Since the release of the Strategy, additional scientific discoveries have greatly enhanced our understanding of how to prevent and treat HIV. Accordingly, further Federal action is appropriate in response to these new developments. For example, a breakthrough research trial supported by the National Institutes of Health showed that initiating HIV treatment when the immune system was relatively healthy reduced HIV transmission by 96 percent. In addition, evidence suggests that early treatment may reduce HIV-related complications. These findings highlight the importance of prompt HIV diagnosis, and because of recent advances in HIV testing technology, HIV can be detected sooner and more rapidly than ever before.
Based on these and other data, recommendations for HIV testing and treatment have changed. The U.S. Preventive Services Task Force now recommends that clinicians screen all individuals ages 15 to 65 years for HIV, and the Department of Health and Human Services Guidelines for Use of Antiretroviral Agents now recommends offering treatment to all adolescents and adults diagnosed with HIV.
Furthermore, ongoing implementation of the Affordable Care Act provides a historic opportunity for Americans to access affordable, quality health care. The Act is expanding access to recommended preventive services with no out-of-pocket costs, including HIV testing, and, beginning in 2014, insurance
companies will not be able to deny coverage based on pre-existing conditions, including HIV. Starting October 1, 2013, Americans can select the coverage that best suits them through the new Health Insurance Marketplace, and coverage will begin January 1, 2014.
Despite progress in combating HIV, important work remains. Since the publication of the Strategy, data released by the Centers for Disease Control and Prevention show that there are significant gaps along the HIV care continuum — the sequential stages of care from being diagnosed to receiving optimal treatment. Nearly one-fifth of the estimated 1.1 million people living with HIV in the United States are undiagnosed; one-third are not linked to medical care; nearly two-thirds are not engaged in ongoing care; and only one-quarter have the virus effectively controlled, which is necessary to maintain long-term health and reduce risk of transmission to others.
In light of these data, we must further clarify and focus our national efforts to prevent and treat HIV infection. It is the policy of my Administration that agencies implementing the Strategy prioritize addressing the continuum of HIV care, including by accelerating efforts to increase HIV testing, services, and treatment along the continuum. This acceleration will enable us to meet the goals of the Strategy and move closer to an AIDS-free generation.
Sec. 2. Establishment of the HIV Care Continuum Initiative. There is established the HIV Care Continuum Initiative (Initiative), to be overseen by the Director of the Office of National AIDS Policy. The Initiative will mobilize and coordinate Federal efforts in response to recent advances regarding how to prevent and treat HIV infection. The Initiative will support further integration of HIV prevention and care efforts; promote expansion of successful HIV testing and service delivery models; encourage innovative approaches to addressing barriers to accessing testing and treatment; and ensure that Federal resources are appropriately focused on implementing evidence-based interventions that improve outcomes along the HIV care continuum.
Sec. 3. Establishment of the HIV Care Continuum Working Group. There is established the HIV Care Continuum Working Group (Working Group) to support the Initiative. The Working Group shall coordinate Federal efforts to improve outcomes nationally across the HIV care continuum.
(a) Membership. The Working Group shall be co-chaired by the Director of the Office of National AIDS Policy and the Secretary of Health and Human Services or designee (Co-Chairs). In addition to the Co-Chairs, the Working Group shall consist of representatives from:
(i) the Department of Justice;
(ii) the Department of Labor;
(iii) the Department of Health and Human Services;
(iv) the Department of Housing and Urban Development;
(v) the Department of Veterans Affairs;
(vi) the Office of Management and Budget; and
(vii) other agencies and offices, as designated by the Co-Chairs.
(b) Consultation. The Working Group shall consult with the Presidential Advisory Council on HIV/AIDS, as appropriate.
(c) Functions. As part of the Initiative, the Working Group shall:
(i) request and review information from agencies describing efforts to improve testing, care, and treatment outcomes, and determine if there is appropriate emphasis on addressing the HIV care continuum in relation to other work concerning the domestic epidemic;
(ii) review research on improving outcomes along the HIV care continuum;
(iii) obtain input from Federal grantees, affected communities, and other stakeholders to inform strategies to improve outcomes along the HIV care continuum;
(iv) identify potential impediments to improving outcomes along the HIV care continuum, including for populations at greatest risk for HIV infection, based on the efforts undertaken pursuant to paragraphs (i), (ii), and (iii) of this subsection;
(v) identify opportunities to address issues identified pursuant to paragraph (iv) of this subsection, and thereby improve outcomes along the HIV care continuum;
(vi) recommend ways to integrate efforts to improve outcomes along the HIV care continuum with other evidence-based strategies to combat HIV; and
(vii) specify how to better align and coordinate Federal efforts, both within and across agencies, to improve outcomes along the HIV care continuum.
