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Overview of Key AIDS Issues I. Status of the Epidemic More than 500,000 people have been diagnosed with AIDS in the United States. More than 300,000 have already died. An estimated 600-900,000 Americans are living with HIV infection. New York City has been particularly hard hit by the several "waves" of the epidemic. It has dramatically affected gay and bisexual men in New York, as well as substance abusers and their partners. The Centers for Disease Control now estimates that at least half of all new infections of HIV are related to substance abuse. New York City is one of the hardest hit jurisdictions. Almost 84,000 people in NYC have been diagnosed with AIDS. II. Key Accomplishments of the Clinton Administration AIDS Funding: In the four budgets submitted to Congress, the President has increased total government funding for AIDS research, prevention, and care by 43%, including a 132% increase for the Ryan White CARE Act. Research funding has increased by 34%; AIDS prevention by 24%; and AIDS housing assistance by 42%. These increases have occurred in the context of almost flat discretionary spending. Drug Approval: The FDA has approved or provided new labelling indications for 17 new products to treat HIV or HIV-related conditions while dramatically reducing the time it takes for drug review and approval. A new class of antiretroviral drugs, known as protease inhibitors, were approved in record time. Defense of Medicaid: Nearly 50 percent of all people living with AIDS are on Medicaid; over 90 percent of children with AIDS are on Medicaid. The defense of the entitlement status of Medicaid has been critical to the AIDS community. Focusing of the Research Effort: 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. The Administration has fought strongly to support the budget authority of the Office of AIDS Research in the face of opposition from some Congressional Republicans. III. Key Issue: Ryan White CARE Act On Monday, the President signed into law the reauthorization of the Ryan White CARE Act. This extends for five years a program vital to the lives of people living with HIV and AIDS. The CARE Act serves more than 300,000 people nationwide. It is designed to support