As we start 2006, I'm haunted by a strange sense of déjà vu. Although 2005 was to have been the year of both a reauthorization of the Ryan White CARE Act and a focus on increased federal appropriations, neither happened by the end of the year. Congress, splintered by controversial nominees to the Supreme Court and the largest natural disasters to have ever hit our country, did not even blink when the CARE Act expired on September 30. While funding levels had yet to be finalized as this issue went to press, there were no new funds earmarked for HIV/AIDS efforts in either the House or Senate versions of the budget.

Have we really forgotten the importance of fighting AIDS? As the Campaign to End AIDS so clearly articulated, there is still much work to be done. Funding levels have dipped, leaving thousands on waiting lists. Prevention efforts have been politicized to the point that the infection rate is beginning to rise after more than a decade of constant levels. The AIDS community, which has always been so good at rallying together in a time of crisis, has begun to splinter into factions that aim to pit rural communities against urban communities and government offices against community-based organizations.

While we've never had enough money, while our prevention efforts have always been dictated by politics and while our coalitions have always been fragile at best, to start a year with so much optimism but then to end it with nothing of substance to show is disheartening at best. However, as I read the personal responses to the C2EA, review the history of the early years of the epidemic, and see the new faces and hear the new voices of people living with HIV that are speaking out and taking action for the first time, I can't help but to feel hopeful for the year ahead.

Fighting for Funding

All politics are local, so the old adage goes. In our case, we must pay attention to it. As the federal appropriations battle reached a peak, Senator Tom Coburn (R-Okla.) introduced an amendment to the Senate appropriations bill that would have delayed $60 million in nonessential construction at the CDC so that those funds could be transferred to the AIDS Drug Assistance Program. This was introduced not to punish the CDC, but in response to the current political mandate to secure any new funding from existing budget line items. Certainly, the CDC plays a critical role in protecting and preserving the public health in our country and around the world. For far too long, their infrastructure needs have been overlooked and ignored.

However, I was frustrated at best when the Congressional record of the debate relayed statements from Georgia Senator Saxby Chambliss (R-Ga.) stating that contractors had come across a rocky area on the campus during construction and CDC Director Julie Gerberding decided to create a scenic area for agency employees. "I guess what we've got out there is a gazebo of some sort that must have a Japanese tinge to it," Chambliss said, adding, "It looked like a nice place where employees could go out in the open air and have lunch." While the construction dollars are for far more than this one garden, it serves as an example of how far we have yet to go in educating our own elected officials on the needs of the people they represent.

Reauthorization Fight Continues

Numerous efforts were underway at the end of the year to bring the community closer together during the struggle to reauthorize the Ryan White CARE Act. With too many community groups looking out only for the interests of their immediate constituencies, the infighting between organizations had reached such an impasse that the very future of the Ryan White CARE Act was in doubt. One effort to respond to this was the creation of a the constituent-based Ryan White Legislative Group. In announcing the creation of this work group, the organizers released the following statement:

United by the common goal of securing passage of a reauthorized Ryan White CARE Act that responds effectively to the needs of all communities impacted by HIV/AIDS, AIDS Action, AIDS Alliance for Children Youth & Families, CAEAR Coalition, National Association of AIDS Education and Training Centers, National Association of People with AIDS and National Minority AIDS Council are launching the Ryan White Legislative Group to develop and implement coordinated legislative and grassroots strategies.

As organizations representing people living with HIV and AIDS and those providing frontline services, we see everyday the tremendous value of CARE Act services in the lives of people living with HIV/AIDS, their families and communities. We are committed to strengthening and expanding those programs to reflect changes in the HIV/AIDS epidemic and to serve the unmet needs in communities nationwide.

Our organizations look forward to working with the Administration, Members of Congress, and our allies in the HIV/AIDS community to secure, as swiftly as possible, reauthorization of the Ryan White CARE Act with sound legislative changes.

Hopefully, this group will find ways to work with other coalitions, such as the Ryan White ACTION Campaign (www.ryanwhiteaction.org). This coalition was founded by the AIDS Institute, National Alliance of State and Territorial AIDS Directors, the HIV Medical Association and The American Academy of HIV Medicine to promote public education and awareness of the Ryan White CARE Act. Too many lives depend upon us all working together.

Georgia Legislative Update

The Georgia Legislature begins its session in early January. ADAP funding continues to be our top priority, with an anticipated shortfall of at least $2.6 million in next year's budget. This year, however, we are also very concerned about the Governor's proposed changes to the Medicaid program. If these changes are enacted, it could cause severe disruptions in services throughout the state. We are again working with the Georgia Coalition for a Responsible Budget (GA-CURB) to monitor this proposal and fight against changes that would hurt low-income people living with HIV/AIDS.

These and other issues will be covered in depth at our annual AIDS Policy Briefing on February 1 at the Powell Goldstein law firm in Midtown Atlanta. While further details on the Policy Briefing and ADAP Lobby Day were not finalized at press time, please visit our web site and join our announcement list for the latest information on how you can support our efforts.