How ID, HIV Clinicians Can Influence Policy in an Election Year

Infectious diseases (ID) and HIV clinicians can shape federal and state policy by pairing patient stories with sustained, bipartisan relationship-building, speakers said October 23 at an IDWeek 2026 symposium in Washington, DC.¹

The session, "Your Voice, Your Patients, Your Community: ID and HIV Advocacy in an Election Year," was moderated by Jose Rodriguez, associate director of public policy and advocacy at the HIV Medicine Association (HIVMA). Haley Pritchard, MD, MS, FIDSA, associate professor of clinical medicine in the Section of Infectious Diseases at Indiana University School of Medicine, served as interactive moderator.

"We have a responsibility as physicians not just to treat our patients, but to stand up for them also," Pritchard told The American Journal of Managed Care^® (AJMC^®). "So much of health and health care starts outside the doctor's office, so that's where it's important to make our voice heard."

Federal Priorities Facing ID and HIV Clinicians

The Infectious Diseases Society of America (IDSA) has expanded its advocacy training and congressional outreach as federal policy shifts, according to Amanda Jezek, senior vice president of public policy and government relations at IDSA. "IDSA and HIVMA and [the Pediatric Infectious Diseases Society] will continue to stand up and fight back until we have beaten back these attacks," Jezek told attendees.

A continuing resolution funding the government through December 11 keeps a proposed White House Office of Management and Budget rule from taking effect for now, according to Jezek, who said the rule would prioritize political alignment over scientific merit in funding decisions. IDSA is a coplaintiff with the American Academy of Pediatrics in a lawsuit over changes to vaccine recommendations. Plaintiffs secured stays on new appointments to the Advisory Committee on Immunization Practices (ACIP) and on changes to the childhood vaccine schedule, and the federal government is appealing the ACIP stay, she added.

IDSA is pushing to fund the Bio-Preparedness Workforce Pilot Program, which would offer loan repayment to ID and HIV clinicians, and to advance the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act to revitalize antibiotic and antifungal development, Jezek explained. Because PASTEUR cannot pass on its own, the next Congress offers 2 possible vehicles: FDA user fee reauthorization and reauthorization of the Pandemic and All-Hazards Preparedness Act. "In the next Congress, we've got 2 shots on goal," she said.

The HIV community helped stop $2 billion in proposed cuts to HIV programs this year, though about $1 billion in cuts remains on the table in a House appropriations bill, according to Andrea Weddle, MSW, executive director of HIVMA. Outside sources put the stopped cuts at nearly $2 billion in the fiscal year 2026 spending bills² and the pending House proposal at about $1 billion for fiscal year 2027.³

How Clinicians Build Relationships With Congress

One patient story helped win a congressional cosponsor for the PASTEUR Act, Rajinder Bajwa, MD, FIDSA, vice president of medical affairs and chief medical officer at Niagara Falls Memorial Medical Center in New York, recounted. His team told staff for Representative Nick Langworthy (R, New York) about a constituent who developed a drug-resistant post-surgical infection. Over the following months, the team stayed in contact and served as a resource, and Langworthy became a cosponsor, Bajwa explained. They met the congressman himself at this year's Advocacy Day. Langworthy is among 5 House members who reintroduced the bill in February.⁴

"The staff members actually are, I would say, the gatekeepers to those offices," Bajwa said. "Advocacy is all about building relationships, finding a common ground, and communicating consistently," he added.

Drawing public attention to a proposed federal action can matter. "Even just shining a little bit of light on an action or a policy that they're trying to push forward can make a big difference," Weddle said.

Trainees should not wait to get involved, according to Clair Russell, a fourth-year medical student at the Alabama College of Osteopathic Medicine. "You do not have to wait until you're a resident, a fellow, an attending to get involved, and all you need is a story," she emphasized.

Kelsey L. Rowe, MD, MBA, a pediatric infectious diseases physician at Cardinal Glennon Children's Hospital in St. Louis, said that her children's books on vaccines aim to reach families where decisions are made. "We all know that the only successful vaccines are the ones that are actually given, and that a lot of decisions about vaccination are made not only in the clinic rooms but also in the living room," she explained.

Clinicians should bring trainees to legislative meetings, according to Hansel Tookes, MD, MPH, professor of medicine in the Division of Infectious Diseases at the University of Miami Miller School of Medicine. "Send your medical students," he said. "They listen to medical students because they're going to be taking care of them in the future."

Pritchard said she tells trainees, residents, and fellows the same thing. "No one can do everything, but everyone can do something," she noted.

What State-Level Advocacy Achieved in Florida and Indiana

Florida's cuts to its AIDS Drug Assistance Program threatened treatment for nearly 16,000 people living with HIV, Pritchard explained while introducing the discussion. The changes lowered income eligibility from 400% to 130% of the federal poverty level and removed the antiretroviral Biktarvy (bictegravir, emtricitabine, and tenofovir alafenamide; Gilead Sciences) from coverage.⁵ Tookes outlined the coalition response. Government affairs offices kept clinicians from traveling to the state capital, so people living with HIV testified instead, he said.

"Who the legislators needed to hear from was our patients," Tookes explained. Advocates secured 3-month emergency fills of Biktarvy and restoration of the 400% threshold, he added. Tookes tells his patients who is responsible, naming Florida Governor Ron DeSantis and President Donald Trump. "DeSantis took your Biktarvy. Trump took your subsidy, straight up," he said.

