National Journal examines advocates,' lawmakers' efforts to create domestic HIV/AIDS plan

The National Journal on Saturday examined the efforts of some lawmakers and advocates to call for "renewed attention" to the HIV/AIDS epidemic in the U.S., including pushing for a national plan to address the epidemic.

According to the Journal, the recent reauthorization of the President's Emergency Plan for AIDS Relief by Congress -- which committed an additional $48 billion in spending on global HIV/AIDS over the next five years -- as well as a recent CDC report that estimated there were 56,300 new HIV infections in the U.S. in 2006, have given advocates "momentum." However, advocates are waiting to see if the momentum "translates into action," specifically the creation of a domestic HIV/AIDS plan "on par with PEPFAR, " the Journal reports.

Some advocates are calling on Congress to streamline domestic HIV/AIDS services so that agencies responsible for such services are working together under one plan. Most domestic HIV/AIDS funding goes to Medicare and Medicaid. Other agencies -- such as CDC, NIH and the Health Resources and Services Administration -- also share domestic HIV/AIDS funding. CDC attempted to create a national plan in 2001 but it was not fully implemented, the Journal reports. However, CDC's plan has been extended until 2010. President Bush recently requested $753 million for CDC's HIV/AIDS domestic budget for 2009, but there have been calls to increase prevention funding.

Financial services bills pending in both houses of Congress include funding for the White House Office of National AIDS Policy to develop a national plan. A version of the legislation that passed a Senate appropriations subcommittee in July included $1.4 million for the office to develop the plan. In addition, a resolution recently introduced by Rep. Barbara Lee (D-Calif.) and Sen. Hillary Rodham Clinton (D-N.Y.) calls for the creation of a national strategy.

Comments

Julie Scofield, executive director of the National Alliance of State and Territorial AIDS Directors, said that instead of having each AIDS relief agency work on their its own strategies, "the nation needs a road map that promotes synergy between agencies."

Chris Collins, an HIV/AIDS consultant who wrote a national strategy plan for the Open Society Institute, said that in order for a national plan to be strategic, clear benchmarks must be outlined and responsibilities assigned. Thomas Coates, director of the University of California-Los Angeles Program in Global Health, said "We need a strategy that's not a little bit of something for everyone but that's specifically focused on the populations and the geographic areas where HIV is spreading most rapidly."

A report released by the Black AIDS Institute in July criticized Congress for its lack of attention to the disproportionate affect that HIV/AIDS is having on blacks in the U.S. According to the Journal, blacks account for almost half of new cases of HIV/AIDS although they account for 12% to 13% of the total population (Johnson, National Journal, 9/20).