FY 2020 Annual Performance Plan and Report - Goal 2 Objective 2

Fiscal Year 2020
Released March, 2019

Goal 2. Objective 2: Prevent, treat, and control communicable diseases and chronic conditions

Communicable diseases and chronic conditions affect the lives of millions of Americans every day. The emergence and spread of infectious diseases—such as HIV/AIDS, hepatitis, tuberculosis, measles, and human papillomavirus—can quickly threaten the stability of public health for communities and place whole populations at risk. The rise of globalization and ease of travel also has made it easier for domestic and international outbreaks—such as recent outbreaks of measles, pandemic influenza A, Ebola, Zika, and chikungunya—to create public health challenges. Moreover, the prevalence of chronic conditions—such as diabetes, heart disease, stroke, and cancer—in the United States continues to contribute to the daily struggles of Americans. The occurrence of multiple chronic conditions also exacerbates the adverse health impacts and health care costs associated with chronic conditions and their associated health risks. HHS programs and initiatives focus on promoting partnerships, educating the public, improving vaccine development and uptake, advancing early detection and prevention methods, and enhancing surveillance and response capacity.

The Office of the Secretary leads this objective. The following divisions are responsible for implementing programs under this strategic objective: ACL, ASPA, ASPR, CDC, CMS, FDA, HRSA, IHS, NIH, OASH, OGA, and SAMHSA.

Objective 2.2 Table of Related Performance Measures

Increase the percentage of Ryan White HIV/AIDS Program clients receiving HIV medical care and at least one viral load test who are virally suppressed (Lead Agency - HRSA; Measure ID - 16.III.A.4)21
  FY 2013 FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020
Target N/A N/A N/A N/A N/A 83% 83% 83%
Result N/A N/A 83% 85% 10/31/19 10/31/20 10/31/21 10/31/22
Status N/A N/A Historic Actual Historic Actual Pending Pending Pending Pending

The Ryan White HIV/AIDS Program (RWHAP) works to improve health outcomes by preventing disease transmission or slowing disease progression for disproportionately impacted communities. One way RWHAP accomplishes its mission is through the provision of medications that help patients reach HIV viral suppression. People living with HIV who use medications designed to virally suppress the disease are less infectious, which reduces the risk of their transmitting HIV to others. In FY 2019 and 2020, RWHAP will continue to play a central role in ending the HIV epidemic by ensuring that persons living with HIV have access to regular care, receive antiretroviral medications, and adhere to a regular schedule for taking their medications.

Increase the percentage of adults aged 18 years and older who are vaccinated annually against seasonal influenza (Lead Agency - CDC; Measure ID - 1.3.3a)
  FY 2013 FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020
Target 47% 50% 53% 56% 59% 62% 62% 62%
Result 42% 44% 42% 43% 38% 09/30/19 09/30/20 09/30/21
Status Target Not Met but Improved Target Not Met but Improved Target Not Met Target Not Met but Improved Target Not Met Pending Pending Pending

In the United States, on average 5-20 percent of the population contracts the flu, more than 200,000 people are hospitalized from seasonal flu-related complications, and approximately 36,000 people die from seasonal flu-related causes. This measure reflects the universal influenza vaccination recommendation and aligns with the Advisory Committee on Immunization Practices' updated recommendation (as of 2010) for the seasonal influenza vaccine. Seasonal influenza vaccinations rates for adults ages 18 years old and over increased slightly by 2 percentage-points from FY 2013 (42 percent) to FY 2014 (44 percent), then varied from 42 percent in FY 2015 to 43 percent in FY 2016, and most recently decreased to 38 percent in FY 2017. Interpretation of these results should take into account limitations of the survey, which include reliance on self-reporting of vaccination status and a decrease in response rates. No decreases in flu vaccination coverage were seen in preliminary estimates from claims-based data systems. Four in ten adults report receiving a flu vaccination. In FY 2019 and 2020, CDC will continue to monitor the percentage of adults aged 18 and older who are vaccinated annually against seasonal influenza to inform its strategies for improving adult vaccination coverage rates.

Continue advanced research and development initiatives for more effective influenza vaccines and the development of safe and broad-spectrum therapeutics for use in seriously ill and/or hospitalized patients, including pediatric patients (Lead Agency - ASPR; Measure ID - 2.4.15b)
  FY 2013 FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020
Target N/A N/A N/A N/A Baseline 2 2 2
Result N/A N/A N/A N/A 2 7 12/31/19 12/31/20
Status N/A N/A N/A N/A Historic Actual Target Exceeded Pending Pending

It is estimated that a highly contagious and virulent airborne pathogen, such as a novel influenza virus, could kill tens of millions of people globally in less than a year. Influenza and other emerging infectious diseases with pandemic potential continue to mutate, evolve, spread geographically, and infect animals and humans. Effective treatments for those who are severely ill with influenza are a critical component of pandemic preparedness and response, with significant benefit for use in annual influenza epidemics. Despite this persistent need, there are no approved influenza antiviral drugs indicated for use in severely ill and hospitalized patients in the United States.

During 2018, BARDA supported manufacturing efficiency improvements to achieve a two-fold or more increase in the number of pandemic influenza vaccine doses produced, which led to the supplemental licensure of cell-based vaccine being incorporated into the national supplies for seasonal influenza. BARDA assisted two programs to support development of improved influenza vaccines or next generation vaccines. In addition, BARDA assisted four programs for late stage development of influenza antivirals and therapeutics. These programs include antiviral drugs with novel mechanisms of action, new therapeutics, and host-based therapeutics. Development of these candidate products will improve our pre-pandemic preparedness and also support use of the products to address seasonal influenza. In FY 2020, BARDA will continue to support advanced development of novel therapeutics and next generation vaccines to increase our pandemic response capability and improve products available for response to seasonal influenza.

21 Changes in the Ryan White Services Report on how viral suppression data derived before 2015 used a different data collection methodology and are not comparable to data collected using the current methodology.


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