Regions Square Off in Battle Over AIDS/HIV Funds Reauthorization

Many Southern AIDS advocates strongly disagree with the findings of a recent study by the Washington-based Communities Advocating Emergency AIDS Relief (CAEAR) Coalition. The coalition found that Southerners with HIV/AIDS are not being shortchanged in the distribution of federal funds and in some cases are allocated more money than patients in large cities.

At issue is the 1990 Ryan White CARE Act, which provides roughly $2 billion annually in federal HIV/AIDS funding. Congress has been reviewing the act, which expired in September, for possible reauthorization. Southern advocates are calling for major changes to route more funds to the region, where more than 45 percent of new HIV cases occur.

An April 26 report by the Government Accountability Office (GAO) found California received $5,624 per patient in 2004, compared to $3,675 per patient in Alabama. The CAEAR report found Alabama received $5,778 in 2004 compared to a national funding rate of $4,475.

CAEAR Coalition board member Jeff Graham said the GAO study and other past studies only analyzed funding from Title 1 and Title 2 of the CARE Act. Most Southern states do not have Eligible Metropolitan Areas of 500,000 or more and so do not receive Title 1 funds. The CAEAR study looked at funding from all provisions of the CARE Act, including early intervention and assistance to women and children. When calculated this way, Graham said, the disparity among regions is not so great.

"What's to be gained by this is to get the correct information out there in this public debate about reauthorization," Graham said. "It's to draw the focus to really what is the greatest issue, which is five years of funding cuts."

Evelyn Foust, director of the HIV/AIDS Division of the North Carolina Department of Health and Human Services, noted that advocates from the South are not looking at rerouting money from Title 1 states as the best solution. "My position has been that we should work together to get significant new dollars," Foust said. "If there is no new money, then I think we have no choice but to ask them for a redirection of current funds to people who have more need."

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