December 12, 2003

This Week In Washington
1. Congress Adjourns for the Year without a Federal Budget
2. New State Department Global AIDS Coordinator Meets with Advocacy Groups
3. NORA Holds Monthly Meeting

In the News
1. CAEAR Coalition Foundation Reports Impact of Minority AIDS Initiative
2. D.C. to Increase Free Condom Distribution to Prevent HIV

Announcements
1. AIDS Vote Invites Individuals/Organizations to Endorses HIV Platform
2. PACHA Subcommittee to Host Town Hall Meeting
3. Solutions in Correctional Health Care Explored

This Week in Washington
1. Congress Adjourns for the Year without a Federal Budget
Congress has adjourned the first session of the 108th Congress without a federal budget in place for this fiscal year, which began on October 1, 2003. Although the House passed the $820 billion omnibus bill on Monday, December 8 by a vote of 242-176, the Senate did not pass the bill by voice vote on Tuesday, December 9, as Majority Leader Bill Frist, (R-TN) had hoped.

The omnibus spending package contains the seven unfinished appropriations bills for fiscal year (FY) 2004 (by placing bills into a single “package,” Congress can pass all the bills with a single vote, rather than voting on each one separately). The unfinished bills contained in the omnibus package are as follows: 1) Labor, Health and Human Services and Education (HR 2660), which includes funding for Ryan White CARE Act programs, the Centers for Disease Control and Prevention, and the National Institutes for Health; 2) Foreign Operations (HR 2800), which includes $2.4 billion in funding for global AIDS programs; 3) Veterans Affairs, Housing and Urban Development (HR 2861), which includes funding for HOPWA (Housing Opportunities for Persons with AIDS; 4) Commerce-Justice –State (HR 2799); 5) District of Columbia (HR 2765); 6) Transportation and Treasury (HR 2989), and 7) Agriculture (HR 2673).

The omnibus bill package includes $492 billion for mandatory programs (i.e., Congress is required, by law, to fund) as well as $328 billion in discretionary spending (which is non-mandatory and determined on an annual basis) for the departments of Agriculture, Commerce, Education, Health and Human Services, Housing and Urban Development, Justice, Labor, State, Transportation, Treasury and Veterans Affairs, as well as for programs in government agencies as diverse as National Aeronautics and Space Administration (NASA), the Environmental Protection Agency (EPA) and the Peace Corps; the District of Columbia; and the White House

The Senate will vote on the omnibus package upon its return to Washington D.C. after the Congressional holiday break. Currently, Congress is scheduled to reconvene on Tuesday, January 20, 2004. The agencies whose funding is included in the omnibus will continue to operate under a Continuing Resolution (CR)–which will fund the government at FY 2003 funding levels until a budget for FY 2004 is passed. The current CR expires on January 31, 2004

To link to the full omnibus conference report, go to http://thomas.loc.gov/cgi-bin/cpquery/R?cp108:FLD010:@1(hr401).

2. New State Department Global AIDS Coordinator Meets with Advocacy Groups
On Wednesday, December 10, AIDS an ad hoc group of Washington, DC health advocacy organizations, including AIDS Action, was granted a meeting with the new State Department global AIDS coordinator, Ambassador Randall Tobias, who just returned this Monday from a the second of two trips since to Africa since assuming his new role at the State Department.

Going into the meeting, attendees wished to cover a number of topics, many of which related to the recently released request for proposals (RFP) for the President’s Emergency Plan for AIDS Relief (PEPFAR). These topics including the following: HIV prevention programs, the role of public-private partnerships, and Tobias’ thoughts on the capacity of countries and organizations’ to effectively use funds they receive through the global AIDS program.

Tobias immediately acknowledged how important it was for him to meet with the Washington-based groups and stressed the value of community input in crafting the U.S.-based response to the global HIV pandemic. This notwithstanding, he reminded meeting attendees that President’s Emergency Plan for AIDS Relief is still in its infancy. His official appointment by the U.S. Senate to global AIDS coordinator occurred only 60 days ago, and he was still trying to gain a mastery of the AIDS pandemic and its effects. Further, the new initiative does not officially have operating funds yet (for more information on this matter, see the item 1 of this section). For these reasons, some questions cannot yet be answered.

Although he admitted that the President’s Emergency Plan for AIDS Relief was still in its development stages, Tobias expressed his intention to get operations up and running as soon as possible. The goal is to make decision on the proposals by the middle of January when, ideally, the funds will be available. In granting contracts, Tobias and his staff seek to establish a varied response to the pandemic. They recognize that HIV affects countries and their inhabitants in myriad ways, and the different circumstances in each country will necessitate a different response. For example, he asserted that the three-pronged approach to HIV prevention—ABC (Abstinence, Be faithful, and Condom use)—will need to be prioritized and utilized in different combinations in each population, depending on how HIV is transmitted in that particular population. In the end, Tobias stated, a balanced approach to the pandemic will be needed.

