A study by the Institute of Medicine of the National Academies' Board on Health Promotion and Disease Prevention says that the method the federal government currently uses to calculate the number of AIDS cases to determine how to allocate Ryan White AIDS funds should remain unchanged for at least the next four years. Federal AIDS funds are disbursed to states based on the number of AIDS patients reported in each state and whether those levels are rising. The government plans to begin allocating federal funds in 2004 based on the number of new HIV infections reported in each state instead of on full-blown AIDS cases.
However, the IOM study, which was commissioned by Congress and paid for by the Department of Health and Human Services, says that HIV reporting programs at state and local levels are still too inaccurate and incomplete to accurately report the numbers of new HIV cases. Because of accuracy concerns, the Centers for Disease Control and Prevention also does not accept HIV case data from 15 states that use code-based HIV reporting systems in lieu of recording names of those who are HIV-infected.
"Until HIV case reporting or other estimation techniques provide better data about regional variability in the number of HIV cases, information on HIV cases cannot be used to determine distribution of funds," the study concludes. More than $1.3 billion in federal funding was distributed to states and cities in fiscal 2003 based on the number of people living with AIDS in each state or community.