Proposals for Ryan White Reauthorization Reflect Shifts in HIV Epidemic, HRSA Administrator Writes in Letter to the Editor

An HHS proposal for the reauthorization of the Ryan White CARE Act "is an opportunity to respond to recent changes in the spread and treatment" of HIV/AIDS, Elizabeth Duke, administrator of HHS' Health Resources and Services Administration, writes in a letter to the editor in response to an Aug. 18 New York Times editorial on the proposal (Duke, New York Times, 8/29). HHS Secretary Mike Leavitt last month called on Congress to reauthorize the act and outlined the changes the Bush administration would like to have made to the program, including an end to current provisions that allow certain metropolitan areas to be "held harmless" from possible Ryan White grant reductions (Kaiser Daily HIV/AIDS Report, 7/28). The Times in the editorial called the proposal "both irresponsible and unfair," saying it was tantamount to "punishing areas that have rallied the community to combat AIDS" and called on lawmakers and the public to "rebuff" the proposal (Kaiser Daily HIV/AIDS Report, 8/18). However, Duke says the reauthorization proposals "were developed after months of consultation with national experts and HIV/AIDS groups" and would help the administration "determine where the need is greatest" to "distribute money through a new severity-of-need analysis that reflects the number of HIV cases, poverty and available services." Under the current CARE Act, money is distributed through "formulas that use unreliable data, double count AIDS cases and include hold-harmless provisions," she says (New York Times, 8/29).

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