On Monday, April 8, 2024, the President’s Domestic Policy Advisor to the President at the White House made history when they announced that Francisco Ruiz was appointed as Director of the White House Office of National AIDS Policy (ONAP).

Mr. Ruiz is the first Latino, gay man living with HIV to serve in this crucial position within the White House and the Domestic Policy Council (DPC). He has a wealth of personal and professional experience. Mr. Ruiz led the National Partnerships Team within the Division of HIV Prevention at the Centers for Disease Control and Prevention (CDC) and has held positions at the National Alliance of State and Territorial AIDS Directors  and the National Latino AIDS Action Network. He brings a valuable commitment to promoting health equity to this role.

Mr. Ruiz will succeed Harold Phillips as the Director of ONAP. Mr. Phillips served in the role from 2021 through January 2024. During his time at ONAP, Mr. Phillips oversaw the release of the 2022-2025 National HIV/AIDS Strategy, which included the momentous development of a quality of life indicator as well as an elevated focus on racial equity, the needs of sex workers, immigrants, and people aging with HIV.

PWN would like to congratulate this groundbreaking leader within the Latinx community and the community of people living with HIV. We look forward to meaningfully collaborating with Mr. Ruiz in our ongoing efforts to advance the principles and core recommendations in the PWN Policy Agenda (2018) and the US People Living with HIV Caucus' Demanding Better: An HIV Federal Policy Agenda by People Living with HIV (2021).

>> You can read the US People Living with HIV Caucus’s congratulations to Mr. Ruiz here <<

On March 26th, the Supreme Court heard oral arguments for a case challenging the U.S. Food and Drug Administration’s (FDA) 23-year-old approval of mifepristone. Mifepristone, also known as the “abortion pill,” is used along with another drug (misoprostol) to end a pregnancy that is less than 10 weeks along. Mifepristone is safe, common and effective for medication abortion. It has a 95-99% success rate in ending an early pregnancy, and in 2022, medication abortion accounted for more than half of all U.S. abortions.

The anti-abortion plaintiffs in this case are challenging the 2016 and 2021 rules issued by the FDA, both of which greatly increased mifepristone access. The 2016 change updated the mifepristone label to allow the drug to be used for up to 10 weeks of pregnancy, instead of the earlier seven. Prior to 2016, just 37% of all US abortions were eligible for mifepristone. After the 2016 change, that number jumped to 75%. The 2021 rule removed a requirement that mifepristone be dispensed through 3 in-person visits. This enables patients to receive mifepristone through the mail after telehealth appointments, which is sometimes the only option for people living in healthcare deserts. 

These rules are essential for maintaining broad mifepristone access. Despite the fact that most of the judges on the Supreme Court lean conservative, most Justices seemed skeptical of limiting access to mifepristone during oral arguments. There are a couple of reasons why the Court may not negate these critical rules.

1. The anti-abortion group bringing the lawsuit does not have standing. In order to bring any federal lawsuit, the suing party, or the plaintiff, must meet the requirement of “standing.” Standing requires that the suing party has suffered some actual or threatened injury. Future injuries are permissible, but they cannot be “speculative” – they must be certain. Here, the plaintiffs are a group of anti-abortion doctors and organizations. They argue that they have standing because they may have to treat a patient suffering complications from an abortion pill (which are exceedingly rare). Most of the justices questioned whether they could show that they had undergone or would imminently undergo any particular injuries as a result of the FDA’s regulations. 

2. The Court is wary of issuing a nationwide injunction. When plaintiffs bring a case to court, in addition to describing the legal violation and harm that occurred, they also describe the remedy they are requesting from the Court. In this case, the plaintiff’s proposed remedy would roll back the FDA’s 2016 and 2021 regulations nationwide, drastically undercutting access to mifepristone for everyone. This is known as a “nationwide injunction.” During oral arguments, even conservative Justices questioned why a nationwide injunction was necessary as opposed to a narrower form of relief.

Why does this matter?

 If the Supreme Court limits access to mifepristone nationwide, they will ensure widespread reproductive injustice. In states with abortion bans, mifepristone through a telemedicine appointment is one of the few options for people hoping to terminate their pregnancies. Telemedicine is also a more affordable option than driving several hours or flying out of state for care. Drug and biotech companies have also warned that restricting mifepristone access will impact the development of a wide array of other FDA-approved medications, including HIV prevention medication. The case could create a legal precedent for the Court overriding the scientifically-based rules of a health and safety administration like the FDA.

