I’ll end AIDS epidemic, cure childhood cancer
President Donald Trump made few new promises during his campaign speech Thursday night in Cincinnati. But two promises resonated with people, judging by interest on the internet: curing pediatric cancer and curing AIDS.
During the rally at U.S Bank Arena, he said: “The things we’re doing in our country today, there’s never been anything like it. We will be ending the AIDS epidemic shortly in America, and curing childhood cancer very shortly.”
Let’s take the promises, which both originated in his 2019 State of the Union message, one at a time.
Curing pediatric cancer
First, the cure rate for pediatric cancers is already at 80 percent. Kaiser Health News reports that’s because “of the tremendous progress that’s been made with childhood leukemia.” But for other pediatric cancers, “the cure rates haven’t changed in 20 years,” Kaiser says.
Trump said in the State of the Union in February that he would set aside $500 million for research into pediatric cancer over 10 years.
The proposal would be a boost in federal spending on cancer. But it’s unclear “how meaningful the increase is in relation to current federal spending on childhood cancer research,” Kaiser reported earlier this year.
“The National Institutes of Health estimates its 2019 spending in this area to be $462 million, according to research portfolio data. So, $500 million over 10 years, or an average $50 million a year, amounts to a bit more than a 10 percent increase,” Kaiser’s Victoria Knight wrote.
“To put it in perspective: The $500 million figure pales in comparison to other medical research initiatives that previous presidents have outlined amid the pomp and circumstance of this annual speech,” Knight wrote.
“Barack Obama announced during his 2016 State of the Union that he wanted to ‘make America the country that cures cancer once and for all,’ launching what came to be known as the ‘Cancer Moonshot’ initiative. In his initial announcement, Obama proposed $1 billion to be parceled out over fiscal years 2016 and 2017,” Knight wrote later in the story.
“That amounts to an average of $500 million over two years.”
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Knight added this: “But presidents don’t always get all they ask for. In December 2016, Congress passed the 21st Century Cures Act, which instead allotted $1.8 billion to the Moonshot effort over seven years. That averages to about $257 million for each of those years, though it’s up to Congress each year to decide on the Moonshot’s actual appropriation.”
Trump’s proposed budget for next fiscal year cuts funding for the National Institutes for Health by $900 million, but includes the pediatric cancer money, according to the website Cancerhealth.com.
Ending AIDS epidemic
Trump said in the State of the Union that he would end HIV transmission by 2030, a task that Kaiser called “doable but daunting.”
Ending the transmission of the AIDS-causing virus is “a goal long sought by public health advocates,” Kaiser reported. “But even given the vital gains made in drug therapies and understanding of the disease over nearly 40 years, it is not an easy undertaking.”
“The reason we have an AIDS epidemic is not just for a lack of the medication,” Dr. Kenneth Mayer, medical research director at the Boston LGBT health center Fenway Institute, told Kaiser’s Carmen Heredia Rodriguez. “There are a lot of social, structural, individual behavioral factors that may impact why people become infected, may impact if people who are infected engage in care and may impact or affect people who are at high risk of HIV.”
Health and Human Services Secretary Alex Azar, who provided details of the initiative after Trump’s announcement, said the administration will target viral hot spots by providing local groups more resources, using data to track the spread of the disease and creating local task forces to bolster prevention and treatment.
At the time, neither Azar nor other federal officials who briefed reporters offered cost estimates for the program.
Azar said the plan seeks to reduce new infections by 75% in the next five years and 90% in the next decade.
Cincinnati, Columbus and Cleveland are among 57 jurisdictions targeted under a plan the president unveiled in his State of the Union address in January to cut new HIV infection by 75% in five years and by 90% in 10 years. The president proposed spending $291 million to kick off the initiative.
Dr. Robert Redfield, who Trump appointed as director of the federal Centers for Disease Control and Prevention, was in Cincinnati on Thursday before Trump’s campaign rally and got an update on the HIV program locally along with Dr. Amy Acton, Ohio’s director of health.
Pushing up new HIV infections, particularly in the Cincinnati area, has been the epidemic in needle-drug use. Gay and bisexual men of color between 25 and 34 are at highest risk.
Redfield said the prevention initiative will rest on reducing the stigma of getting tested for HIV, providing medication that can prevent those at high risk from getting infected and organizing syringe exchanges. Needle addicts can spread HIV by sharing dirty needles.
Health officials must tackle the problem of communicating with young people, Redfield said, noting he usually only gets a response from his adult children when he texts them.
“We have the tools to bring an end to the AIDS epidemic in our hands today without a vaccine” with pre-exposure medication and syringe exchanges, Redfield said. “Not only can we do this, we have no intention of not succeeding.”