Giving Thanks

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

In 2020, with the introduction of the coronavirus disease 2019 (COVID-19) into our daily lives, it was often said that 2021 would have to be better! It just had to be better, right? Well, life has a tendency of throwing curveballs and this year has been no exception. Arguably 2021 hasn't been much better than last year and in many ways it has been even worse (i.e., 386,233 people have died due to the virus, compared with last year's toll of 385,343).[1] That said, there remains much for which to be thankful...and it seems timely and appropriate to acknowledge them. Today is about giving thanks.

First and foremost, Bill Arnold. This Lion of the modern-day HIV/AIDS advocacy changed my life for the better, literally. Sure, losing him to the Heavens earlier this year has been painful but it also open to door to reflection. Rarely does the world introduce us to a kinder, more gentle, sincere and interesting fella. Bill's time honored stories were as much a staple to him as his notoriously famous fly fishing vest. I miss both. Bill was my colleague, my board co-chair, my client, my mentor...and most of all, my friend. But, I'm giving thanks for having known him!

Bill Arnold, 1938-2021

I'm also giving thanks to Phil, Elmer, Wanda, Jen, Eric, Lyne, Hilary, Lisa, Glen, Jennifer, Theresa, and Guy. As my board of directors, they embody a commitment to excellence. Without their leadership, support and vision the ADAP Advocacy Association wouldn't be the respected organization it is today. This collective group of folks have found a way to govern our group under unanimous consent, which speaks volumes to their character as individuals.

It is hard to imagine our efforts to promote and enhance the AIDS Drug Assistance Programs (ADAPs) would even be possible without our advocacy partners. We complement each other's work each and every day, and for that I'm giving thanks. Among them, Brian Hujdich and everyone at HealthHIV, and Bruce Richman and everyone at the Prevention Access Campaign ("Undetectable = Untransmittable" U=U campaign), and Shabbir Imber Safdar and everyone at the Partnership for Safe Medicines, and of course, Jeffrey R. Lewis and everyone at the Legacy Health Endowment. 

Our funders! It is also hard to imagine where we'd be without their ongoing support, financially and otherwise. Our organization has demonstrated that meaningful partnerships do exist between patient advocacy and the pharmaceutical industry. The dogmatic claims that industry funding is paramount to a bride are not only unfounded, they're also unhelpful to our collective efforts to improve access to care and treatment. Giving thanks to our industry, and non-industry funders, including AbbVie, AIDS Alabama, Avita Pharmacy, Community Access National Network, Gilead Sciences, Janssen Pharmaceutical Companies of Johnson & Johnson, Magellan Rx Management, Maxor National Pharmacy Services Company, MedData Services, Merck, Napo Pharmaceuticals, North Carolina AIDS Action Network, Partnership for Safe Medicines, Patient Access Network Foundation, Patient Advocate Foundation, PayPal Giving Fund, Pharmaceutical Research and Manufacturers of America, Ramsell Corporation, ScriptGuideRx, Theratechnologies, ViiV Healthcare, and Walgreens. Giving thanks to our small donors, too. You could donate to so many other charities, yet you choose to support us!

#YourVaccineIsWaiting. With the ongoing Covid-19 pandemic showing no sign of slowing down, we're giving thanks to the life-saving Pfizer-Biontech, Moderna, and Johnson & Johnson vaccinations, and to all of the people who made it possible. And to that end, additionally we're giving thanks to Josh Robbins, Tez Anderson, Jen Laws, Michelle Anderson, and Jonathan J. Pena, MSW for making possible our educational public service announcements! "Ya'll" (enter Josh's voice) did a great service to our community. 

As this pandemic has stretched to the limits the first responders and front-line healthcare workers we all too often take for granted, it must be said, THEY are the reason we are surviving the coronavirus. Giving thanks to all the pharmacists, physicians, surgeons, nurses, physician assistants, medical assistants, nursing aids, respiratory therapists, anesthesiologists, phlebotomist, behavioral health professionals, social workers, police officers, firemen (and women), and emergency medical technicians.

And most of all, I'm giving thanks to my three-year son, Sebastian. I'm proud to be your Pa Pa! Your presence in my life makes it a litter easier to cope with the craziness that surrounds us.

Finally, giving thanks to YOU for reading our blogs every week. Happy Thanksgiving!

