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11/21/96 THU 18:27 FAX 2026321090
AIDS POLICY
002
Major Clinton Administration Accomplishments in HIV/AIDS
Increased funding for AIDS research, prevention, and care by
more than 50% in first four years.
Increased funding for the Ryan White CARE Act by 158 percent
and increased number of cities eligible for CARE Act funds
from 34 to 49.
Tripled funding for the AIDS Drug Assistance Programs, which
helps low-income uninsured people with AIDS purchase needed
therapies.
Created the Office of National AIDS Policy at the White
House to direct Federal AIDS policy.
Signed the NIH Revitalization Act of 1993, creating a
strengthened Office of AIDS Research at NIH and vesting it
with authority to plan and carry out the AIDS research
agenda.
Accelerated AIDS drug approval to record times. Since 1993,
the Food and Drug Administration has approved 16 new AIDS
drugs and two new diagnostic tests.
Facilitated creation of the Forum for Collaborative HIV
Research to identify research opportunities to improve care
for people with HIV.
Preserved the Medicaid guarantee of coverage for people
living with AIDS. Nearly 50 percent of people with AIDS and
92 percent of children with AIDS rely on Medicaid for health
coverage.
Launched the community planning partnership, which empowers
local communities to make decisions about the distribution
of AIDS prevention funding.
Vigorously enforced the Americans with Disabilities Act,
which prohibits discrimination against people with HIV/AIDS.
02/24/97 MON 18:00 FAX 2026907318
DHHS/ASPA
002
Fridg Announcement
MMWR AIDS Death Rate Report
The February 28 issue of the Morbidity and Mortality Weekly Report (MMWR) will
include an article detailing the latest trends in AIDS cases and deaths. Highlights of that
article are:
AIDS Deaths
Overall, AIDS-related deaths in the U.S. declined 12 percent in the first six months of
X
[
1996 compared with the same time period in 1995. This is the first decline in deaths
in the history of the epidemic.
AIDS-related deaths declined in all regions of the country with the biggest declines in
the Northeast and West and the smallest in the South).
AIDS deaths were down among men (15%), gay/bisexual men (18%), and IV drug
users (6%).
AIDS deaths were up among women (3%) and heterosexuals (3%).
While all races experienced a decline in AIDS deaths, the declines were greatest
among Whites (21%), Hispanics (10%), and Asian-Pacific Islanders (6%) and
smallest among African-Americans (2%).
AIDS Cases
The number of Americans diagnosed with AIDS increased by only 2 percent in 1995
versus 1994 (63,000 vs. 61,600).
The incidence of AIDS cases has been virtually level since 1992 (increasing less than
5% each year).
Reductions in incidence have been greatest among men, gay/bisexual men, and IV
drug users.
AIDS incidence has been rising among women, African-Americans, and
heterosexuals.
Because of longer life expectancy, the number of Americans living with AIDS
increased 10 percent from mid-1995 to mid-1996 to 223,000.
02/24/97 MON 18:00 FAX 2026907318
DHHS/ASPA
003
02/20/97 17:39
HRSA PUBLIC AFFAIRS
OS NEWS
NO.188 P002/004
DRAFT
FOR IMMEDIATE RELEASE
CONTACT: HRSA Press Office
(upon clearance)
301-443-3376
#43
HHS AWARDS NEARLY $202 MILLION FOR HIV/AIDS CARE
Health and Human Services Secretary Donna E. Shalala today announced the sward of
nearly $202 million to 49 eligible metropolitan areas (EMAs) with a high incidence of
HIV/AIDS to provide primary health care and support services to low-income, uninsured and
underinsured individuals and families affected by the disease.
Funded under Title I of the Ryan White Comprehensive AIDS Resources Emergency
(CARE) Act, the awards supplement November 1996 formula grants to the same 49 EMAs, and
provide a wide range of ambulatory health and support services, including primary health care,
case management. housing and transportation assistance, respite care, and substance abuse and
mental health services, as well as inpatient case management services to expedite discharge and
prevent unnecessary hospitalization.
"Thesc new funds boost the ability of heavily impacted communities to give people with
HIV/AIDS the range of essential health care and support services they need to live better, longer
lives," said Secretary Shalala. "CARE Act funds are a major element in the Clinton
dministration's stand against the HIV/AIDS health care crisis in communities across America"
The Ryan White CARE Act is administered by HHS' Health Resources and Services
Administration (IIRSA). HRSA administrator Ciro V. Sumaya, M.D., M.P.H.T.M., said,
"These awards help bridge the gap that communities experience in providing services to people
with HIV/AIDS who are without other resources. As medical research offers new hope in the
fight against IIIV/AIDS. the CARE Act program gives communities the funds to make hope a
-more-
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02/20/97 17:39 HRSA PUBLIC AFFAIRS -> OS NEWS
NO.188 P003/004
-2-
I
DRAFT #43
reality."
To be eligible for Title I funding, an EMA must have a population of at least 500,000 and
have reported more than 2,000 AIDS cases in the preceding Dyears, except for previously-
funded EMAs. More than $1.4 billion has been awarded in formula and supplemental grants
under Title I since the CARE. Act was first funded in FY 1991, including $372 million in FY
1996, and $429.3 million in FY 1997. The number of EMAS funded under Title I has grown
from 16 in FY 1991 to 49 in FY 1997. An estimated 300,000 people received services from Title
I grantees in 1995, the most recent year of reported data.
A list of the 49 EMAs and their grants is attached.
###
002
12/23/96 MON 11:47 FAX 2026321090
AIDS POLICY
Office of National AIDS
Policy
National AIDS Strategy
Talking Points
What is the National AIDS Strategy?
This is a time of extraordinary change in the AIDS epidemic and it is essential that the
government have its act together so that we can take advantage of these opportunities. The
Strategy does three things: First, it establishes six long-term goals for the President's second term.
Second, it establishes short-term opportunities for progress in the next 12 months to move us
toward these goals. Third, it lays out dollar-for-dollar what the government is spending NOW on
AIDS programs across the government.
What are those goals? When will you achieve them?
The goals are: to support research to find more effective treatments, a vaccine for the uninfected,
and a care for those living with HIV/AIDS; to support prevention efforts to systematically reduce
new HIV infections until there are no infections; to assist people with HIV/AIDS in obtaining
affordable, high-quality care; to fight AIDS-related discrimination at every turn; to lead the
international fight to end the epidemic; and to quickly translate research advances into new forms
of treatment and prevention.
No one can guarantee that all of these goals can be met in four years but they must guide
everything that is done from this moment forward. The President is determined to make as much
progress as possible in each of these areas and, where possible, reach these goals.
