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EO 13649Executive OrderObama · D

Executive Order 13649

Accelerating Improvements in HIV Prevention and Care in the United States Through the HIV Care Continuum Initiative

This executive order establishes the HIV Care Continuum Initiative and a supporting interagency Working Group to coordinate federal efforts to improve HIV testing, linkage to care, treatment, and viral suppression. It directs agencies to prioritize addressing gaps along the HIV care continuum and requires recommendations within 180 days, with annual progress reports thereafter.

Federal Register Open PDF 78 FR 43057

Impact dates

  1. Annual report on government-wide progress in implementing this order (to be included in existing NHAS annual report)

  2. Working Group recommendations to President on actions agencies can take to improve outcomes along HIV care continuum

Key directives

  • Establish HIV Care Continuum Initiative overseen by Director of Office of National AIDS Policy
  • Establish HIV Care Continuum Working Group co-chaired by Director of ONAP and HHS Secretary or designee
  • Working Group to coordinate federal efforts to improve outcomes across HIV care continuum
  • Working Group to consult with Presidential Advisory Council on HIV/AIDS
  • Working Group to review agency efforts, research, and stakeholder input
  • Working Group to identify impediments and opportunities for populations at greatest risk
  • Working Group to recommend integration with other evidence-based HIV strategies
  • Working Group to specify alignment and coordination of federal efforts
  • Working Group to provide recommendations to President within 180 days
  • Annual reports on government-wide progress to be included in existing NHAS reporting

Who is ordered

Timeline

Immediate

  • Establishment of HIV Care Continuum Initiative
  • Establishment of HIV Care Continuum Working Group

Near term (90d)

  • Working Group begins coordinating federal efforts
  • Consultation with Presidential Advisory Council on HIV/AIDS
  • Review of agency efforts and research

Long term

  • Working Group recommendations due to President
  • Annual progress reports on government-wide implementation
  • Ongoing integration of HIV prevention and care efforts

Risks & tensions

  • Subject to availability of appropriations may limit implementation without dedicated funding
  • No enforcement mechanism for agency compliance with Working Group recommendations
  • Vague: 'other agencies and offices, as designated by the Co-Chairs' leaves membership open-ended
  • Annual reporting tied to pre-existing NHAS reporting structure rather than standalone requirement
  • Populations at greatest risk not explicitly defined in text
Executive Order 13649: Accelerating Improvements in HIV Prevention and Care in the United States Through the HIV Care Continuum Initiative · Executive Orders