Senators Burr, Sessions, and Coburn Call for More Equitable Ryan White CARE Act HIV/AIDS Funding

WASHINGTON, D.C. - U.S. Senators Richard Burr (R-NC), Jeff Sessions (R-AL), and Tom Coburn, MD (R-OK) today called for more equitable distribution of Ryan White CARE Act funds, saying the funding disparities and the elevated rate of new HIV/AIDS infections among Southern rural and minority populations must be addressed. Currently, Southern states, which now account for a majority of HIV/AIDS cases in the nation, are being shortchanged in Ryan White CARE Act funding.

The three senators raised the issue at a news conference sponsored by the National Minority Health Month Foundation and the Southern AIDS Coalition.

Ryan White CARE Act funding provides medical care, anti-retroviral treatments, counseling and testing, and other services for HIV/AIDS patients.

"Ryan White CARE Act funding must be distributed more equally among states. North Carolina's waiting list for the AIDS Drug Assistance Program has been close to 1,000 in recent years. This is unacceptable," Burr said. "The Ryan White CARE Act exists to protect and support those living with HIV and AIDS. In North Carolina, we have approximately 18,900 residents living with HIV and AIDS. It is time for Ryan White funds to be distributed more evenly so all patients, not just those living in New York, San Francisco and Boston, can receive the care they need."

A recent Government Accountability Office (GAO) investigation found that several funding schemes in the current Ryan White CARE Act program discriminate against rural and Southern states. States with large metropolitan areas benefit from "double counting" in which those with AIDS who live in cities are counted twice—once under title I (large metropolitan area CARE Act funding) and again under title II (state CARE Act funding). Funds are currently being distributed based upon cases of AIDS, the end stage of HIV infection, rather than cases of HIV and AIDS. Those living with HIV in Southern states represent the emerging epidemic and therefore are not counted in CARE Act federal funding formulas. Finally, while shortchanged Southern states have been forced to implement waiting lists and other restrictions for AIDS drugs, GAO found that at least one metropolitan area—San Francisco—receives funding for dead people and is provided twice the amount of funding per AIDS cases as every other area.

"It is time for HIV and AIDS patients to receive equitable treatment regardless of where they live," Sessions said. "Geography should not be a death sentence, and the South in particular has gotten the short end of the stick. Right now Alabama's patients receive far less assistance than those in big cities, even though Alabama's HIV rate is above the national HIV rate. Lives are on the line and I am committed to moving this legislation forward so that patients in Alabama and every state receive fair funding."

Senator Coburn, a physician who has treated patients with HIV over the past two decades, stated "Congress should put the lives of all those living with HIV ahead of petty parochial and political interests that have stalled the CARE Act reauthorization for the past year and pass the compromise bill before October 1. It is unacceptable that federal funding is being allocated for dead people in one area, while patients in other areas are literally dying on waiting lists for AIDS drugs. The CARE Act must be updated to ensure access to treatment for all Americans living with HIV, promote early diagnosis, and provide more equitable funding that reflects the face of HIV/AIDS today. The discrimination that renders Americans living with HIV in rural and Southern states as having only a fraction of the worth of those living elsewhere must end."

The South has been particularly hard hit in recent years, with seven of the nation's 10 highest AIDS rates located in the region. Most of the growth is occurring in the African American population, especially among African American women. The Centers for Disease Control and Prevention estimates about 40,000 people in the United States become infected with HIV each year, and more than 1 million Americans currently have HIV/AIDS. Over 500,000 Americans have died as a result of AIDS.

North Carolina has approximately 18,900 people living with HIV or AIDS. In 2004, 66.7% of people living with AIDS in North Carolina were African Americans, the 5th highest rate in the nation. North Carolina currently ranks 14th among states with the greatest number of AIDS cases in the nation.

Alabama has more than 10,000 people living with HIV. Another 5,000 may also be infected, but they don't know their HIV status. While African Americans make up about 26 percent of Alabama's population, they account for over 70 percent of new HIV/AIDS cases. Further, a third of all new infections are among women of childbearing age. And unfortunately, the South has the highest death rate from AIDS of any area in the country.

The Ryan White CARE Act Reauthorization (S. 2823) legislation was favorably voted out of the Senate HELP Committee in May with only a single dissenting vote. It is awaiting action by the full Senate.

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