The year 2020 was unlike any other – filled with loss and uncertainty for so many. With the nation still rocked by a global pandemic, this year is proving to be no different. Despite many obstacles, the Asthma and Allergy Foundation of America (AAFA) remains committed to advocating for the asthma and allergy community.

Last year, we led and took part in more than 20 different coalitions working together to move bills through Congress and state governments. Four of the bills AAFA championed and supported became law – a huge achievement!

Here’s a helpful, in-depth review of what AAFA accomplished in 2020 for our community in key policy areas:

COVID-19 Response

Letter campaigns make a difference. AAFA started and co-signed more than 80 letters to government agencies, Congress, and other groups on priority issues. Twenty of those letters were directly related to the COVID-19 pandemic.

• Albuterol Inhaler Shortages – Just after COVID-19 was declared a pandemic, we saw a shortage of albuterol inhalers due to increased demand. People with asthma and food allergies should have access to the medicines they need. AAFA took immediate action. We worked directly with the Food and Drug Administration (FDA) and Congressional leaders to make sure people with asthma and allergy have access to the supply they need. We also raised awareness with groups that make up the drug supply chain and industry advocates including a joint article with the Pharmaceutical Care Management Association (PCMA) published by "Morning Consult." Working together, we’ve seen no further issues with albuterol shortages.
  
  
• FDA’s “Temporary Policy Regarding Certain Food Labeling” – In response to the COVID-19 pandemic, the FDA released “Temporary Policy Regarding Certain Food Labeling Requirements During the COVID-19 Public Health Emergency” in May 2020. The policy allows food producers to make minor recipe changes without changing the label or informing consumers in some way. The top 8 major allergens, sesame, celery, lupin, buckwheat, molluscan shellfish, mustard, and other ingredients known to cause allergic reactions and sensitivities were all exceptions to this policy.
  
  AAFA led a coalition of 13 other food allergy groups in our response to this guidance. In our letter to the FDA, we stated that we were pleased to see the FDA recognize allergens outside of the top 8 foods, but that we request all substitutions be reported on manufacturers’ websites and sent out via social media to protect people with allergies or sensitivities. The FDA immediately responded to our letter. AAFA met with the Director of the Center for Food Safety and Applied Nutrition (CFSAN). After the meeting, the FDA explained its guidance based on our concerns.
  
  

Healthy Settings for People With Asthma and Allergies and Passage of School-Based Allergies and Asthma Program Act

AAFA supports policies that create healthy settings for children and adults with asthma and allergies. In 2020, AAFA signed onto 10 letters related to healthy settings.

• School-Based Allergies and Asthma Management Program Act − On Jan. 5, 2021, the School-Based Allergies and Asthma Management Program Act (H.R. 2468) was signed into law. This bipartisan law will help protect millions of U.S. children with asthma and food allergies at school. AAFA and the American Academy of Allergy, Asthma & Immunology (AAAAI) led the charge on the bill from the beginning.
  
  This bill gives grants to states that improve asthma and allergy care inside of schools. In Jan. 2020, Kenneth Mendez, AAFA’s President and CEO, testified before the House Energy and Commerce Subcommittee on Health in support of H.R. 2468 setting the stage for movement on the bill. AAFA is proud to have played a key role in getting this game-changing bill for students passed.
  
  
• Clean Air Sharp Minds Act − On Feb. 27, 2020, Senator Cory Booker and Rep. Katherine Clark introduced the Clean Air Sharp Minds Act. AAFA shared thoughts with the bill sponsors earlier that month. The proposed act would give schools a three-year grant to help them improve indoor air quality. The grant would allow schools in high pollution areas to install commercial air filters. The bill did not move in the last Congress. But we look forward to working with the bill sponsors again this year. Stay tuned for an Action Alert when it is reintroduced.
  
