The U.S. House of Representatives passed the Global Access to HIV/AIDS Prevention, Awareness, Education and Treatment Act Dec. 11. Henry Hyde ( R-Ill. ) and Tom Lantos ( D-Calif. ) , party leaders on the International Relations Committee, championed the bipartisan effort. It passed on a unanimous voice vote.
The measure would authorize spending $1.3 billion dollars to fight the epidemic outside of the U.S. during the fiscal year that began Oct. 1. Some $750 million would be earmarked for the AIDS trust fund promoted by UN Secretary General Kofi Annan. The remainder would be parceled out through the U.S. Agency for International Development ( USAID ) and bilateral programs.
But it's too soon to start counting the cash...the Senate has yet to act on the legislation. Additionally, an appropriations bill is what determines the total actually made available to spend. Rep. Jim Kolbe ( R-Ariz. ) chairs the appropriations subcommittee with jurisdiction. While he supports increased funding for AIDS, he warned against "unrealistic expectations" in light of competing demands.
Appropriations for domestic AIDS expenditures are part of the bill for the Department of Health and Human Services. Late last week, the following budget items were approved, according to HRC: Ryan White CARE Act got an increase of $103.1 million over the president's request of $1.8 billion. The increase in AIDS Drug Assistance Program ( ADAP ) falls "woefully short" at $50 million, $40 million of which will used to account for rising medication costs, HRC said.
Prevention dollars increase $38 million for the CDC in 2002, to bring it to $691.5 million. HRC said this is not enough to implement the CDC's 5-year prevention plan. NIH spending was increased $3 billion over the current fiscal year.
But modest increases in federal funding are not going to be enough. The need for services continues to grow as more people begin therapy and live longer. And state governments are cutting back their funding as part of an overall retrenchment because of the slumping economy.
Illinois Republican Gov. George Ryan proposed cutting that state's contribution to ADAP ( AIDS Drug Assistance Program ) by 43 percent as part of an overall reduction in state spending. Bill Arnold, with the ADAP Working Group in Washington, D.C., predicted, "More states will follow across the country...guaranteed."
The results will be waiting lists to begin therapy and limitations on the different drugs available to treat patients.