San Francisco Could Lose Millions in AIDS Funding

The Senate Health, Education, Labor and Pensions Committee on Wednesday voted unanimously for a four-year extension of the funding provided under the Ryan White CARE Act of 1990. However, according to aides to Speaker of the House Nancy Pelosi (D-Calif.), San Francisco could lose up to $5.3 million for HIV/AIDS care and treatment under the proposed funding formula.

Since the act's 2006 reauthorization, San Francisco has been losing funding as resources were shifted in response to increases in AIDS cases in rural areas and among women. Using a separate appropriations process, Pelosi last year secured an additional $7 million in AIDS money for the city. Her aides say she supports a provision of the act that would offer a permanent solution to the problem.

Pelosi's aides deny the charge leveled by Sen. Michael Enzi (Wyo.), the committee's ranking Republican, that the provision is simply an earmark for San Francisco. Pelosi, they say, is trying to increase funding across the country, not just in her home district.

Sen. Tom Harkin (D-Iowa), the committee's chair, said the extension plan continues the effort, begun with the act's 2006 renewal, to balance the needs of high-prevalence cities and states with those of locales currently experiencing rapidly growing epidemics. The funding formula provides greater resources to areas with high HIV prevalence, not just high AIDS rates, as had been the previous practice.

To avoid disruptions in funding for HIV/AIDS services, Congress must act to renew Ryan White by Oct. 31.

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