05.03.06

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

U.S. Senators Jeff Sessions (R-AL), Richard Burr (R-NC) and Tom Coburn (R-OK) today called for a more equitable distribution of HIV/AIDS funding, saying that rural areas - particularly in the South - are being shortchanged at the expense of large metro areas.

The three senators raised the issue at a news conference. Sessions and Burr are members of the Senate Health, Education, Labor and Pensions Committee, which later this month is scheduled to reauthorize the 1990 Ryan White CARE Act, the main federal HIV/AIDS spending law. Coburn has introduced a stand-alone bill that would readjust the distribution formula.

Ryan White CARE Act funding provides medical care, anti?retroviral treatments, counseling and testing for HIV/AIDS patients who need it the most.

"Why do states like Alabama have waiting lists for people to get basic drugs while places like New York, Houston and San Francisco have so much money that they provide acupuncture, massage therapy, dog-walking and 'companion services'? Ryan White himself would not get the proper funding under the current funding formula," Sessions said, referring to the Indiana teenager who died in 1990 after contracting AIDS from hemophilia treatments.

HIV/AIDS funding formulas direct a great deal of money to "eligible metropolitan areas" - cities with populations of at least 500,000 with more than 2,000 reported AIDS cases in the past five years - rather than simply allowing money to follow HIV/AIDS patients in each state. This two-tiered system allows eligible metropolitan areas to get direct money from the federal government, on top of state funds.

According to a June 2005 Government Accountability Office report, some states receive $1,500 more than other states per AIDS case, thanks to the formula that favors big cities.

"Ryan White CARE Act funding must be distributed more equally among states. Southern states like North Carolina have been historically underfunded and yet the South continues to have one of the highest numbers of AIDS cases," Burr said. "The Ryan White CARE Act exists to protect and support those battling HIV and AIDS. It is time for Ryan White funds to be distributed more evenly so all HIV and AIDS patients benefit and not just those patients living in the largest urban areas."

"The U.S. federal government will spend over $20 billion on HIV/AIDS related programs this year alone. There is no acceptable reason why we should deny any American living with HIV access to medically necessary care. Yet under current federal formulas, San Francisco is receiving funding for those who died over a decade ago while patients in rural America are literally dying awaiting access to medication on AIDS Drug Assistance Program waiting lists," Coburn said.

The South has been particularly hard hit in recent years, with seven of the nation's 10 highest AIDS case rates located in the region. Because Alabama has no "eligible metropolitan area," the state receives $3,657 per AIDS patient in federal money, compared to $5,264 per patient in California.

In 2004, the latest year for which statistics are available, Alabama had 5,729 cumulative HIV cases and 7,744 cumulative AIDS cases. Alabama is one of several states with a federal AIDS Drug Assistance Program waiting list that at times has swelled to more than 600 patients. Alabama ranks 13th in cumulative HIV cases and 24th in cumulative AIDS cases.

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

As of January 1, 2006, there were 4,442 reported cases of HIV/AIDS in Oklahoma. While there currently is no ADAP waiting list, the state has enacted caps on the number of enrollees and expenditures per enrollee due to funding shortfalls.

The Centers for Disease Control estimates that about 40,000 people in the United States become infected with HIV each year, and that more than 1 million Americans currently have HIV/AIDS. African Americans account for half of all new AIDS cases, and African American women account for two thirds of new AIDS cases among women.