What are some of those opportunities for progress?
One example is the new coordinated AIDS vaccine initiative at NIH headed by Nobel Laureate
Dr. David Baltimore. A second example is the recent progress in reducing the number of infants
born with HIV in this country. That number has declined by 27 percent since the President took
office and we want to make further progress in the year ahead. Third, we are experiencing very
high rates of infection among women, intravenous drug users, and young people. The CDC will
target those three population groups with intensive prevention programs, Finally, the Department
of Health and Human Services is coordinating the development of better information for patients
and their doctors on the best use of the new combination drug therapies.
How is this different from the myriad of other plans that have been issued in the past?
This is the first time the Federal government -- and the President of the United States has put
together a comprehensive planning document. All of the commissions established in the past have
called for the development of such a strategy. This is not a report to be studied, it is a plan that
will guide this Administration's activities for the next four years.
003
12/23/96 MON 11:48 FAX 2026321090
AIDS POLICY
Critics say the Strategy doesn't go far enough, that it's too vague, and that it dodges all the
controversial issues. Your response?
The National AIDS Strategy is a far-reaching document that covers every Department of the
Federal government involved with AIDS. It lists specific opportunities for progress in the year
ahead and provides a framework our efforts to combat the epidemic. The implementation of this
Strategy will involve the relevant Federal Agencies, the private sector, community-based
organizations, the Presidential Advisory Council on HIV/AIDS, and people who are living with
HIV and AIDS. It will be directed by the Office of National AIDS Policy.
What about needle exchange programs?
The report clearly identifies drugs users and their sexual partners as a population that requires
priority attention. The question of how to specifically address those issues is part of the
implementation process. The Congress has asked the Department of Health and Human Services
to prepare a report on this issue that is due in mid-February. It would be inappropriate for this
Strategy to interfere with or pre-empt that process.
Why did it take so long?
The development of this Strategy began a little more than a year ago. It required the involvement
of all relevant Federal Agencies. But more importantly it also required outreach to those who are
on the front lines of the epidemic. The Office of National AIDS Policy conducted 13 town hall
meetings around the country to ask the affected communities what they would like to see in a
National AIDS Strategy and what kind of goals the President should set. This input was
extremely valuable to the creation of this document. We also sought the advice of the Presidential
Advisory Council on HIV/AIDS and national AIDS organizations.
What difference with this Strategy make in the lives of people with AIDS?
It is our hope that it will make a significant difference in terms of better treatments for people
living with AIDS not only in this country but for people around the world. They will have better
information about the way those treatments should be used and better prevention programs to
protect people from infection.
###
004
12/23/96 MON 11:48 FAX 2026321090
AIDS POLICY
THE WHITE HOUSE
WASHINGTON
For Immediate Release
Contact:
Richard Sorian
Office of National AIDS Policy
(202) 632-1090
President Clinton Releases First-Ever National AIDS Strategy
On December 16, 1996, President Clinton released the first-ever National AIDS
Strategy, establishing six "broad but vital goals" to guide Federal AIDS policy for his
second term in office. The document also outlines numerous "opportunities for progress"
under each of the goals to be accomplished in the next 12 months.
The National AIDS Strategy is the product of more than a year of work by the
Office of National AIDS Policy, directed by Patricia S. Fleming. The Office was created
in 1993 by the President to provide greater focus to the national response to the
challenges presented by HIV and AIDS.
In a letter accompanying the Strategy, the President said, "We have made
tremendous progress in our understanding of HIV and HIV disease, improving
treatments and preventing infections, and we have increased federal funding for AIDS
research, prevention, care, and housing by more than 50 percent in the past four years.
But we have much more work to do."
As of September 30, 1996, the Centers for Disease Control and Prevention had
received reports of 566,002 cases of AIDS among persons in the U.S. More than 343,000
of these persons were reported to have died as a result of complications related to HIV.
An estimated 40,000 to 80,000 Americans become infected with HIV each year.
According to the Strategy, the epidemic of HIV and AIDS "presents unique social,
economic, and public health challenges to governments and individuals here in the
United States and around the world. While significant progress has been made in
understanding the disease and developing treatment, HIV remains a deadly infections for
which there is no vaccine, no cure, and for which there is an expanding, but still limited,
inventory of available treatments."
Development of the National AIDS Strategy required the participation of 28
Federal Agencies involved in AIDS programs including the Departments of Health and
Human Services, Housing and Urban Development, Veterans Affairs, Defense, State,
Energy, Justice, and others. The Strategy also reflects the input of numerous national
and community-based AIDS organizations and the proceedings of 13 regional town hall
meetings that sought the input of people living with HIV/AIDS, their families and
caregivers, and other concerned citizens.
- more -
005
12/23/96 MON 11:49 FAX 2026321090
AIDS POLICY
The National AIDS Strategy sets forth six national goals:
To develop more effective treatments for people living with HIV/AIDS, a
preventive vaccine for the uninfected, and a cure for those who are currently
infected through strong, continuing support for HIV-related research;
To reduce the number of new HIV infections in adults and children in the U.S.
until the rate of new infections reaches zero by providing strong, continuing
support for effective HIV prevention efforts;
To ensure that people living with HIV have access to services, from health care to
housing and supportive services, that are affordable, of high quality, and
responsive to their needs;
To ensure that all people living with HIV are not subject to discrimination;
To provide strong, continuing support for international efforts to address the HIV
epidemic; and,
To ensure that research advances are translated into improved HIV prevention
programs and enhanced care for HIV-positive persons.
In each of these target areas, the National AIDS Strategy includes specific
opportunities for progress in the year ahead. These actions are intended to move us
toward the goals enunciated by the President. They include:
PREVENTION
Targeting vulnerable populations.
The HIV epidemic continues to have a disproportionate impact on certain
populations where infection rates are rising at a rapid pace. Congress has
approved the President's request for an additional $32 million in AIDS prevention
funding specifically for programs targeting such vulnerable populations as
adolescents, women, gay men of color, and substance abusers and their sexual
partners.
Strengthening community-based programs.
Community prevention planning is one of the key innovations in CDC's
prevention programming. This partnership with local communities puts Federal
funds to work based on locally-designed priorities. This year, CDC will be
providing its partners with additional technical assistance and resources needed to
improve the performance of this vital initiative.
2
12/23/96 MON 11:49 FAX 2026321090
AIDS POLICY
006
Reducing transmission of HIV from mother to child.
