Financing and Delivering Pre-Exposure Prophylaxis (PrEP) to End the HIV Epidemic.

The U.S. has the tools to end the HIV epidemic, but progress has stagnated. A major gap in U.S. efforts to address HIV is the under-utilization of medications that can virtually eliminate acquisition of the virus, known as pre-exposure prophylaxis (PrEP). This document proposes a financing and delivery system to unlock broad access to PrEP for those most vulnerable to HIV acquisition and bring an end to the HIV epidemic.

From COVID Vaccines to HIV Prevention: Pharmaceutical Financing and Distribution for the Public's Health.

The complexity and inefficiency of the U.S. health care system complicates the distribution of life-saving medical technologies. When the public health is at stake, however, there are alternatives. The proposal for a national PrEP program published in this issue of the Journal applies some of the lessons of the national COVID vaccine campaign to HIV prevention. In doing so, it draws on other examples of public health approaches to the financing of medical technology, from vaccines for children to hepatitis C treatment.

The Epidemic During the Pandemic: Assessing the Federal Drug Administration's Efforts to Curb Youth Smoking After Passage of HR2339 by Congress

The act sought to improve Food and Drug Administration (FDA) regulation ofthe marketing, sale, makeup, safety, and study of electronic nicotine delivery systems (ENDSs). Since the passage ofthe act, the United States has made some progress in limiting youth access to flavored ENDSs. Factors influencing youth tobacco use included flavoring in tobacco products, product marketing and access, and misconceptions about health risks.5 Studies also show that tobacco industry profits from the sale of ENDSs have increased since the passage of HR2339 and through the COVID-19 pandemic. Public health advocates must quickly respond to tobacco industry marketing tactics by debunking misleading campaigns promoting new synthetic nicotine and "tobacco-free" products attempting to circumvent regulation.8 Along with increases in taxes on ENDSs and enactment of policies restricting the sale of flavored products at the local level, such actions can help protect young people from the harms caused by tobacco products and help discourage them from ever starting at all. ,4jPH CORRESPONDENCE Correspondence should be sent to Michael D. Celestin Jr, PhD, NCTTS, CHES, Behavioral and Community Health Sciences Program, School of Public Health, Louisiana State University Health Sciences Center New Orleans, 2020 Gravier St, 3rd Floor, New Orleans, LA 70112 (e-mail: mceles@lsuhsc.edu).

A Playbook for Implementing Medicaid Expansion: Louisiana's Experience.

Policy Points Twelve states have yet to expand Medicaid under the Affordable Care Act (ACA). Louisiana offers a model of steps that states and counties can take to rapidly enroll eligible persons while balancing eligibility integrity and doing so within a limited administrative budget. In a post-COVID-19 health care landscape, Medicaid expansion can improve and protect population health and boost state economies, even amid budget shortfalls. Even though Louisiana compares well with other states in eligibility and enrollment efforts, future expansions may integrate other social support programs into their implementation strategies.

The Clarion Call of the COVID-19 Pandemic: How Medical Education Can Mitigate Racial and Ethnic Disparities.

Public health crises palpably demonstrate how social determinants of health have led to disparate health outcomes. The staggering mortality rates among African Americans, Native Americans, and Latinx Americans during the COVID-19 pandemic have revealed how recalcitrant structural inequities can exacerbate disparities and render not just individuals but whole communities acutely vulnerable. While medical curricula that educate students about disparities are vital in rousing awareness, it is experience that is most likely to instill passion for change. The authors first consider the roots of health care disparities in relation to the current pandemic. Then, they examine the importance of salient learning experiences that may inspire a commitment to championing social justice. Experiences in diverse communities can imbue medical students with a desire for lifelong learning and advocacy. The authors introduce a 3-pillar framework that consists of trust building, structural competency, and cultural humility. They discuss how these pillars should underpin educational efforts to improve social determinants of health. Effecting systemic change requires passion and resolve; therefore, perseverance in such efforts is predicated on learners caring about the structural inequities in housing, education, economic stability, and neighborhoods-all of which influence the health of individuals and communities.