Administration to unveil national AIDS strategy amid frustrations of advocates

The White House will unveil a national HIV/AIDS strategy on Tuesday against the backdrop of advocates’ increasing complaints that the administration and Congress are not doing enough to fight the epidemic.

Advocates say federal funding for AIDS prevention and treatment is failing to meet critical needs both in the U.S. and abroad.

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Earlier this month, the AIDS Healthcare Foundation said it was "very disappointed" in the lack of support for the President's Emergency Plan For AIDS Relief, or PEPFAR, launched by President George W. Bush in 2003. Congress is not appropriating anywhere near the $48 billion over five years it authorized in 2008, the group said, and the administration has yet to publish a best-practices report required by law.

On the domestic front, state AIDS directors joined advocates last week for a three-day summit to draw attention to the funding shortfalls facing the AIDS Drug Assistance Program (ADAP), created by Congress in 1990.

Almost 2,100 low-income people with AIDS are on ADAP waiting lists in 11 states, and advocates have asked for $126 million in additional funding.

Health and Human Services (HHS) Secretary Kathleen Sebelius said in a July 6 letter that her department would allocate $25 million more for the program. But the ADAP Advocacy Association lambasted that as a "day late, dollar short" proposal.

"At a time when we should be celebrating the President's leadership on the imminent release of the United States' first-ever National AIDS Strategy, we are increasingly dismayed at the disconnect coming from the White House to address the ADAP crisis," Brandon Macsata, the association's CEO, said in a statement.

The administration has asked for a $20 million increase, to $855 million, in ADAP funding over last year's appropriation.

And congressional Democrats support a fiscal year 2010 emergency supplemental — opposed by Republicans — that contains $126 million for the ADAP program.

Republicans have jumped in the fray too.

An ADAP event at the Capitol Wednesday was co-hosted by Sen. Richard Burr (R-N.C.), who has sponsored legislation to transfer to HHS $126 million in stimulus bill money to fund the program. North Carolina has the highest number of people on waiting lists: 783.

Sens. Mike Enzi (R-Wyo.), Tom Coburn (R-Okla.) and George LeMieux (R-Fla.) are co-sponsors.

The administration’s new AIDS strategy will mark the first time the U.S. has a coordinated plan for tackling the epidemic. The plan will have three aims: to reduce HIV infections, increase access to and quality of care for people living with HIV and reduce HIV-related health disparities.

Michael Saag, chair of the nation's largest organization of HIV care-givers and researchers, said that will help put the issue of AIDS back on the front-burner. And, he added, it may rekindle the debate over patient care, which can be drowned out by the constant drumbeat for more drug spending — a drumbeat supported by the pharmaceutical industry.

"Instead of always asking for more, more, more," Saag told The Hill, "let's look at how we can be more effective."

The announcement of the strategy’s unveiling earned tentative praise from a variety of groups that lead the fight against the disease.

"I'm very hopeful, given what we've heard so far, that [the strategy] is going to point us to a reformed and more effective effort on the domestic epidemic," said Chris Collins, vice president and policy director for the Foundation for AIDS Research.