There has been a significant reduction in the number of infants diagnosed with
AIDS as a result of perinatal (mother-to-child) transmission of HIV. Between
1991 and 1995, the number of such infants declined 27 percent, including a 17
percent drop in 1994-95 alone. Research sponsored by the National Institutes of
Health determined that the use of AZT by HIV-positive pregnant women and
their newborns can reduce the risk of perinatal transmission by two-thirds. In the
coming year, the Public Health Service will be working in conjunction with major
medical and public health organizations to reduce this number further.
RESEARCH
Accelerating AIDS Vaccine Development
The National Institutes of Health will establish a restructured AIDS vaccine effort
headed by Nobel Laureate David Baltimore of MIT to accelerate progress in
research and development of an effective AIDS vaccine. Vice President Gore will
continue his high-level work with the pharmaceutical industry, researchers,
clinicians, and patient advocates to move increase private-sector research and
development of AIDS vaccines.
Maintaining the Office of AIDS Research
One of the most important developments of the past four years was the enactment
of legislation strengthening the Office of AIDS Research (OAR) at the National
Institutes of Health. In the year ahead, the Administration will seek
reauthorization of the OAR and retention of the Office's authority to develop and
carry out the AIDS research budget at NIH.
Developing Topical Microbicides
The National Institutes of Health and the Centers for Disease Control and
Prevention will begin a four-year $100 million effort to accelerate research and
development of safe and effective barriers to HIV transmission for women and
men.
Advancing Prevention Science
The National Institutes of Health is developing a comprehensive prevention
science agenda that will address the biomedical, behavioral, and social approaches
to AIDS prevention interventions.
3
11/21/96 19:28:04
FactsLine->
2026321090 FactsLine
Page 002
HHS NEWS
EMBARGOED: 4 P.M. EST
Contact: CDC, National Center
Thursday, Nov. 21, 1996
for HIV, STD and TB Prevention
Office of Health Communication
(404) 639-8895
CDC REPORT SHOWS SHARP DROP IN AIDS IN INFANTS
The number of reported cases of perinatally acquired (mother-to-
infant) AIDS declined by 27 percent between 1992 and 1995, according to
information released today by the Centers for Disease Control and
Prevention (CDC). Increased use of perinatal zidovudine (AZT) therapy
by HIV-infected pregnant women and their newborns is the most likely
factor leading to this reduction, CDC said.
"This is a dramatic example of the power we have to conduct world-
class scientific research and then to quickly and effectively put new
research findings to work saving lives," said HHS Secretary Donna E.
Shalala.
The National Institutes of Health (NIH) sponsored an AIDS clinical
trial, ACTG-076, that was concluded in early 1994 after it proved
successfully ahead of schedule, that the risk of perinatal transmission
of HIV could be reduced by as much as two-thirds with the use of AZT
therapy by HIV-positive pregnant women during pregnancy and childbirth
and by newborns for six weeks after birth. Following release of those
results, a consortium of Public Health Service agencies including CDC,
NIH, and the Health Resources and Services Administration (HRSA)
immediately began to coordinate efforts designed to capitalize on this
research. Guidelines were drafted and issued by the Public Health
Service to promote routine and universal HIV
11/21/96 19:28:39
FactsLine->
2026321090 FactsLine
Page 003
-2-
counseling and voluntary testing for all pregnant women. CDC and the
Agency for Health Care Policy and Research (AHCPR) also developed and
released educational materials for health care professionals and women
of childbearing age.
Today's report by CDC in the Morbidity and Mortality Weekly Report
clearly demonstrates that these efforts are paying off, health experts
say.
"This information confirms that our approach to perinatal HIV
prevention is working," said CDC Director David Satcher, M.D., Ph. D.
"As a direct result of these efforts, babies' lives are being saved." "
The report shows that the incidence of perinatally acquired AIDS
peaked in 1992, followed by a short period of stabilization. Cases
began to decline in 1992 and 1993 and dropped dramatically in 1994.
Researchers believe the small initial reduction indicates possible
effects of other preventive and medical factors including an increase
in the number of childbearing women receiving AZT therapy for their own
health.
More dramatic declines in reported AIDS cases in children followed
release of the PHS guidelines with a decline of 8 percent from 1993 to
1994 and a drop of 17 percent from 1994 to 1995, making it clear that
routine and universal HIV counseling and voluntary testing, combined
with AZT therapy is highly effective in preventing HIV.
###
Note: HHS press releases are available on the World Wide Web at:
http://www.dhhs.gov.
02/24/97 MON 18:01 FAX 2026907318
DHHS/ASPA
005
02/20/97 17:39
HRSA PUBLIC AFFAIRS
OS NEWS
NO.188 P004/004
FY 1997 Ryan White CARE Act
Title I Emergency Relief Supplemental Grants
EMA
FY 1997 Supplemental Award
Atlanta, Ga.
$
Austin, Texas
Baltimore, Md.
Bergen-Passaic. N.J.
# 43
Boston, Mass.
Caguas, Puerto Rico
Chicago, III.
Cleveland, Ohio
DRAFT
Dallas, Texas
Denver, Colo.
Detroit, Mich.
Dutchess County, N.Y.
Ft. Lauderdale, Fla.
Ft. Worth, Texas
Hartford, Conn.
(To be filled-in)
Houston, Texas
Jacksonville, Fla.
Jersey City, N.J.
Kansas City, Mo.
Los Angeles. Calif.
Miami, Fla.
Middlesex-Somerser-Hunterdon, N.J.
Minneapolis-St. Paul. Minn.
Nassau-Suffolk. N.Y.
New Haven, Conn.
New Orleans, La.
New York. N.Y.
Newark, N.J.
Oakland, Calif.
Orange County. Calif.
Orlando, Fla.
Philadelphia. Pa.
Phoenix, Ariz.
Ponce. Puerto Rico
Portland, Orc.
Riverside-San Bernardino, Calif.
Sacramento, Calif.
St. Louis, Mo.
San Amonio. Texas
San Diego, Calif.
San Francisco. Calif.
San Jose, Calif.
San Juan. Puerio Rico
Santa Rosa. Calif.
Seattle, Wash.
Tampa-St. Petersburg. Fla.
Vineland-Milvile-Bridgeton, N.J.
Washington. D.C.
West Palm Beach, Fla.
Total
$
02/24/97 MQN 18:00 FAX 2026907318
DHHS/ASPA
1
001
HUMAN SERVICES USA
&
HEALTH
FAX
of
PEPARTMENT
TRANSMISSION
U.S. Department of Health and Human Services
Office of the Secretary
2/24/97
DATE:
TO:
Pan Abonathy
FAX:
456-2878
PHONE:
FROM:
Richard Sorian
Office of Public Affairs
Phone: 202-690-7470
Fax:
202-690-7318
[email protected]
TOTAL NUMBER OF PAGES TRANSMITTED: K 5
COMMENTS:
Draft info on ACDS deaths
Draft HRSA press release
200 Independence Avenue, S.W., HHH Bldg., Room 638E, Washington, D.C. 20201
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2026321096-
202 456 2223;# 1
OFFICE OF NATIONAL AIDS POLICY
EXECUTIVE OFFICE OF THE PRESIDENT
750 17th Street, N.W.
