As the United Nations opens its High-Level Review Meeting on HIV/AIDS, the U.S. is trying to weaken a political declaration by opposing the setting of clear targets with time frames for stopping the disease. At the same time, a monitoring report shows that the U.S. has fallen short on its own commitments made at the UN five years ago to curb the disease at home. With no national plan in the U.S. for HIV prevention, treatment, and support, with half the people in the U.S. who need HIV treatment not receiving it, and with the number of new HIV infections in the U.S not decreasing in over a decade, AIDS continues to have a devastating impact on communities of color, gay men and men who have sex with men, injecting drug users, and the poor.

"The U.S. is in no position to preach to other countries on how to address the AIDS epidemic when it has much to answer for back home," said Chris Collins, author of the report published by the Public Health Watch HIV/AIDS Monitoring Project of the Open Society Institute. "There is no denying that the U.S. leads in funding for AIDS globally, but without its own national strategy that focuses on outcomes for prevention, treatment and service delivery, the U.S. delegation needs to speak to how they're going to do better for Americans as they try to influence international policy."

The monitoring report provides the first comprehensive analysis of how the United States is responding to the domestic AIDS epidemic and calls on the U.S. government to step up prevention and treatment efforts. Based on extensive consultation with experts and review of U.S. AIDS policy and outcomes, the report -- HIV/AIDS Policy in the United States: Monitoring the UNGASS Declaration of Commitment on HIV/AIDS -- reveals:

• The financing system for AIDS services in the U.S. does not allow for "comprehensive and sustained access to quality HIV care."

• The U.S. failed to meet the 2005 prevention target set by its own Centers for Disease Control and Prevention and the number of annual new HIV infections has remained at 40,000 for over a decade.

• HIV prevention resources are not allocated in the most cost-effective manner and research on program effectiveness often does not inform policy.

• The disproportionate impact of AIDS on African Americans and other communities of color, gay men and men who have sex with men, injection drug users, and the poor continues unabated.

• Only approximately half of people living with HIV/AIDS in the U.S. are receiving regular HIV-related care.

• Only approximately half of those people who meet medical criteria for use of antiretroviral (ARV) treatment for HIV are actually receiving the drugs.

• A significant number of people living with HIV/AIDS are being tested for HIV too late in the course of disease to benefit from early care.

"The U.S. needs to help strengthen, not weaken the political declaration at the UN meeting on AIDS, and at home, our government needs to launch a vigorous, federally managed effort to test, refine, and deliver innovative programming that improves outcomes for communities of color," said Rachel Guglielmo, project director of the Public Health Watch Project. "We need to use proven tools such as frank sexual education and needle exchange to bring HIV incidence down. The U.S. should put its funding priorities here and abroad into programs that are based on solid evidence of what works. Only by first delivering on its commitments at home, can the U.S. speak with full credibility to other nations at the UN. "

A copy of HIV/AIDS Policy in the United States: Monitoring the UNGASS Declaration of Commitment on HIV/AIDS is available by contacting Geoffrey Knox at 212-229-0540 or at www.publichealthwatch.info.

The Open Society Institute, a private operating and grantmaking foundation, works to build vibrant and tolerant democracies whose governments are accountable to their citizens. To achieve its mission, OSI seeks to shape public policies that assure greater fairness in political, legal, and economic systems and safeguard fundamental rights. OSI works in over 60 countries including the United States, Europe, Asia, Africa, Latin America, and the Middle East.