  
• Air Travel Safety − Ensuring the safety of people with asthma and allergies while traveling on planes is one of AAFA’s major concerns. We sent a letter to the Subcommittee on Aviation. And AAFA has continued to attend the Department of Transportation’s (DOT) Disabilities Advocacy Working Group.
  
  On Dec. 2, 2020, the DOT finalized the rule, “Traveling by Air with Service Animals.” The rule allows airlines to treat emotional support animals as pets. Since then, Alaska Airlines, American Airlines, Delta Airlines, and United Airlines all announced bans on emotional support animals.
  
  We do believe preventing the abuse of service animal policies will reduce (not eliminate) the risk of allergic reactions and asthma episodes. But AAFA will continue to push the DOT for reasonable accommodations for the asthma and allergy community.
  
  

Access to Health Care, Medicine, and Health Insurance Coverage

People with asthma and allergies should have access to the medicine and devices they need. And they should be able to afford them. AAFA reached out to State Legislatures, Congress, and Federal Agencies in 30 letters about improving access and reducing cost.

• Coronavirus Aid, Relief, and Economic Security Act – Since 2018, AAFA has worked with members of the Healthy Choices Coalition to pass the Restoring Access to Medication Act of 2019 (H.R. 1922). Congress included the text of the bill in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The CARES Act was signed into law on March 27, 2020. This law now allows you to buy over-the-counter (OTC) medicines with tax-preferred savings accounts. These types of accounts are called flexible spending arrangements (FSAs) and health savings accounts (HSAs).
  
  
• Partnership to Protect Coverage – AAFA joined the Partnership to Protect Coverage (PPC) late last year. The PPC is a partnership of top patient groups. It supports adequate health care coverage that is affordable and easier to access. It also aims to protect Medicare and Medicaid coverage.
  
  
• The 100 Days Agenda: a Patient First Blueprint – In November, AAFA joined 33 other groups to share “The 100 Days Agenda: a Patient-First Blueprint” with the Biden-Harris transition team. We hope this blueprint will improve access for millions of Americans with pre-existing conditions.
  
  

Clean Air, Climate Change, and Health

AAFA supports clean, safe air for everyone. We urge the passing of strong standards. They can reduce harmful air pollution that worsens the climate change crisis. The quality of our environment has a direct impact on our health and the health of future generations. AAFA signed onto 17 letters related to clean air and climate and health.

The Environmental Protection Agency (EPA) finalized several rules last year that impact people with asthma and allergies. AAFA sent many letters, spoke at virtual public hearings, and met with the Office of Management and Budget to voice our concern about these rules:

• Safer Affordable Fuel-Efficient (SAFE) Vehicles– This rule will increase the burning of fossil fuels and harmful pollution. It rolls back vehicle emissions and efficiency standards from 2021 to 2026.
  
  
• New Source Performance Standards for the Oil and Natural Gas Industry – This rule weakens protections from methane and other harmful pollution from the oil and gas industry. Methane is a strong greenhouse gas that affects climate change and makes air pollution worse.
  
  
• National Ambient Air Quality Standards for Particulate Matter – This rule keeps the current air quality standards for particle pollution. Science shows that the current standards do not protect human health. Particle pollution is a major risk factor for developing asthma and for those who already have asthma.
  
  
• National Ambient Air Quality Standards for Ozone – This rule keeps the current air quality standards for ozone pollution. Science shows the current standards do not protect human health. Ozone pollution is also a major risk factor for developing asthma and for those who already have asthma.
  
  

AAFA and other health and medical groups have already met with the Biden-Harris transition team. We asked them to address these and other harmful rules as soon as possible in 2021. AAFA is ready to support the EPA’s stated mission to protect human health and the environment.

Food Allergies

AAFA supports funding for a variety of federal policies and programs that benefit people with asthma and allergies. AAFA signed onto 10 letters advocating for funding for programs within the EPA, the Department of Health and Human Services (HHS) and the Department of Defense (DoD).