Washington, DC 20503
Phone: 202-632-1090
Fax: 202-632-1096
FACSIMILE COVER SHEET
TO: Pauline Abernathy/June June
FAX NUMBER: 456-2223
FROM: Patsy Fleming
DATE: 1/15/97
PAGES INCLUDING COVER SHEET:
COMMENTS:
This is about the AIDS strategy and
other issues. I have sent a acopy to
June along with o ther documents.
These are the most of often heard
criticisms. not only of the Strategy)
but also of the Admini stration
generally vis-a-vis AIDS.
SENT BY:Xerox Telecopier 7020 ; 1-15-97 ; 4:55PM ;
2026321096-
202 456 2223:# 2
[6] From: Rex Wockner: : (WCKNRR) at -FABRIK 1/11/97 10:59AM (9272 bytes: 156 ln)
To: Jay Blotcher at AMFAR-NY, WCKNRR at -FABRIX
Subject: NC2458: National AIDS Strategy Op ed
Message Contents
From: Rex Wockner
Date: Sat, Jan 11, 1997 10:59 AM
Subject: NC2458: National AIDS Strategy Op ed
To: Jay Blotcher; Rex Wockner
Forwarded message:
From: [email protected]
Date: 97-01-10 15:12:51 EST
Hi Jess - I hope you and Rex had a good Christmas and a Happy New Year. My
holidays were nice. Things here are very busy and very cold. I thought you
might be interested in this. Pass it on to Rex if you would. Thanks, Keith
A DECADE LATE
By Keith A. Anastasi
NGLTF Policy Institute
Fifteen years into the AIDS epidemic and over 300,000 lives lost, and
the federal government recently released its first National Aids Strategy.
Outgoing National AIDS Policy Director Patricia Fleming boasts in the
foreword; "the appendices to this report lay out, for the first time,
detailed descriptions of the objectives and goals involved in the
Federal response to HIV." Nearly two decades of sickness and death and
the government is praising the release of its first strategy to deal with
the worst public health crisis in modern history. Our government should be
embarrassed that it has taken over a decade to produce a National AIDS
Strategy. I have lived with HIV, dealt with our federal system of care,
and fought for the needs of people with HIV/AIDS and those struggling to
remain uninfected for over 10 years. I had hope the report would outline
the programs and funding we desperately need and that our government was
finally getting serious about a solution for the complex problems of the
epidemic. The report falls well short of that hope.
The report shows that HIV infection among young people, people of color-
particularly women of color, and the poor continues to rise in
disproportionate numbers. With HIV spreading dramatically in the South the
strategy to deal with these problems remains inadequate. Letting local
communities determine and create "innovative prevention efforts " is not
sufficient when racism, sexism and homophobia continue to interfere with
HIV/AIDS education efforts. The federal government working with HIV/AIDS
educators from all communities must develop a basic standard of accurate,
explicit, cultural and language appropriate education information that
schools and communities are required to provide.
The report contains virtually no mention of how the government plans to
deal with the increasing spread of HIV in prisons and the specific needs
of prisoners living with HIV/AIDS. Condoms and latex dams are still not
available in state and federal prisons and inmates with HIV/AIDS struggle
to get proper medical care, nutritious food, and medication. Ignoring
that sex and Intravenous Drug use is going on in our prisons will not make
the problem go away. The government needs to develop a strategy to deal
with these problems; and this report does not offer a plan.
In the area of research the report proposes some of the strategies the
AIDS community has demanded for years. For example, The Forum for
Collaborative HIV Research, a new group designed "to catalyze
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collaborations among government researchers, pharmaceutical companies,
third party payers, and the community," is an idea similar to one veteran
AIDS Activist Larry Kramer suggested over a decade ago. I supported Larry
Kramer's "Manhattan Project" then and I support the government's watered
down version now. We have waited too long for the government to take the
lead in developing a collaborative effort to fight AIDS.
The development of a vaccine to prevent further infection must remain a
top priority but cannot overshadow the need to provide care for those
already infected. Care for people living with HIV/AIDS along with the
development of a cure must be our nation's top priority. Continued
funding of the Ryan White Care Act is an integral part of providing care
for people with HIV/AIDS but it alone does not meet the needs of those
infected. Mr. Clinton must continue the fight to preserve Medicaid
coverage for the more than 50 percent of adults and 90 percent of children
with AIDS who rely upon it. The struggle to provide housing for people
with HIV/AIDS is an ongoing problem yet the report does not support
strongly enough the reauthorization of Housing Opportunities for People
With AIDS (HOPWA) set to go before the 105th Congress. With this
important program up for reauthorization in 1997, the Clinton
administration must commit itself to protecting HOPWA'S funding. Without
HOPWA thousands of people with
HIV/AIDS could go homeless.
The preservation of these and other existing programs is not enough. No
strategy is complete until the people it means to help receive all the
help they need. The federal government increased funding for State AIDS
Drug Assistance Programs (ADAP) yet they still remain underfunded with
many programs on the verge of collapse. As a person that depends on ADAP
for my HIV treatment, I wait on additional funding to expand this program
while my life hangs in the balance. The fact is, thousands of people with
HIV/AIDS are not receiving life saving drugs like Protease Inhibitors, the
latest and most effective treatments for HIV, because they are not
available through state or federal programs like ADAP and are too
expensive to afford otherwise. The government's contribution in the
development of these treatments must include a guarantee that every man,
women and child with HIV/AIDS in America will receive them regardless of
their ability to pay. The National AIDS Strategy does not do that and it
should.
The rise in infection among Intravenous Drug users indicates the
government's failure to design and fund programs that work to prevent
addicts and their partners from becoming infected. The report states,
"HIV transmission is closely related to substance abuse" but its strategy
fails to provide a National Needle Exchange Program. The Clinton
administration: has failed to display the political will to approve a
program the governments own studies indicate will dramatically reduce the
number of HIV infections. In explaining that "substance abuse treatment
is a major form of HIV prevention" the report fails to mention that major
cuts in funding for substance abuse treatment programs in 1996 make it
more difficult to educate addicts and help them recover.
