic benefits, as well as the scientific advancements it will provide and has provided in the past. Ditto for an HIV cure. Secondly, the way that we can give people medicine, both to treat their infection and to protect people from getting infected, are advancing very rapidly. A new drug, lenacapavir, has recently been approved not only for treating but also for preventing HIV. And uniquely, it's simple to administer. It's about as easy to administer as a vaccine, and it can protect a person for up to six months.
HUANG: So reducing or eliminating HIV requires a two-pronged approach. There's the prevention part of it and then the treatment part of it. And I'm wondering how you see these cuts impacting each of those approaches.
BROOKS: One of the things that worries me is that the focus of the current administration with regard to HIV - which incidentally is included as a new part of the Administration for a Healthy America - that HIV bureau or division, whatever it's ultimately named, seems highly focused on just treatment. But I think those of us who work in infectious diseases know well that treatment is not going to be the way you're going to get out of any epidemic. Prevention is a vital component. And what we're seeing now is particularly around prevention research and prevention activities, a real reduction in what's being done.
HUANG: So given where we are, and that, you know, the fact that Trump's initiative to eliminate HIV in the U.S. is still being funded, like you said, maybe under the new Administration for a Healthy America, even as other HIV research is being cut, do you think the U.S. can still reach this goal of eliminating HIV by 2030?
BROOKS: Well, I'm a born optimist, and I am hopeful. But honestly, I think that with the cuts being made in research and, in particular, the remarkable and, in my opinion, draconian cuts being made to federal investment in HIV prevention, are going to lead to an increase in new HIV infections nationally. We have made great strides in this country under the president's first-term signature initiative to eliminate the HIV epidemic in America. In the first four years that it was in effect, we've seen a 12% decline in new infections nationally and a 19% decline in deaths due to HIV.
HUANG: It sounds like what you're saying, Dr. Brooks, is that current HIV patients will still be able to access treatment, but you're particularly worried about the prevention part of it, the prevention of new people from getting HIV. Is that right?
BROOKS: That's absolutely right. You know, PrEP, this medication that is given to prevent infection - it stands for pre-exposure prophylaxis - has made terrific advances. There's a new drug that's out there that you only have to take twice a year through injection that can be administered as easily as a vaccine. However, the drug may be available, and it may be very potent, but not everybody has access to it. To reach this drug and to get that protection, you need to be aware that you are at risk for HIV and learn that you don't have HIV, so the drug can protect you. And then you need to be able to get to a place that can administer it, you need to be able to afford it, and you need to be able to stay engaged in the kind of care that you need to administer the drug as long as you need it.
HUANG: That's Dr. John Brooks, former chief medical officer to the CDC's Division of HIV Prevention. Dr. Brooks, thanks for joining us.
BROOKS: Thank you very much. Take care. Transcript provided by NPR, Copyright NPR.
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