Bush Calls for Boosted AIDS Spending in State of the Union Speech

President Bush, in his State of the Union address on Tuesday, called for Congress to both reauthorize the Ryan White CARE Act, which provides money for HIV services across the country, and to boost AIDS spending to help states eliminate waiting lists for treatment programs. The Ryan White Act expired on September 30 and has continued operating at last year's funding levels since its expiration. Congress is expected to reauthorize the law this spring.

The increased spending Bush called for would be used to eliminate waiting lists and other cost-cutting measures at state-run AIDS Drug Assistance Programs, which provide free anti-HIV drugs to poor HIVers. Currently, 21 states have implemented such cost-cutting steps as capping program enrollment, reducing the number of drugs provided, or tightening financial eligibility requirements. Nine states have ADAP waiting lists, with nearly 1,600 people awaiting access to the programs, according to the National Association of State and Territorial AIDS Directors.

Bush also noted in his State of the Union speech the disproportionate impact HIV is having on African-Americans and called on churches and faith-based groups working in African-American communities to fight HIV stigma and promote HIV antibody testing.

AIDS groups were heartened by Bush's call to renew the Ryan White Act and boost ADAP spending but note that Bush and the Republican-led Congress have done little in the domestic AIDS fight to date. "Bush had six years to appropriate funding to end waiting lists for lifesaving HIV/AIDS medications in this country," says AIDS Project Los Angeles executive director Craig E. Thompson in a press statement. "It is hard not to be skeptical when there is no will behind the words."

The Ryan White Action Campaign says that while it is pleased with Bush's comments, it remains unclear what Congress will do. "The Administration put forth their principles for a renewed CARE Act last year, but Congress allowed the current law to lapse," says Gene Copello, executive director of the AIDS Institute and a campaign member, in a press statement. "The ball is now in Congress's court. They need to reauthorize the Ryan White CARE Act, and do so in a way that ensures funding reflects the actual needs of HIV/AIDS patients and their families throughout the country. Too many Americans, perhaps over 300,000 of them, are not receiving lifesaving drugs."

The AIDS Alliance for Children, Youth, and Families also says that while Bush's call to eliminate ADAP waiting lists is admirable, it worries the Administration is placing too much emphasis on treatment and not enough on other support systems. "We cannot turn the CARE Act solely into a program that provides tests and pills," says Alliance executive director David Harvey in a press statement. "We need a CARE Act that supports high-quality health and social services through family-centered care programs."

Phill Wilson, executive director of the Los Angeles-based Black AIDS Institute, says in a press statement that Bush "once again pledged bold action last night to stop the HIV/AIDS epidemic in America, citing the disproportionate impact among African-Americans in particular. The institute applauds that pledge. Unfortunately, this is not the first time we've heard it--and we're sadly still waiting for the Administration to act in a way that is congruent with its words."

Wilson notes that the White House's budget proposal cuts $4.5 million in HIV prevention funding for the U.S. Centers for Disease Control and Prevention and flat-lines most other AIDS spending in the country. The Administration also has pushed for a $10 billion cut in Medicaid spending, which will hurt low-income HIVers. "In the coming days, the White House will submit its next budget proposal," Wilson says. "Perhaps it will reflect the ideals of the 'hopeful society' the president described. But given the goals outlined in the rest of his speech, we won't hold our breath." (Advocate.com)