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January 15, 2004
Dear Mr. President: I am writing to ask you to provide our nation with an update on the achievements in the United States’ response to the domestic HIV epidemic since you became President. My request is made on behalf of the diverse membership of AIDS Action: a national organization based in Washington, DC that represents AIDS service organizations, local health departments, and research groups across America. Specifically, we at AIDS Action are requesting that you provide such an update in this year’s State of the Union address. As the executive director of AIDS Action, I, along with the Board of Directors and our membership, have experienced an incredible year in the U.S.-driven, global response to HIV due to your leadership. While in attendance at your State of the Union address one year ago, I witnessed an amazing step in America’s response to HIV/AIDS. As a result of your leadership, the federal government has mobilized to launch the unprecedented, five-year, $15 billion Emergency Plan for AIDS Relief—an extraordinary step in the response to the global pandemic. Yet such developments in our country’s response to the global HIV pandemic cannot be accurately assessed without also examining the current state of the domestic epidemic. AIDS Action was pleased to see you recognize this fact in your January 2003 address, shortly after you delivered the State of the Union address, when you announced the CLIA-waiver for the rapid test. Again you showed a clear understanding of the importance of speaking directly to the American people by inviting America to get tested for HIV so that our medical system could extend treatment to those who need it in our country. In addition, you directly addressed the urgent needs for new monies by announcing an increase in your budget for the AIDS Drug Assistance Program (ADAP), America’s commitment to making life-saving drugs available to HIV-positive people who cannot afford them. One year later, unfortunately, the U.S. continues to face obstacles in its attempts to decrease the number of new infections and properly care for all individuals living with the disease here at home. The increase for ADAP funds, as it currently stands in the FY 2004 omnibus appropriations bill, is only $39 million—far short of the $215 million necessary to supply drugs to all Americans who need access to the life-saving program. Furthermore, the implementation of the rapid test has faced incredible obstacles related to proper training, cost, and state regulations for HIV-testing. As a nation, we are nowhere near realization of the full benefits of the rapid test. Finally, we must clear these obstacles amidst rising rates of HIV infections and AIDS cases. AIDS Action and the broader HIV/AIDS community recognize the proactive steps that the Centers for Disease Control and Prevention has taken in moving to implement its new Advancing HIV Prevention initiative, which calls for making HIV testing a part of standard medical care and places an increased priority on preventing new HIV infections by educating those living with the virus. This new direction, albeit long overdue, leads to some concerns. Perhaps most pertinent is the concern that the identification of new cases of HIV will require increased funding to care for them. We know that federal dollars are integral to sustaining and advancing the HIV care system in our country. We also know that federal discretionary funding for healthcare programs is currently suffering, while many other necessary programs compete for the limited allocation of funds provided in the strained U.S. budget. Consequently, we must ask ourselves the question: How will the public healthcare system accommodate the additional number of people who must come into care? AIDS Action requests that you respond to this question and our related concerns about the domestic HIV epidemic in your upcoming State of the Union address in order to give the country an update on where we stand in our response to this disease that still affects approximately 900,000 people in the United States. In addition, we would like to see you, the Secretary of Health and Human Services, and the Surgeon General address this matter for the general public with more frequency and visibility. If our nation’s goal is to make HIV testing in medical settings routine, then we need to continually inform and update all Americans by making the discussion of HIV and AIDS common in everyday conversation as well as official presentations. For evidence of how effective this strategy can be, one only needs to look to the success of Uganda. President Yoweri Museveni speaks directly to the citizens of Uganda—not once a year in an official address, but every time he speaks, he speaks clearly and demonstrably about their need to know their HIV status, remain abstinent as young people, be faithful to their partners, and use condoms when they choose to be sexually active. We encourage you, Mr. President, and your senior public health officials to do the same. I would like to close this letter by again recognizing your outstanding leadership to turn the tide against the global HIV pandemic over the past twelve months. Almost a year ago today, your words gave hope to those living with HIV around the world. AIDS Action’s Board and staff were honored to work with your Administration to support the bill’s passage and attend the bill-signing, where I met you and conveyed our appreciation for your leadership. We are all pleased to see the proposed global AIDS initiative continue to evolve into a groundbreaking humanitarian aid program and we look forward to continuing to work with Dr. Joesph O’Neill and the rest of the team at the Office of the Global AIDS Coordinator. We urge you to keep the domestic epidemic at the forefront of your attention and your addresses as you speak to the nation. As always, we remain available to work with you in crafting a successful response to HIV; here in the United States, and abroad. Sincerely,
Marsha A. Martin, DSW
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