The national strategy's section dealing with civil rights does not go
far enough. We still battle discriminatory legislation such as measures
that criminalize sex by HIV positive people or deny them the opportunity
to serve in the armed services. Access to comprehensive, affordable
health insurance for uninsured people with HIV/AIDS is still not a legally
protected right. There is no strategy to deal with cross- border HIV/AIDS
issues, a problem that severely taxes communities trying to coordinate
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education and service efforts with neighboring countries and deal with
complex immigration issues. Our government should take the lead in
dealing with these issues but again fails to do SO.
The 1997 National AIDS Strategy is a long awaited and alarming
beginning. It simply provides a framework from which a complete and
thorough strategy can develop. It is often a rehashing of information and
ideas that the HIV/AIDS community has been discussing and trying to
grapple with for years. The budgetary appendices of the report make it
clear that our work is far from over. Our communities will continue to
struggle to care for people with HIV and AIDS. At times the report
devotes as much space to praising the Clinton administration for its past
accomplishments as it does to laying out an effective plan for the future.
We now must continue to fight for our lives and for the funding and
programs the government, with over a decade of experience and information
to work with, has failed to provide.
The National Gay and Lesbian Task Force is a progressive organization that
has supported grassroots organizing and pioneered in national advocacy
since 1973. Since its inception, NGLTF has been at the forefront of
virtually every major initiative for lesbian and gay rights. In all its
efforts, NGLTF helps to strengthen the gay, lesbian, bisexual and
transgender movement at the state level while connecting these activities
to a national vision for change.
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Date: Sat, 21 Jan 1997 10:59:26 -0800 (PST)
From: Rex Wockner <[email protected]>
Subject: NC2458: National AIDS Strategy Op ed
To: [email protected]
Message-ID: <Pine.3.89.9701111029.A28625-0100000enetcom13a
MIME-Version: 1.0
Content-Type: TEXT/PLAIN; charset-US-ASCII
12/10/96 TUE 17:49 FAX 2026321090
AIDS POLICY
0
001
OFFICE OF NATIONAL AIDS POLICY
EXECUTIVE OFFICE OF THE PRESIDENT
750 17th Street, N.W.
Washington, DC 20503
Phone: 202-632-1090
Fax: 202-632-1096
FACSIMILE COVER SHEET
TO:
FAX NUMBER: 456-2878
FROM: R.Fasian
DATE:
PAGES INCLUDING COVER SHEET: 4
COMMENTS:
002
AIDS Spending: Health and Human Services Discretionary Programs (in thousands)
Program
FY93
FY96
FY97
97v.96
97v.93
FDA
$72,628
$72,745
$72,745
...
+1.6%
HRSA
$390,341
$763,526
$996,252
+30.5%
+186.3%
Ryan White CARE
($348,013)
($738,465)
($996,252)
(+31.5%)
(+186.3%)
Title 1
($184,757)
($391,700)
($449,943)
(+14.9%)
(+143.5%)
Title II
($115,288)
($260,847)
($416,954)c
(+60%)
(+262%)
Title птв
($47,968)
($56,568)
($69,568)
(+23%)
(+45%)
Title IVª
AIDS POLICY
($29,000)
($36,000)
(+24%)
NA
Title VA (AETCs)
($12,287)
($16,287)
(+33%)
NA
Title VB (Dental)
($6,937)
($7,500)
(+8.1%)
NA
Other HRSA AIDS
($42,328)
($25,061)
NA
NA
NA
IHS
$3,303
$3,660
+5%
CDC
$498,263
$583,433
$616,981
+6%
24%
NIH
$1,071,457
$1,407,824
$1,502,000
+6.7%
+40.2%
SAMHSAᵇ
$25,656
$14,300
AHCPR
$9,824
$6,634
-28%
12/10/96 TUE 17:49 FAX 2028321090
OHAP/OMH/OCR
$7,930
$4,523
+5%
Total, HHS
$2,079,191
$2,856,645
$3,213,251
+12.4%
$54.5%
HOPWA
$100,000
$171,000
$196,000
+14.6%
+96%
DOMESTIC
$2,179,191
$3,027,645
$3,409,251
+126%
+56.4%
DISCRETIONARY
The HRSA pediatric demonstration projects were not incorporated into Title IV until FY94 at $22 million.
The FY97 request for substance abuse and treatment overall at SAMHSA is $1.6billion, an increase of $207 million over FY96.
This includes an earmark of $167 million for the AIDS Drug Assistance Program
12/10/96 TUE 17:49 FAX 2026321090
AIDS POLICY
003
TO AIDS POLICY OFFICE
P001/002
11-21-96 12:56PM FROM OASPA NEWS DIV
HHS NEWS
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
EMBARGOED: 4 P.M. EST
Contact: CDC, National Center
Thursday, Nov., 21, 1996
for HIV, STD and TB Prevention
Office of Health communications
(404) 639-8895
CDC REPORT SHOWS SHARP DROP IN AIDS IN INFANTS
The number of reported cases of perinatally acquired (mother-
to-infant) AIDS declined by 27 percent between 1992 and 1995,
according to information released today by the Centers for Disease
Control and Prevention (CDC) Increased use of perinatal zidovudine
(AZT) therapy by HIV-infected pregnant women and their newborns is
the most likely factor leading to this reduction, CDC said.
"This is a dramatic example of the power we have to conduct
world-class scientific research and then to quickly and effectively
put new research findings to work saving lives, " said HHS Secretary
Donna E. Shalala.
The National Institutes of Health (NIH) sponsored an AIDS
clinical trial, ACTG-076, that was concluded in early 1994 after it
proved successful ahead of schedule indicating that the risk of
perinatal transmission of HIV could be reduced by as much as two-
thirds with the use of AZT therapy by HIV-positive pregnant women
during pregnancy and childbirth and by newborns for six weeks after
birth. Following release of those results, a consortium of Public
Health Service agencies including CDC, NIH, and the Health Resources
and services Administration (HRSA) immediately began to coordinate
efforts designed to capitalize on this research. Guidelines were
drafted and issued by the Public Health Service to promote routine
12/10/96 TUE 17:50 FAX 2026321090
AIDS POLICY
004
TO AIDS POLICY OFFICE
P002/002
11-21-96 12:56PM FROM OASPA NEWS DIV
- 2 -
and universal HIV counseling and voluntary testing for all pregnant
women. CDC and the Agency for Health Care Policy and Research
(AHCPR) also developed and released educational materials for health
care professionals and women of childbearing age.
Today's report by CDC in the Morbidity and Mortality Weekly
Report clearly demonstrates that these efforts are paying off,
health experts say.
"This information confirms that our approach to perinatal HIV
prevention is working," said CDC Director David Satcher, M.D., Ph.D.
