Honoring Ryan White's Legacy

The Ryan White CARE Act, America’s life stream to those living with and at risk for HIV, is expiring, threatening to unravel one of the nation’s most critical health care safety nets

BY Advocate.com Editors

September 29 2005 11:00 PM ET

It’s been almost 10 years since new AIDS drugs transformed HIV infection from a near-certain death sentence to a manageable and chronic illness for people with access to quality health care. In that decade the promise of a longer, richer, and healthier life infused hope in millions of people across the globe.

But hope gave way to complacency, on the part of the government as well as individuals. HIV infection rates continue to soar unabated, and access to life-prolonging AIDS drugs and vital treatments and services remains elusive for far too many men, women, and children living with HIV in America, Africa, and elsewhere.

While the challenges around HIV and AIDS have changed, the epidemic remains one of the great health care crises of modern times. Just think about these simple facts:

  • Today, two thirds of all HIV and AIDS diagnoses
    in America are among people of color. In fact, a
    recent study by the Centers for Disease Control
    and Prevention confirmed that in five major cities, 46%
    of black men who have sex with men are
    HIV-positive and two thirds of these men do not
    know their status.
  • Current federal Medicaid law covers protease
    inhibitors only for people who have an AIDS
    diagnosis. Put simply and tragically, that means
    under Medicaid rules, the drugs that prevent HIV from
    progressing to AIDS are dispensed only to people
    who already have AIDS. That’s like
    requiring fire extinguishers only in buildings that are
    already on fire.
  • Every hour, two young people become infected
    with HIV. Perhaps it’s because
    they’re not getting the unvarnished truth about
    how HIV spreads. Perhaps it’s because
    their sex partner isn’t getting adequate
    treatment and counseling. Perhaps it’s
    because they mistakenly think there’s a
    cure. But one thing’s certain: Every year in the
    United States 20,000 young people are infected,
    and that is a national tragedy.
  • The global epidemic rages without pause.
    According to a Kaiser Family Foundation fact
    sheet, HIV is the leading cause of death worldwide
    among people age 15 to 59. And of the 3.1 million people
    who died of AIDS complications across the globe
    in 2004, more than half a million were children.

On September 30 the Ryan White Comprehensive AIDS Resources Emergency Act, America’s life stream to men, women, and children living with and at risk for HIV, expired, threatening to unravel one of the nation’s most critical health care safety nets. While basic spending on HIV and AIDS will continue, resources remain inadequate, and there won’t be a structure and blueprint for fighting HIV and AIDS with the fortitude needed to meet today’s epidemic. Among the most urgently needed priorities in the Ryan White CARE Act are continued delivery of treatment and services like housing, dental care, nutrition, and access to life-prolonging AIDS drugs.

Renewal will help ensure that communities can direct money and resources in ways that meet the specific needs of that community and an assurance that people living with HIV are part of that decision-making. A new version of the CARE Act must also continue to help meet the special needs of women and children, including prevention of transmission of the virus from mother to child.

The gay population responded with courage and bravery to the early years of the AIDS epidemic, when we were sometimes abandoned by our families, our friends, our doctors, and our government. Today, gay, lesbian, bisexual, and transgender Americans must continue to face this threat head-on. Almost half of all new infections in the United States are the result of male-to-male transmission. Meanwhile, science-based prevention funding at the Centers for Disease Control and Prevention has been flat for years. We must fulfill our historical duty to help fight the epidemic in all affected communities, particularly among people of color and around the globe.

When Ryan White was first diagnosed with AIDS, he bravely symbolized the need to conquer the stigma and fear that surrounded this epidemic. Today, he is a symbol of hope and the best instincts of the American people. Let’s honor his legacy by reauthorizing the CARE Act so the fight against AIDS will be as strong as he was.

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