Leading infectious disease organizations across the country are issuing statements to Congress urging lawmakers to immediately provide $100 million for the Center for Disease Control’s (CDC’s) Viral Hepatitis Programs to help prevent outbreaks of HIV and hepatitis C virus (HCV) due to injection drug use and the nation’s opioid crisis, Healio reports.

Nationwide about 25 percent of people living with HIV also have hepatitis C. Among HIV-positive injection drug users, coinfection with HCV is between 50 and 90 percent.

The letters — which were sent by staffers at the National Alliance of State and Territorial AIDS Directors (NASTAD), The AIDS Institute, the Harm Reduction Coalition, the National Minority AIDS Council and AIDS United—warn that national hepatitis efforts are largely underfunded, to the point that the true scope of the hepatitis epidemic in the country remains unknown. The letters also warn that a large portion of Americans are unaware of their hep C status and that further funding would help significantly increase testing in several states.

Meanwhile, the CDC has documented 30 states determined to be experiencing or at risk for a significant increase in viral hepatitis rates or HIV outbreaks due to injection drug use. The number of hepatitis C cases nationwide has nearly tripled between 2010 and 2015, and hep C has killed more Americans than all other 60 notifiable infectious diseases combined. Advocates say that at the current rate of national funding, resource-strapped health departments are having trouble getting ahead of a new wave of infections and desperately need additional funding.

In their letters, the organizations also detailed that the approval of this funding could be used to improve testing for both HIV and hepatitis as well as link patients struggling with opioid addiction to substance abuse services, care and treatment. Advocates are also proposing to offer more education about the increase in infectious disease due to opioid use as well as expand training for intervention specialists and other health care professionals. 

That said, the battle will not be easy. In order to access that funding, President Trump would need to increase previously placed caps on non-defense funding, reject 2018 funding cuts to programs like the Minority AIDS Initiative and Housing Opportunities for People with AIDS (HOPWA) and restore cuts made in 2017 to programs like the CDC STD program and the Ryan White program.