AIDS Groups Battle Over Federal Funding

A proposal to reauthorize the federal Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, which this year was budgeted at almost $2.1 billion, is stalled in Congress. In order to continue providing care to tens of thousands of patients with little or no insurance, the program must be reauthorized every five years. The next authorization is scheduled for next month.

The main Senate bill, sponsored by Sens. Mike Enzi (R-Wyo.) and Ted Kennedy (D-Mass.), would mandate three-quarters of funding to be used for medical services. Opponents from some AIDS groups say this would force cuts to basic services they consider critical to overall patient care, including meals and housing.

In New York, Gay Men's Health Crisis feeds 350 patients a day and provides housing and legal assistance. Under the congressional proposal, GMHC could lose up to $1 million annually, said Janet Weinberg, its managing director of development and legislative funding. GMHC's clients are entering the system sicker, poorer and with problems including hepatitis C co-infection and substance dependence. "If you don't know where you're putting your head at night, are you going to get to the doctor?" Weinberg asked.

Proponents of the change argue for national standards of care and increased treatment access, noting that of the 1 million US HIV cases, half are not receiving treatment and one-fifth are uninsured. While AIDS remains life-threatening, drug cocktails have changed it into a treatable disease, said Michael Weinstein, president of the Los Angeles-based AIDS Healthcare Foundation, and "If we reauthorize Ryan White without recognizing that, it would be criminal negligence." Weinstein expressed concern there would be insufficient money for new, costlier treatments for drug-resistant HIV. "Ryan White is not about maintaining the AIDS establishment. We have to examine all of the sacred cows and we have to slaughter most of them," he said.

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