A similar coalition formed in Indiana, where the state's syringe services program faced renewal before a legislature Pritchard called fairly hostile. The program returned $7 in health care savings for every dollar invested and reduced new hepatitis C cases in served areas by 76%, she said. It was extended, though not for as long as advocates wanted. The extension became law without the governor's signature.^6,7

How the 2026 Midterms Could Reshape ID and HIV Policy

The Cook Political Report rates 213 House seats as solid, likely, or lean Democratic, leaving Democrats needing 5 of 21 toss-up races to reach a 218-seat majority, according to Dan Renberg, partner and government relations practice coleader at ArentFox Schiff, IDSA's outside government relations counsel. The forecaster's ratings page, updated October 23, 2026, now lists 220 seats as solid, likely, or lean Democratic and 17 as toss-ups.⁸ A shift in control could cost IDSA Republican allies, he cautioned, naming Representative Mariannette Miller-Meeks (R, Iowa), Senator Susan Collins (R, Maine), and Senator Roger Marshall (R, Kansas) as supporters facing difficult races.

A new majority could also crowd out smaller priorities. "Just because the Democrats might win the majority doesn't mean all of a sudden appropriations is going to be a free-for-all," Renberg warned. Representative Frank Pallone (D, New Jersey) and Senator Bernie Sanders (I, Vermont), the ranking members of the House Energy and Commerce Committee and the Senate Committee on Health, Education, Labor, and Pensions, respectively, and the likely chairs if Democrats win control, and their staffs have viewed the PASTEUR Act as a giveaway to the pharmaceutical industry, he added. IDSA will reframe its message around patients who need new antibiotics, he explained.

"Start off with the district staff," then ask to be connected to health policy staff and, eventually, the member, Renberg advised. "A story makes the difference," he emphasized. "You know more than any congressional member or staffer."

Audience Questions Focus on Framing and Safety

During the question period, an attendee from Florida urged IDSA to pair its defensive messaging with advocacy for broader health system change, including a single-payer system. Jezek responded that, as staff, her views are not the priority. "What's important are the views of our members," she said. The issue is not bipartisan in Congress, she added.

Another attendee at a public university described fear of open records requests after speaking publicly. Pritchard advised notifying the institution's government relations office, using personal email and phone for advocacy, and stating clearly when speaking for oneself or for IDSA rather than an employer. Tookes acknowledged the concern. "It is a terrifying environment to work in," he said.

Why Advocacy Is Central to IDSA's Direction

The formal program closed with a broader case for why advocacy belongs in everyday clinical work. Clinicians hold 4 forms of power: stories, voice, impact across party lines, and speaking truth to power, according to Jeanne M. Marrazzo, MD, MPH, FIDSA, chief executive officer of IDSA.

"Stories are everything to the people who make these decisions," she said. She framed the work as nonpartisan. "It's about who cares, who cares about what we do and the impact we can have on our communities," Marrazzo explained. "It's not just about what happens in the midterms."

Tookes tied advocacy to clinical care in a comment to AJMC after the session. "I'm just so energized right now, so energized by the room, by everybody's unwavering commitment to advocate for our patients," he said. "It's just like what I said: our advocacy is just as important. It's inextricable from antiretrovirals; it's all important. If we're going to be able to like make a better world for the people that we care for and love, advocacy is essential."

References

1. Rodriguez J, Pritchard H. Your voice, your patients, your community: ID and HIV advocacy in an election year. Presented at: IDWeek 2026; October 23, 2026; Washington, DC.
2. Major victory: bipartisan FY26 bills reject nearly $2B in proposed HIV funding cuts. Save HIV Funding. January 20, 2026. Accessed October 23, 2026. https://savehivfunding.org/major-victory-bipartisan-fy26-bills-reject-nearly-2b-in-proposed-hiv-funding-cuts/
3. House Republicans propose $1 billion in cuts to domestic HIV programs. HIV+Hepatitis Policy Institute. June 4, 2026. Accessed October 23, 2026. https://hivhep.org/press-releases/house-republicans-propose-1-billion-in-cuts-to-domestic-hiv-programs/
4. Reps. Carter, Peters, Langworthy, Levin, Carey reintroduce bill encouraging drug development to combat antimicrobial resistance. Office of Rep. Buddy Carter. February 5, 2026. Accessed October 23, 2026. https://buddycarter.house.gov/news/documentsingle.aspx?DocumentID=16321
5. Lawmakers reach deal to restore funding for HIV medication assistance program. WLRN. May 26, 2026. Accessed October 23, 2026. https://www.wlrn.org/health/2026-05-26/adap-hiv-aids-medication-florida
6. Braun declines to sign needle exchange extension. Indiana Public Media. March 9, 2026. Accessed October 23, 2026. https://www.ipm.org/news/2026-03-09/braun-declines-to-sign-needle-exchange-extension
7. Indiana syringe program extension becomes law without governor's signature. Louisville Public Media. March 10, 2026. Accessed October 23, 2026. https://www.lpm.org/news/2026-03-10/indiana-syringe-program-extension-becomes-law-without-governors-signature
8. 2026 House race ratings. The Cook Political Report. Updated October 23, 2026. Accessed October 23, 2026. https://www.cookpolitical.com/ratings/house-race-ratings