Recently, about 200 stakeholders gathered for the inaugural Syndemic Solutions SummitExit Disclaimer to share, discuss, and advance syndemic approaches to the intersecting epidemics of HIV, viral hepatitis, substance use and overdose, sexually transmitted infections (STIs), mental health, and reproductive and sexual health. Such approaches are called for in the National HIV/AIDS Strategy, STI National Strategic Plan, and Viral Hepatitis National Strategic Plan. Organized by the University of Missouri–Kansas City’s Collaborative to Advance Health Services, the summit was held July 26–27 in Kansas City. It gathered a diverse group of participants including leaders from community and national organizations; health departments; researchers; local, state, and federal government officials; and people with lived experiences. We were pleased to represent the HHS Office of Infectious Disease and HIV/AIDS Policy (OIDP) at the summit and hear the important information shared.

A syndemic can be defined as the clustering and interaction of two or more diseases, as a result of social and structural determinants of health (SDOH), that lead to excess burden of disease in a population.

Prior to the conference, federal, state, and local public health leaders met at the City of Kansas City, Missouri, Health Department to listen and learn from community organizations about the barriers to syndemic work and to discuss potential solutions to overcome these barriers. Community organizations are best positioned to provide services to people within their own community who are most impacted by syndemics. Despite this, representatives from community organizations shared that they are not getting the resources necessary to address syndemics, so more effective mechanisms need to be established at the federal and state levels to get funds to community organizations.

Dr. Mermin Discusses Syndemic Framework

On day one of the summit, keynote speaker, Jonathan Mermin, MD, MPH, Director of CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, provided an overview of a syndemic framework, which recognizes people, place, policy, and science. Dr. Mermin elaborated on the strategic elements necessary to address the syndemics of HIV, viral hepatitis, substance use and overdose, STIs, mental health, and reproductive and sexual health:

• Put people first.
• Focus on equity.
• Put money where the epidemic is.
• Leverage policy as a public health tool.
• Support workforce and partnerships.

Dr. Mermin also emphasized that Syringe Service Programs (SSPs), a key tool in addressing the syndemics, need to be fully integrated as a core component of public health. SSPs are a community-based prevention program that can provide services like linkage to substance use disorder treatment, access to and disposal of sterile syringes and injection equipment, vaccination, testing, and linkage to prevention services or care and treatment for infectious diseases. SSPs are often illegal, underfunded, and siloed in many states across the U.S., and are therefore an underutilized public health tool in addressing the syndemics.

Examples of Syndemic Approaches

The summit also showcased syndemic approaches that have been implemented at the national, state, local, and community levels. Although these programs varied, each approach centered around putting people first—providing services that people want rather than what public health professionals think they need.

Some programs featured:

• The Indigenous HIV/AIDS Syndemic Strategy: Weaving Together the National, HIV, STI and Viral Hepatitis PlansExit Disclaimer
• End the Epidemics Coalition in CaliforniaExit Disclaimer
• Syndemic Services in an FQHC KC CARE Health CenterExit Disclaimer
• La Bodega clinic at Erie County Medical Center in BuffaloExit Disclaimer

OIDP, within the Office of the Assistant Secretary for Health, has convened a Syndemic Steering Committee to bring together federal leaders from across the U.S government to identify, develop, and adopt federal actions and policies that address the syndemics of HIV, viral hepatitis, STIs, mental health, and reproductive and sexual health. We look forward to sharing insights from the summit with our colleagues on the steering committee.