"As a direct result of these efforts, thousands of babies' lives are
being saved."
The report shows that the incidence of perinatally acquired
AIDS peaked in 1992, followed by a short period of stabilization.
Cases began to decline in 1992 and 1993 and dropped dramatically in
1994. Researchers believe the small initial reduction indicates
possible effects of other preventive and medical factors including
an increase in the number of childbearing women receiving AZT
therapy for their own health and an increased use of preventive
therapy for AIDS-related opportunistic infections among HIV-infected
children.
More dramatic declines in reported AIDS cases in children
followed release of the PHS guidelines with a decline of 8 percent
from 1993 to 1994 and a drop of 17 percent from 1994 to 1995, making
it clear that routine and universal HIV counseling and voluntary
testing, combined with AZT therapy is highly effective in preventing
HIV.
###
Note: HHS press releases are available'on the World Wide Web at:
http://www.dhhs.gov.
10/09/96
12:25
OMB AD HP
002
ID:
OCT 08'96
13:41 No. 002 P.02
PH - 96
NATIONAL INSTITUTES OF HEALTH
AIDS vs. Cancer Research
QUESTION:
In the face of higher rates of incidence and deaths from other
diseases such as cancer and heart disease, is NIH's spending on
AIDS research out of balance with that for other diseases?
ANSWER:
I do not believe that research on AIDS is "out of balance"
with other diseases. NIH research funding in 1997 for cancer
($2.4 B) exceeds research on AIDS ($1.4 B) and heart disease
($893 M). However, such comparisons can be a bit misleading.
The public health impact and the value of dollars spent on
any disease must be assessed through a series of measures,
including mortality and morbidity: incidence and prevalence
rates; cause and mode of transmission; fatality rates,
years of potential life lost; demographic factors, and
research opportunities. It is inappropriate to use any one
of these criteria independent of the others when making
resource allocation decisions.
What we spend on AIDS research is a vital and necessary
investment in the Nation's public health. The following
reasons help distinguish AIDS from cancer and heart disease:
AIDS 19 still a growing epidemit and remains one of the
most serious threats to the Nation's public health.
AIDS is infectious and, because it mutates 80 quickly,
future trends are not entirely predictable.
AIDS disproportionately kills younger people during their
most productive years.
AIDS has a wide impact far beyond the diagnosis of a single
disease, as it contributes to other public health crises in
tuberculosis, other sexually transmitted diseases, drug
abuse. and infant mortality.
AIDS is becoming a growing burden on the public sector as
the demographics of AIDS and HIV infection are changing
more and more to individuals in lower economic brackets.
AIDS research spin-offs are benefiting many other areas,
such as cancer, lupus, diabetes, rheumatoid arthritis,
multiple sclerosis, Alzheimer's disease, dementia,
encephalitis, and meningitis.
10/09/96
12:26
OMB AD HP
003
ID:
OCT 08'96
13:42 No 002 P.03
PH - 97
National Institutes 02 Health
1995
1996
1937
1 Chg
Dollars:
AIDS
$1,333,875,000
$1,407,824,000
$1,431,908,000
+1.78
Cancer*
$2,217,000,000
$2,351,000,000
+1.88
Heart Disease
$834,000,000
$877,000,000
$893,000,000
41.84
- ADDS - - is the AIX
New Cases per Year:
AIDS
73,000
Cancer
1,252,000
Heart Disease
n.a.
Dollars per Case:
AIDS
$18,272
Cancer
$1,770
Heart Disease
n.a.
Deaths per Year:
AIDS
41,930
Cancer
547,000
Heart Disease
955,000
Dollars per Death:
AIDS
$31,812
Cancer
$4,053
Heart Disease
SB73
ADDITIONAL INFORMATION:
Growing Public Health Impact:
The pandemic of AIDS and HIV infection continues to grow - more
persons in every geographic area and age group are becoming
infected every day, despite what we have learned about it and
its transmission. Unlike cancer or heart disease, AIDS is an
expanding public health threat. In 1994, more than 80,000 new
AIDS cases were reported to CDC. It is estimated that
approximately 40,000 new HIV-infections occur yearly among
adults and adolescents.
Since the disease was identified only 15 years ago, AIDS has
killed over a quarter of a million Americans. In the U.S., one
person dies from AIDS every 8 minutes.
Unknown in 1980, AIDS was the 15th leading cause of death
overall in the U.S. in 1987. Today, it is the 8th ranked cause
of death in the U.S., accounting for over 38,000 deaths per
year. AIDS is the leading cause of death among persons between
the ages of 25 and 44, representing nearly one in four deaths.
During the same time, rates of cancer and heart disease have
remained relatively stable.
10/09/96
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004
ID:
OCT 08'96
13:43 No 002 P.04
PH - 98
The World Health Organization (WHO) estimates that 18.5 million
adults and 1.5 million children world-wide already have become
HIV-infected and nearly 10,000 new infections occur each day.
More than 2.5 million adults, children, and infants have died.
Approximately 90% of HIV-infected individuals are in developing
countries, with Africa and now Asia bearing the greatest burden
of the epidemic.
AIDS Research Spin-offs:
AIDS research has accelerated study of the human immune system,
contributing to our understanding and treatment of many other
diseases, such as cancer and autoimmune diseases, including
lupus, diabetes, rheumatoid arthritis, and multiple sclerosis.
AIDS research has led to a better understanding of the
mechanisms by which infectious agents and inflammatory cells
gain access to the brain. This research has valuable
implications for research on Alzheimer's disease, dementia,
multiple sclerosis, neuropsychological disorders, encephalitis,
and meningitis.
AIDS research has enhanced the care of patients with other
immunodeficiency states, such as cancer patients and patients
who have received immunosuppressive therapy for bone marrow or
solid organ transplants, who are susceptible to many of the
same opportunistic pathogens.
THE WHITE HOUSE
WASHINGTON
The Clinton Administration and HIV/AIDS
In 1992, when he ran for President of the United States, Bill Clinton said he would
"provide the leadership this country needs for a loud, clear, and consistent war on AIDS." In
his first three years in office, the President has translated that pledge into action, turning around
more than a decade of governmental policies that were regarded as at best apathetic and at worst
hostile to those living with HIV/AIDS. Following are the highlights of the Administration's
HIV/AIDS-related actions taken since January 20, 1993.
AIDS Advisory Council. The President has created a 30-member Presidential Advisory Council
on HIV and AIDS to provide him and his Administration with expert outside advice on the ways
in which the Federal government should respond to the HIV/AIDS epidemic. Specifically, the
Council is charged with making recommendations in the areas of AIDS-related research,
prevention, and care.