The Supreme Court has yet to hand down a final ruling on mifepristone access. The questions during oral arguments suggest that the Court will not decimate access to mifepristone in this case. However, two deeply conservative Justices did reference an obsolete law (“the Comstock Act”) that advocates warn could be misused to enforce a nationwide abortion ban in the future. As of now, access and approval to mifepristone remains unchanged. We hope that it will stay that way, as access to medication abortion is a vital pillar of reproductive freedom.

• There have been significant developments in Floridian anti-LGBTQ+ rules and laws this month.

  •  LGBTQ+ advocacy groups and the state of Florida have reached a settlement to clarify provisions of the “Don’t Say Gay” bill, which originally passed in 2022. Students and teachers can discuss LGBTQ+ topics, as long as the discussions are not part of the curriculum. Although the law remains on the books, the settlement lessens some of the dangerous and discriminatory impacts.

  • The Florida Department of Highway Safety and Motor Vehicles released a memo barring people of trans experience from updating their driver’s licenses with their correct gender. However, this rule likely violates the Real ID Act, a federal law that requires that states include a person’s gender on each driver’s license. 

• Alabama Governor Kay Ivey has signed Senate Bill 129 into law, which targets diversity, equity, and inclusion (DEI) initiatives on college campuses and bans people of trans experience from using the bathroom that matches their gender identity.

• Last year, County Judge Tim O’Hare dissolved the North Central Texas Ryan White Planning Council in Tarrant County, Texas and appointed all new members. At this time, significantly less than one third of the people on the council are people living with HIV, in violation of federal requirements.
• A unit of UnitedHealth experienced a cyberattack in late February which has impacted services under Ryan White. Some pharmacies are refusing to dispense medications because payment claims cannot be processed, causing HRSA to develop contingency protocols for recipients to get their medications as needed.

• Congress’ recently passed spending bill included a temporary reauthorization for the President’s Emergency Plan for AIDS Relief (PEPFAR). The Biden administration had been seeking a 5-year reauthorization of PEPFAR, but faced pushback from republicans as PEPFAR was drawn into larger debates over abortion and contraception.

• Two state Supreme Courts issued devastating opinions that limit access to abortion. In Arizona, the Court reinstated a sweeping 1864 law barring almost all abortions in the state. The Florida Supreme Court overturned decades of precedent and cleared the way for a 6-week abortion ban. In a separate decision, however, the Court ruled that a proposed amendment to enshrine abortion rights in the state constitution can appear on the ballot in November.

• The Alabama State Legislature has passed a law which shields health care practitioners and patients from civil or criminal liability, effectively reversing some of the impacts of a previous state Supreme Court ruling which granted embryos the same rights as people. Though IVF treatments have resumed following its passage, physicians remain wary of future efforts to restrict IVF in Alabama.

• Despite physicians’ warnings that the Texas abortion ban is dangerously unclear, a Texas medical panel has refused to list specific exceptions to the ban. People with serious pregnancy complications have been forced to leave the state because of the ban, which is among the most restrictive in the country.

• President Biden has announced $6 billion in student debt relief for public service workers under the “Public Service Loan Forgiveness” program, including an estimated 78,000 teachers, firefighters, and nurses.
• The Social Security Administration is set to implement a new rule that removes barriers and increases monthly payouts for certain recipients of government benefits. Starting September 30th, an applicants’ history of informal food assistance from friends, family, or other support networks will no longer hinder their benefits.

• Wired has released a report that confirms Denver advocates’ criticisms of Shotspotter, technology used by local law enforcement to purportedly detect gunshots. Data leaked from ShotSpotter reveals that nearly 70% of the people who live in a neighborhood with at least one Shotspotter sensor identify as Black or Latine.
• A federal judge has put on hold a Texas law that would allow law enforcement officers to arrest people suspected of entering the country illegally. The Justice Department has argued that the law is a violation of federal authority and would wreak havoc at the border.

• Louisiana is one of many states that has introduced a suite of “Tough-on-Crime” laws this legislative session, including rolling back some of the tools local prosecutors can use to undo wrongful convictions. The new suite of laws makes Louisiana one of the most punitive justice systems in the nation.