(d) Reporting.
(i) Within 180 days of the date of this order, the Working Group shall provide recommendations to the President on actions that agencies can take to improve outcomes along the HIV care continuum.
(ii) Thereafter, the Director of the Office of National AIDS Policy shall include, as part of the annual report to the President pursuant to section 1(b) of my memorandum of July 13, 2010 (Implementation of the National HIV/AIDS Strategy), a report prepared by the Working Group on
Government-wide progress in implementing this order. This report shall include a quantification of progress made in improving outcomes along the HIV care continuum.
Sec. 4. General Provisions. (a) Nothing in this order shall be construed to impair or otherwise affect:
(i) the authority granted by law to an executive department, agency, or the head thereof; or
(ii) the functions of the Director of the Office of Management and Budget relating to budgetary,
administrative, or legislative proposals.
(b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.
(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
BARACK OBAMA
Source: ARRL
The High Frequency Active Auroral Research Program (HAARP) — a subject of fascination for many hams and the target of conspiracy theorists and anti-government activists — has closed down. HAARP’s program manager, Dr James Keeney at Kirtland Air Force Base in New Mexico, told ARRL that the sprawling 35-acre ionospheric research facility in remote Gakona, Alaska, has been shuttered since early May.
“Currently the site is abandoned,” he said. “It comes down to money. We don’t have any.” Keeney said no one is on site, access roads are blocked, buildings are chained and the power turned off. HAARP’s
website through the University of Alaska no longer is available; Keeney said the program can’t afford to pay for the service. “Everything is in secure mode,” he said, adding that it will stay that way at least for another 4 to 6 weeks. In the meantime a new prime contractor will be coming on board to run the government owned-contractor operated (GOCO) facility.
HAARP put the world on notice two years ago that it would be shutting down and did not submit a budget request for FY 15, Keeney said, “but no one paid any attention.” Now, he says, they’re complaining. “People came unglued,” Keeney said, noting that he’s already had inquiries from Congress. Universities that depended upon HAARP research grants also are upset, he said.
The only bright spot on HAARP’s horizon right now is that the Defense Advanced Research Projects Agency (
DARPA) is expected on site as a client to finish up some research this fall and winter. DARPA has nearly $8.8 million in its FY 14 budget plan to research “physical aspects of natural phenomena such as magnetospheric sub-storms, fire, lightning and geo-physical phenomena.”
The proximate cause of HAARP’s early May shutdown was less fiscal than environmental, Keeney said. As he explained it, the diesel generators on site no longer pass
Clean Air Act muster. Repairing them to meet EPA standards will run $800,000. Beyond that, he said, it costs $300,000 a month just to keep the facility open and $500,000 to run it at full capacity for 10 days.
Jointly funded by the
US Air Force Research Laboratory and the
US Naval Research Laboratory, HAARP is an ionospheric research facility. Its best-known apparatus is its 3.6 MW HF (approximately 3 to 10 MHz) ionospheric research instrument (IRI), feeding an extensive system of 180 gain antennas and used to “excite” sections of the ionosphere. Other onsite equipment is used to evaluate the effects.
Larry Ledlow, N1TX, of Fairbanks, Alaska, said HAARP ionosonde and
riometerdata have been “invaluable, especially being more or less local, to understand current conditions in the high latitudes.” He said data from other sites “simply do not accurately reflect the unique propagation we endure here.”
To fill the gap, Ledlow said, several members of the Arctic Amateur Radio Club — including Eric Nichols, KL7AJ, author of
Radio Science for the Radio Amateur and articles in
QST — have discussed building their own instruments. “It’s all very preliminary,” he said, “but we really feel the pinch losing HAARP.” Nichols, of North Pole, Alaska, has conducted experiments at HAARP. He called the shutdown “a great loss to interior Alaska hams and many others.”
The ultra-high power facility long has intrigued hams, even outside of Alaska. In 1997, HAARP transmitted test signals on HF (3.4 MHz and 6.99 MHz) and solicited reports from hams and short-wave listeners in the “Lower 48” to determine how well the HAARP transmissions could be heard to the south. In 2007 HAARP
succeeded in bouncing a 40 meter signal off the moon. Earlier this year, HAARP scientists
successfully produced a sustained high-density plasma cloud in Earth’s upper atmosphere.
As things stand, the Air Force has possession for now, but if no other agency steps forward to take over HAARP, the unique facility will be dismantled, Keeney said. He pointed out that it would cost less to bulldoze the antenna field than it would to replace the 180 antennas.
Splashy web postings abound, blaming HAARP for controlling the weather — most recently in the case of Hurricane Sandy and the spate of tornados — and for causing other natural disasters. Quipped Keeney, “If I actually could affect the weather, I’d keep it open.”
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