AIDS Funding. The President has placed AIDS programs among his investment priorities. In
the three budgets he has submitted to the Congress, the President has increased total government
funding for AIDS research, prevention, and care by 40%, including a 108% increase for the
Ryan White CARE Act programs.
Anti-Discrimination. The Justice Department and the Equal Employment Opportunity
Commission have vigorously enforced provisions of the Americans with Disabilities Act that
prohibit discrimination against people with HIV/AIDS. The EEOC has received more than 900
charges alleging employment discrimination against people with HIV and AIDS and has resolved
789 charges, obtaining monetary benefits of over $6.1 million. The Health Care Financing
Administration (HCFA) has taken action on nearly 20 complaints of denial of care by health care
facilities or providers to persons with HIV/AIDS and new efforts are being made to address
discrimination in nursing homes.
Blood Safety. The Food and Drug Administration (FDA) held ground-breaking public meetings
on the use of new technologies to reduce the risk of HIV transmission by blood product
transfusion. The Administration has received the Institute of Medicine report examining the
issues surrounding transmission of HIV throughout the blood supply before 1987. The
Department of Health and Human Services has named the Assistant Secretary for Health to be
the Department's blood safety director, with overall responsibility for ensuring the IOM's
recommendations are carried out and the coordination and oversight of the Public Health
Service's blood safety programs.
Consumer Protection. The FDA is working with community organizations to prevent
fraudulent activities aimed at people living with HIV disease. To date, 10 FDA-funded
coalitions throughout the country including representatives from the community, health
professionals, and law enforcement agencies -- have been established to educate and protect
people with HIV and AIDS from fraudulent products.
3
States to provide targeted home and community-based services to people with HIV/AIDS. In
1995, those programs will serve at least 21,170 individuals. HHS also is developing prototype
waivers to help other States gain quick approval of future waiver applications.
Housing. In the last two years, the Department of Housing and Urban Development's (HUD)
Housing Opportunities for People with AIDS (HOPWA) program has provided $300 million to
communities with a high incidence of HIV infection to provide housing assistance to people
living with HIV/AIDS. HUD also has established the National Office of HIV/AIDS Housing
to assist low-income people with HIV/AIDS to pay for housing. President Clinton cited the
proposal to cut $30 million from HOPWA as one of the reasons for his veto of the fiscal year
1995 rescissions bill.
International Cooperation. The U.S. is actively cultivating international cooperation in
HIV/AIDS prevention and care through participation in the United Nations' new Joint
Programme on HIV/AIDS. Representatives of the U.S. participated in the Tenth International
HIV/AIDS Conference in Yokohama, Japan, and the World AIDS Summit in Paris and is
participating in regional conferences for Latin America and the Caribbean, Asia, and Africa.
The U.S. Agency for International Development sponsored the Third HIV/AIDS Prevention
Conference in Washington DC, which allowed for an exchange of information among diverse
prevention and care groups from around the world and resulted in an agenda of effective
prevention measures to be pursued worldwide. Through USAID, the U.S. is the largest bilateral
donor in international assistance for prevention HIV/AIDS transmission, providing more than
$120 million annually.
Mental Health. HHS awarded the first Federal grants to develop mental health services for
persons living with HIV/AIDS and their families and partners. Approximately 260,000 mental
health counseling sessions for people with HIV were reported during the last six months of 1994.
Approximately 100,000 individuals with HIV also received mental health services under the
Ryan White CARE Act.
Minority Communities. The Public Health Service convened the National Congress on the
State of HIV in Racial and Ethnic Communities, bringing together individuals and organizations
to develop plans to alter the course of HIV in those communities. The National Institutes of
Health (NIH) added four new sites to its AIDS Clinical Trials Group at institutions that serve
predominantly minority populations.
Perinatal Transmission. An NIH-sponsored clinical trial (ACTG 076) provided strong evidence
that use of AZT by HIV-positive pregnant women dramatically reduced the rate of HIV
transmission from mother to infant. The FDA expeditiously approved changes in labelling
indications for AZT to include treatment of HIV-infected pregnant women. The U.S. Public
Health Service issued guidelines in August 1994 on using AZT during pregnancy to reduce the
risk of perinatal HIV transmission. In July 1995, CDC published PHS recommendations for
routine HIV counseling and voluntary HIV testing for all pregnant women in the U.S.
Widespread implementation of these recommendations will enable women to seek and receive
2
Data Gathering. The Department of Health and Human Services (HHS) is supporting three
major efforts directed at gathering and analyzing services provided to persons with HIV disease.
The "AIDS Cost and Services Utilization Survey," the "HIV Cost and Services Utilization
Survey," and the "Hospital Cost and Utilization Project," will provide an important data base
on the cost of AIDS care and the use of health care services by people living with HIV.
Dental Care. The AIDS dental reimbursement program was expanded to address the lack of
dental care available to low-income and under-insured individuals living with HIV/AIDS. The
program, which reimburses accredited dental schools and post-doctoral dental training programs
for uncompensated costs incurred in providing oral health care to HIV-positive individuals,
includes 124 institutions in 35 states.
Disability Eligibility. The Social Security Administration published revised regulations
expanding the list of health manifestations that will be considered in determining eligibility due
to HIV/AIDS for Social Security and Supplemental Security Income disability benefits. The
agency also revised its rules to allow physicians and other health professionals to provide
information to Social Security field offices, which then can make immediate disability findings.
Drug Approval. The FDA has approved or provided new labelling indications for fifteen new
products to treat HIV or HIV-related conditions while dramatically reducing the time it takes for
drug review and approval.
Drug Development. HHS created the National Task Force on AIDS Drug Development, an
historic partnership between government, industry, academia, medicine, and AIDS-affected
community organizations to identify and eliminate barriers to the rapid development of drugs for
HIV and HIV-related conditions. The Task Force has issued 45 specific recommendations,
many of which are currently being implemented.
Early Intervention. The Agency for Health Care Policy and Research issued clinical practice
guidelines for health care professionals to assist in the evaluation and management of early HIV
infection. The guidelines stress the importance of prevention of HIV-related opportunistic
infections and the link between prevention and early diagnosis and care. A quick reference
guide for physicians and consumer guides for adults, adolescents, and the parents of children
with HIV infection was also made available. The U.S. Public Health Service provided support
for a new campaign by the National Minority AIDS Council to promote the use of prophylactic
treatment to prevent the occurrence of pneumocystis carinii pneumonia in people with HIV.
