Federal officials plan to announce Tuesday a national strategy designed to ramp up and better coordinate the government's attack on the country's HIV/AIDS epidemic, an effort to deliver on a Barack Obama campaign promise delayed by the health care overhaul debate and other issues.
Many advocates for HIV/AIDS view the health care bill as "a critically important advance" for people living with HIV, according to Chris Collins, director of the Foundation for AIDS Research. But they say many more resources need to be committed to fight the disease, especially considering it doesn't get the attention it once did. "HIV/AIDS as an epidemic has fallen off the radar screen," said Andy Izquierdo of the National Minority AIDS Council. "A lot of people don’t see it as an issue anymore, even though it’s hitting some communities of color worse than ever."
The expected announcement by the Department of Health and Human Services comes as state programs that provide AIDS drugs to patients with HIV grapple with growing waiting lists for the drugs. More than 2,000 patients are on the waiting lists. HHS Secretary Kathleen Sebelius announced Thursday that she will provide $25 million to states to help pay for the drug treatments, which average more than $12,000 a year. Even so, some advocacy groups said the aid "falls short" of the need.
The administration's announcement also corresponds with the 2010 International AIDS Conference, the biennial gathering of thousands of HIV/AIDS researchers, activists and government officials, which begins July 18 in Vienna. U.S. action related to HIV is closely scrutinized at the conference.
Although most administrations over the past 30 years have set priorities in the battle against AIDS – including creating policy czars to help spotlight the efforts – advocates said this will be the a different type of overall national strategy against the disease. The U.S. has required other nations to implement such strategies in order to receive U.S. funding for HIV/AIDS programs.
AIDS programs now exist as a fractured web of resources ranging from community-based clinics that offer free condoms to subsidized health services to federal agencies that provide massive funding programs for treatment and prevention. Advocates hope the new strategy will streamline the effort and simplify the process for patients to get such resources as education about the disease, testing, treatment and case-management. Julie Scofield, executive director of the National Alliance of State and Territorial AIDS Directors, noted that a variety of federal and state programs seek to help patients, "but not with coordination from the top that can advance our response."
Collins cautioned, however, "There's no quick fix for challenges in the domestic response. We're not going to achieve the improved outcomes we need overnight. This is a long-term investment."
Those challenges include prevention and testing, managing co-occurring infections in people with HIV, and the higher rates of poverty and homelessness among HIV patients. The Centers for Disease Control and Prevention estimated that 1.1 million Americans were living with HIV/AIDS in 2006. The federal government is slated to spend $19.4 billion in 2010 on domestic programs and research, according to data compiled by the Kaiser Family Foundation. (KHN is a project of the foundation.)
Obama, in a statement last month, said the strategy would focus on "reducing new HIV infections, increasing access to care and reducing HIV-related health disparities." Administration officials have held roughly a dozen public meetings with HIV/AIDS patients, activists, advocates and researchers around the country as they've formulated the plan.
Administration officials would not talk about the details of the announcement, nor would they say if Obama plans to seek more funding for HIV/AIDS programs as part of the effort. Although advocates said they hope for additional money, some acknowledged the current fiscal concerns in Washington. "I don't know for sure if there will be funding, but I think we will all be disappointed about how much it is. I just believe we're in such a difficult budget environment," Scofield said.
Nonetheless, Izquierdo stressed, "If it's a strategy without talk of resources or funds that are going to be allocated, then it really fails to be a strategy and just becomes a plan."
Collins said his organization will be looking for measurable results: "What we need is a domestic response to AIDS that fits our epidemic and that's what we don’t have right now." Collins added, "The point of the strategy is about outcomes. … We have to broaden the way we tackle HIV incidence in this country."