While AIDS advocacy groups may disagree about the proposed congressional appropriation formula for reauthorizing the Ryan White CARE Act -- through which more than $2 billion is allocated to cities and state for HIV/AIDS treatment and care -- they agree that not enough funding is available to meet everyone's needs.

The existing allocation formula, based on AIDS cases, would be revised to reflect the number of both HIV and AIDS cases. Funds would shift from jurisdictions battling older epidemics to cities and states facing newer infections, including Midwestern and Southern states, whose advocates mostly supported the bill. Far more people have been infected than have developed AIDS, and these people need treatment before they develop AIDS, say researchers and federal health officials.

The House bill contains a five-year provision that would provide more funding to jurisdictions switching to name-based HIV surveillance. But many state and city officials say the bill does not provide enough money for the five-year transition period, during which time New York could lose $78 million; California $50 million; and New York City $17.8 million, officials said. Illinois, Alabama, North Carolina and the District of Columbia could gain millions more in HIV/AIDS funding.

"The bottom line is the total level of funding is not high enough," said Ernest Hopkins, government affairs director of Communities Advocating Emergency AIDS Relief, which represents AIDS groups from more than a dozen cities and states. As the epidemic continues to grow, the federal appropriations required to sufficiently address it have not, said Hopkins.

"Everybody has acted in good faith," said Jim Driscoll of AIDS Healthcare Foundation, referring to Senate and House members who drafted the bill. They made many changes at AIDS groups' requests, he noted, and produced a compromise bill in which "most of the parties are making gains in at least when you consider the overall bill."

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