Health Benefits. Federal medical assistance programs serve nearly 50% of people living with
AIDS and more than 90% of children with AIDS. Medicaid is the largest single payer of direct
medical services, paying an estimated 25% of the aggregate cost of AIDS-related care. Under
Title II of the Ryan White CARE Act, 18 states operate health insurance continuation programs
that allow low-income people with HIV to continue their private health insurance.
Home Care. AIDS-specific Medicaid home care waivers are in place in 15 states, allowing
4
the care they need for themselves and to reduce the risk of transmitting HIV to their infants by
as much as two-thirds.
Policy Coordination. To provide a central focus for governmental efforts against HIV/AIDS,
the President created the Office of National AIDS Policy within the White House, to advise him
on AIDS policy issues and coordinate interdepartmental activities. An Interdepartmental Task
Force on HIV/AIDS, chaired by National AIDS Policy Director Patricia Fleming, was created
to assist in that effort.
Prevention. CDC has initiated a comprehensive community planning process for HIV
prevention programs, placing control of such programs in the hands of local community
organizations rather than having them dictated by the Federal government. CDC also initiated
an unprecedented review of government-funded HIV/AIDS prevention activities conducted by
panels of individuals from outside of the government. In January 1994, the Centers for Disease
Control and Prevention (CDC) launched the Prevention Marketing Initiative aimed at young
adults (ages 18-25) to change behaviors that contribute to the transmission of HIV. The
initiative features production of frank, forward-thinking public service announcements promoting
both abstinence and the consistent and correct use of latex condoms.
Research Organization. The President signed the National Institutes of Health Revitalization
Act of 1993, placing full responsibility for planning, budgeting, and evaluation of the AIDS
research program at NIH in the Office of AIDS Research. Dr. William Paul, an internationally
acclaimed immunologist, was appointed to head that office and has developed the first
comprehensive plan and budget for AIDS research.
Ryan White CARE Act. In the three budgets he has sent to Congress, the President has
increased funding for the Ryan White CARE Act by 108%, fulfilling the President's promise
to fully fund that program. During the last two years, the number of metropolitan areas eligible
for assistance under Title I of the Ryan White CARE Act has increased from 25 to 49.
Preliminary data indicate that approximately 360,000 clients were served under Title I of the
Act. Eighty percent of U.S. metropolitan areas report providing new or expanded Ryan White
services to people living with HIV, including HIV/AIDS drug assistance; services for women,
children, and other special needs populations; and expanded rural services. All 54 states and
territories are currently funded under Ryan White Title II, serving an estimated 296,000 clients
with those funds. Title III(b), which pays for counseling, testing, and early intervention
services, including treatment, served more than 175,000 clients, including a large number of
women and minorities. Currently, 144 community-based organizations, located in 33 states, the
District of Columbia, and Puerto Rico, are supported with Title III(b) funds. Title IV develops
comprehensive coordinated care systems linked to clinical research in more than 80
communities, meeting the unique needs of children, youth, women, and families.
Reauthorization of the Ryan White CARE Act is a top priority for the Administration in 1995.
Treatment. The NIH Preclinical AIDS Drug Screening Program has screened 72,000 potential
agents for treatment of HIV disease and approved six compounds for Phase I clinical trials. NIH
5
clinical trials involve more than 45,000 HIV-infected individuals. Several promising HIV
protease inhibitors and potent combination drug regimens are slated to begin Phase III efficacy
trials in the near future. Thousands of other HIV-positive individuals are receiving promising
investigational therapies through clinical trials and various expanded access programs.
Vaccines. The NIH has significantly expanded its basic research efforts to design new
approaches to developing AIDS vaccines. It is now evaluating 14 vaccine candidates to identify
those that might be appropriate for efficacy trials. The Department of Defense is also
developing and testing several candidate HIV vaccines to protect U.S. military personnel.
Veterans. The Department of Veterans Affairs (VA) provides care to nearly 17,000 veterans
with HIV-related diseases. The VA operates four specialized AIDS Clinical Units in New York
City, Miami, West Los Angeles, and San Francisco medical centers. AIDS research is
conducted at 85 medical centers, comprising over 800 individual research projects Specialized
AIDS Research Centers dedicated to conducting HIV research are located in New York City;
Durham, NC; San Diego CA; and Atlanta. VA AIDS research is funded by about $6 million
in VA research funds and over $24 million in extramural grants. VA also maintains a national
AIDS data base to track the epidemic within the veterans' population.
Water Safety. The Centers for Disease Control and Prevention and the Environmental
Protection Agency issued guidance for vulnerable populations recommending steps to purify
drinking water to protect against Cryptosporidium, which can be fatal to those with compromised
immune systems. These agencies have also conducted research and outreach about threats of
water-borne diseases to such individuals through funding and hosting several workshops and
training programs.
Women and AIDS. The NIH created a Women's Interagency HIV Study to identify the nature
and rate of HIV disease progression in women. NIH requires that women and members of
minority groups be included in all NIH supported biomedical and behavioral research involving
human subjects. NIH has initiated a major research effort to develop female-controlled barrier
methods, including vaginal compounds, to prevent HIV transmission.
###
January 31, 1996
MEMORANDUM TO JENNIFER KLEIN
FROM:
RICHARD SORIAN
SUBJECT:
AIDS RESEARCH FUNDING HISTORY
Background
As discussed in brief in the "Administration Accomplishments" document, the President has
sharply increased funding for AIDS research. In his three years in office, funding for AIDS
research has increased by 26 percent. That includes a 6 percent increase in the FY1996
budget approved by the Congress.
The President also moved to strengthen the authority of the Office of AIDS Research (OAR)
at NIH, as part of the NIH Revitalization Act of 1993. That law provides OAR with direct
authority to determine the research budgets of each institute and allocate AIDS research
funding accordingly. It also required the hiring of a separate director of OAR (Tony Fauci
had been director while also running NIAID). Dr. William Paul, a noted immunologist, was
named director in 1994.
Recent Action
Congress included NIH in the full-year CR approved at the beginning of January. In doing
so, it actually exceeded the President's request for NIH by $175 million. Based on that, it is
assumed that Congress approved at least the $1.4 billion for AIDS research that the President
requested.
There is, however, continuing controversy about whether or not the Congress provided the
OAR with authority to allocate the AIDS research dollars. The House version of the bill
(which was approved by the full House) did not include such authority; the Senate version
(which cleared committee but did not reach a floor vote) did include the authority. House
staff believes the CR did not include the authority; Senate staff does believe it includes the
authority; NIH isn't sure. We are, however, proceeding with plans to allocate the AIDS
research funds according to the plan laid down by Dr. Paul. This is an issue of great
concern to the AIDS community as a whole.