• National Asthma Control Program (NACP) − Every year, AAFA meets with Congressional offices asking for funding for the National Asthma Control Program (NACP). The NACP is a program that gives grants to states, territories and local governments. The program has helped reduce death rates while asthma rates continue to grow. Though AAFA and other groups asked for $34 million, the program did not get more funding this year. It will be funded for the second year in a row at $30 million.
  
  
• Peer Reviewed Medical Research Program (PRMRP) – We had more success this year related to food allergies. For the second year, we were able to get food allergies on the list of conditions that can be studied under the DoD’s Peer Reviewed Medical Research Program (PRMRP). The PRMRP is a program that has supported medical research for the past 20 years to benefit both military service members and civilians.
  
  
• Center for Science in the Public Interest (CSPI) – AAFA worked with the Center for Science in the Public Interest (CSPI) to lead a coalition letter requesting funding for food allergen labeling. We also asked for this funding for the FDA during a Congressional briefing. For the first time ever, Congress gave an extra $1.25 million to the FDA just for food allergen labeling. This was another major win for AAFA and our community.
  
  
• Food Allergy Funding and Sesame Labeling − AAFA’s 2020 food allergy focus was on food labeling and advocating for the Food Allergy Safety, Treatment, Education, and Research (FASTER) Act.
  
  AAFA is a driving force behind making sure sesame gets added to the list of major allergens food manufacturers will have to include on labels. Under AAFA’s leadership, several advocacy groups have joined forces to make sure lawmakers and the FDA take action. Thanks to Kenneth Mendez’s encouragement, mandatory sesame labeling is included in the FASTER Act.
  
  Last year, we came closer than ever to making this happen. On Nov. 10, 2020, the FDA released the proposed “Voluntary Disclosure of Sesame as an Allergen: Guidance for Industry.” This is a promising step in the right direction. But it falls short of mandatory labeling of sesame as an allergen. AAFA drafted a letter for fellow food allergy advocates to sign on to and led the response calling for further action.
  
  At the same time, two versions of the FASTER Act made their way through the House of Representatives and the Senate. The House version was R. 2117, and the Senate version was S. 3451.
  
  Both versions passed late in the year. Both would have required the labeling of sesame as a major allergen. But, since they were slightly different, the House needed to pass S. 3451 before the bill could be sent to the president. But Congress ran out of time at the end of the year. The House did not pass the bill.
  
  We feel certain the FASTER Act will be reintroduced within the first 100 days of this new Congress. We look forward to seeing it pass in 2021. Stay tuned for an Action Alert!
  
  

Asthma Disparities and Health Equity

Among the 25 million Americans living with asthma, there are serious and persistent racial and ethnic disparities. In September, AAFA released our “Asthma Disparities in America: A Roadmap to Reducing Burden on Racial and Ethnic Minorities” report. AAFA shared the report and its 19 policy recommendations with every Congressional office on Capitol Hill.

AAFA also sent a letter to the Biden-Harris transition team. It outlines our recommendations for addressing asthma disparities. We hope President Joe Biden and his team will listen to our recommendations and use AAFA as a resource. The ongoing disparities in asthma and other chronic health conditions in our country, combined with the current COVID-19 pandemic, have made the need to act for health equity even more urgent.

Looking Forward to 2021

We are so proud of all the work the AAFA team and our communities accomplished in 2020. But we also can’t wait to do more in 2021. There is still a great amount of work to be done, especially to address health equity and climate change. We have already gotten started. First up are:

• FASTER Act − We are eager to see this reintroduced. Stay tuned for an Action Alert on how to get involved.
  
  
• Improving the Social Determinants of Health Act (H.R. 379/S.104) − This bill empowers the Centers for Disease Control and Prevention (CDC) to create a program to:
  • Improve health outcomes and reduce inequities
  • Help public health and community organizations address social determinants of health
    
    
• Black Maternal Health Momnibus Act (H.R.959) − This bill aims to address the health crisis among Black mothers in the U.S.
  
  

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