[1] Musto, Julia (2021, November 23). US COVID-19 deaths in 2021 surpass 2020's toll. MSN News. Retrieved online at https://www.msn.com/en-us/news/us/us-covid-19-deaths-in-2021-surpass-2020s-toll/ar-AAR33qm?ocid=uxbndlbing

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.  

Understanding Breakthrough COVID-19 Infections

By: Richard Moscicki, M.D., Executive Vice President, Science and Regulatory Advocacy & Chief Medical Officer with the Pharmaceutical Research and Manufacturers of America (PhRMA)

****Reprinted with permission from the Pharmaceutical Research and Manufacturers of America****

The biopharmaceutical industry continues to work around the clock to research, develop and manufacture vaccines and therapeutics to prevent and treat COVID-19. Already, we’ve made unprecedented progress, and COVID-19 vaccines have protected hundreds of millions of people in the United States and billions around the globe.

Progress in a pandemic is not linear, unfortunately. Breakthrough infections, an infection with a virus after you have been vaccinated, are possible for some individuals even after vaccination. No vaccine – for COVID-19 or any other disease – is 100% effective in preventing infection in every person who receives it. Still, overwhelmingly, vaccines are preventing or mitigating infection, and continue to be our best tool in fighting COVID-19.

Here are a few common questions about breakthrough COVID-19 infections.

How likely am I to get a breakthrough COVID infection?

• In a recent Lancet study, less than 0.2% of the vaccinated individuals reported a breakthrough infection. And those who did suffer a breakthrough infection were older or had underlying illnesses that may make them more susceptible to infection. This study is part of a growing body of research, including from the CDC, showing the significant protections vaccines provide.
• There are preventative health interventions that can significantly boost protection against COVID-19 even when you’re vaccinated, like wearing masks, social distancing and avoiding crowds.
• Overall, the risk of severe illness from breakthrough infection remains very rare.

Source: PhRMA

What is the chance I get hospitalized if I do get a breakthrough case? 

• According to the CDC, if you are vaccinated and develop COVID-19, you will likely experience less severe symptoms than unvaccinated people and are at a greatly reduced risk of hospitalization.
• Another Lancet study found that elderly people with underlying conditions accounted for most severe breakthrough cases and were more likely to need hospitalization as compared to their vaccinated, younger counterparts. This underscores the need for more people to get vaccinated or receive a booster if eligible to reduce the chance of breakthrough infections.
• An Oxford University study confirmed that overall, people who are fully vaccinated and develop a COVID-19 breakthrough infection had lower risks for death and serious complications such as need for mechanical ventilation, ICU admission, life-threatening blood clots and other issues.

If vaccines don’t prevent me from getting and/or spreading COVID-19, why do I need a vaccine?

• People who are vaccinated are less likely to be infected by COVID-19 and less likely therefore to spread the infection and if a breakthrough infection does occur, the symptoms are typically less severe.

The COVID-19 vaccines are safe, effective, and to date, more than 416 million doses of vaccines have been administered in the U.S. But we know our work isn’t done. Protect yourself and your community by getting vaccinated, receive a booster if eligible, and take appropriate precautions based on your personal risk and the level of transmission in your community. Learn more at PhRMA.org/Coronavirus.

Richard Moscicki, M.D. - Dr. Moscicki serves as executive vice president, Science and Regulatory Advocacy and chief medical officer at PhRMA. He joined the organization in 2017 after serving as the Deputy Center Director for Science Operations for the U.S. Food and Drug Administration’s (FDA) Center for Drug Evaluation and Research (CDER) since 2013. While at FDA, Dr. Moscicki brought executive direction of Center operations and leadership in overseeing the development, implementation, and direction of CDER’s programs. Previous positions include serving as Chief Medical Officer at Genzyme Corporation from 1992 to 2011, where he was responsible for worldwide global regulatory and pharmacovigilance matters, as well as all aspects of clinical research and medical affairs for the company. He served as the senior vice president and head of Clinical Development at Sanofi-Genzyme from 2011-2013.

This opinion piece was also published in the November 11th edition of the Catalyst.

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.  

Ending the HIV Epidemic Hindered by Negative Attitudes, Misinformation & Stigma

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

Is the United States' Ending the HIV Epidemic (EHE) being stymied by the American public's long-standing negative views on HIV/AIDS, largely fueled by misinformation and stigma? A recent national survey suggests the answer to that question is an unfortunate yes. The EHE initiative's four science-based strategies - Diagnose, Treat, Prevent, and Respond - apparently have an uphill battle against bigotry, fear and ignorance. 

