Method Using Number of AIDS Cases to Calculate Ryan White CARE Act Funds Should Remain in Place, Report Says

The method the federal government currently uses to allocate AIDS-related funding to state and local governments should remain unchanged for at least the next four years, according to a report released on Friday by the Institute of Medicine's Board on Health Promotion and Disease Prevention, the AP/Los Angeles Times reports. Approximately $1.3 billion in federal funding was distributed in fiscal year 2003 to states and muncipalities based primarily on the number of individuals with AIDS in each state or community. The Ryan White Comprehensive AIDS Resources Emergency Act, which was enacted in 1990, provides federal funds to states and cities to help low-income people living with HIV/AIDS access care and prevention services. Some lawmakers have suggested that funding might be better allocated using each area's number of HIV-positive people; however, the IOM report found that HIV-reporting mechanisms at state and local levels are too incomplete and may be too inaccurate to correctly determine funding using HIV data instead of AIDS data as the main criterion (AP/Los Angeles Times, 11/7).

Recommendations
The report -- commissioned by Congress and sponsored by HHS -- notes that all but one U.S. state and one city have HIV case reporting systems in place, but while some systems record individuals' names, some use a code. The CDC currently does not accept HIV statistics from the 15 states that use code-based systems because it is too difficult to ensure that cases are not duplicated, according to an IOM release. The report recommends that the CDC work with states to create systems to collect HIV case data; the CDC receive adequate funding to develop a method to eliminate duplication of reported cases; and HHS appoint an independent body to assess ways to estimate the total number of HIV-positive people. The report concludes, "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" (IOM release, 11/7).

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