Less than half of the American public (48%) consider themselves knowledgeable about HIV, which is slightly less than polling done the previous year. One-in-two non-LGBTQ people surveyed (53%) expressed hesitation receiving care from an HIV-positive medical professional, and one-third (35%) held similar attitudes about an HIV-positive teacher.[1] These attitudes reflect opinions held in 2021, not 1981.

Photo Source: GLAAD

The report, “The State of HIV Stigma 2021,” was spearheaded by GLAAD, Gilead Sciences and the Southern AIDS Coalition. Addressing the challenges laid out in the report, GLAAD summarized: "The findings reflect a vast lack of understanding of HIV and how it can be prevented, as well as significant discomfort and unfounded fear about people living with HIV. The Deep South has the highest rates of HIV diagnosis, yet the study reveals that the U.S. South also has some of the highest discomfort levels pertaining to the virus. This is a perfect storm for the perpetuation of misinformation."[2]

So much has been accomplished in the fight against HIV/AIDS since the 1990s with the advent of the highly active antiretroviral therapies (HAART), culminating with the growing acceptance of the science behind U=U ("Undetectable equals untransmissible"). Yet according to the GLAAD report, only 42% knew that someone properly following an antiretroviral drug regimen can’t transmit the virus.[3]  If making U=U foundational in our efforts to end the HIV epidemic is required, then we have much more work to do.

Photo Source: GLAAD

Sadly, among straight, cisgender respondents, half appeared to have closed to door to loving a partner or spouse living with HIV. HALF! Maybe even more troubling is over one-third of the LGBTQ community expressed similar reservations.[4]

The South and Midwest regions of the country reflected higher levels of these negative attitudes, which also correlate with a culture of shame and greater prevalence of HIV criminalization laws.[5] Stigma continues to be a major hurdle in the ongoing efforts to educate Americans about HIV/AIDS. These efforts are further hindered by the incendiary language used by Donald J. Trump about Haitian immigrants and AIDS, or the insensitive, homophobic language used by rapper DaBabby about people living with HIV/AIDS, or the cruel "clean" characterization used by men on gay dating and hookup apps and websites. 

The media isn't without blame here, either. Approximately 6 in 10 Americans get their information about HIV/AIDS from the media.[6] Fortunately, GLAAD's report indicates "56% of non-LGBTQ respondents noted they are seeing more stories about people living with HIV in the media."[7]

"Measuring American attitudes toward HIV and the impact stigma has on people living with HIV" is at the heart of the GLAAD report,[8] and their efforts to monitor the country's mood on this issue is of paramount importance. The success, or failure, of the public policy strategies being employed to end the HIV epidemic will largely depend on combating negative attitudes, misinformation, and stigma.

[1] Kumamoto, Ian (2021, August 26). Half of Americans still don't know shit about HIV — and it's a real problem. MIC. Retrieved online at https://www.mic.com/life/people-know-even-less-about-hiv-than-they-used-to-according-to-new-research-84167181
[2] GLAAD (2021). 2021 State of HIV Stigma Study. Retrieved online at https://www.glaad.org/endhivstigma 
[3] Avery, Dan (2021, August 26). Half of Americans say they’d avoid an HIV-positive doctor. NBC News. Retrieved online at https://www.msn.com/en-us/news/us/half-of-americans-say-theyd-avoid-an-hiv-positive-doctor/ar-AANM01E?ocid=st
[4] GLAAD (2021). 2021 State of HIV Stigma Study. Retrieved online at https://www.glaad.org/endhivstigma
[5] Avery, Dan (2021, August 26). Half of Americans say they’d avoid an HIV-positive doctor. NBC News. Retrieved online at https://www.msn.com/en-us/news/us/half-of-americans-say-theyd-avoid-an-hiv-positive-doctor/ar-AANM01E?ocid=st
[6] McCrea, Megan (2020, April 25). How the Media Shapes Our Perception of HIV and AIDS. Healthline. Retrieved online at https://www.healthline.com/health/media-and-perception-of-hiv-aids 
[7] GLAAD (2021). 2021 State of HIV Stigma Study. Retrieved online at https://www.glaad.org/endhivstigma
[8] GLAAD (2021). 2021 State of HIV Stigma Study. Retrieved online at https://www.glaad.org/endhivstigma

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.