Tobias also pointed out that successful treatment, care, and prevention efforts will require addressing many other international development issues, such as nutrition, sanitation, healthcare infrastructure, and education. The global AIDS program will address some of these issues as needed, but Tobias also believes that a “line” will have to be drawn on these efforts; that is, the global AIDS program needs to be focused on HIV/AIDS; it should not become a broad-based development program. This being said, he stated that his program would also be working toward increased coordination with other international development programs, the private sector, and the governments of the recipient countries to ensure that all needs related to living with HIV, no matter how varied, would be met.

Ambassador Tobias closed the meeting by saying that he was not appointed to be the “14- country AIDS coordinator,” but to be the United States global AIDS coordinator; thus, he will oversee all U.S. global AIDS work. He and his staff plan to create more mechanisms by which the President’s Emergency Plan for AIDS Relief can benefit from community input as the program moves forward. To find out more about the State Department’s Office of the Global AIDS Coordinator, go to http://www.state.gov/s/gac/. To learn about the current requests for proposal from the Office of the Global AIDS Coordinator, go to http://www.state.gov/s/gac/rl/fs/26982.htm.

3. NORA Holds Monthly Meeting
On Monday, December 8, the National Organizations Responding to AIDS (NORA) coalition, for which AIDS Action serves as the convener, held its monthly meeting. The primary focus for this month’s meeting was an update on the global AIDS-related activities of the United States Agency for International Development (USAID) and the new Office of the Global AIDS Coordinator at the Department of State. Gabrielle Bushman of USAID was this month’s featured speaker.

Ms. Bushman provided coalition members with a through overview of the progress that has been made to date on the implementation of PEPFAR – the President’s Emergency Plan for AIDS Relief (which was authorized by the global AIDS bill – H.R. 1298). She shared that USAID and the Department of State have planned for two implementation tracks. The first track has two steps: 1) the announcement and awarding of grants in four key areas and 2) the development of initial, 12-month operational plans. The first set of grants for implementation of PEPFAR will be made in four areas: 1) Support to orphans and vulnerable children affected with HIV; 2) HIV/AIDS prevention through abstinence and behavior change for youth; 3) rapid expansion of antiretroviral therapy programs for HIV-infected persons; and 4) rapid strengthening of blood transfusion services in selected countries. The first two will be managed by USAID, the others by the department of Health and Human Services. In addition, the federal government will be working with the governments of all fourteen countries that have been identified to receive PEPFAR funding to develop a 12-month operational plan for beginning implementation of these programs.

The second track involves development of a five-year implementation plan. Again, this will be done on a country-by-country basis and coordinated by the office of the Global AIDS Coordinator.

In addition, Ms. Bushman shared information regarding the structure of the new office of the Global AIDS Coordinator, Ambassador Randall Tobias. She told coalition members that, ultimately, the office will have a staff of roughly 60 people and will be led by Ambassador Tobias and the two deputy coordinators – Dr. Joe O’Neill and Ambassador John Lange.

For more information about USAID’s global AIDS programs visit: http://www.usaid.gov/pop_health/aids/index.html. For more information about the Office of the Global AIDS Coordinator visit http://www.state.gov/s/gac/.

After Ms. Bushman’s presentation, coalition members heard an update on the status of the fiscal year 2004 appropriations process from Donna Crews of AIDS Action (for more news on the appropriations process, please see article 1 in this section). The coalition also held an election to fill vacant seats on NORA’s Executive Committee. Donna Crews of AIDS Action, Pat Hawkins of the Whitman Walker Clinic, Jim Harvey of the HIV Community Coalition, and Marcela Howell of Advocates for Youth were elected to the 2004 Executive Committee.

For more information about NORA, email Jessica Tytel, NORA Coordinator, at jtytel@aidsaction.org.

In the News
1. CAEAR Coalition Foundation Reports Impact of Minority AIDS Initiative
The Communities Advocating Emergency AIDS Relief (CAEAR) Coalition Foundation released a report on December 4: The Minority AIDS Initiative in CARE Act Title I Communities. The report documents the impact that new funding in the Minority AIDS Initiative (MAI) has had on Title I grantees of the Ryan White CARE Act. In addition, the report provides an overview of the level and use of Minority AIDS Initiative (MAI) funds by grantees who, like all Title I grantees, are located within one of 51 metropolitan areas with populations of 500,000 or more and at least 2,000 reported AIDS cases in the past five years.

A press release issued by the CAEAR Coalition Foundation on December 4 noted that the new funds, which are federal dollars, have had an important [and positive] impact on the availability of services and access to care for people of color with HIV; the attention that the service needs of HIV positive people in minority populations receive during the community planning process; and the capacity of minority community-based organizations to serve these populations. More precisely, eighty-eight percent of the Title I grantees who receive MAI funding report MAI improved the capacity of minority community-based organizations to serve people of color living with HIV. Eighty-one percent report that MAI helped increase the number of new minority clients.

The MAI was created in 1999 to address the disproportionate impact of HIV in communities of color and improve HIV related-health outcomes, and over the past five years, MAI funding for Title I has grown from $5 million in fiscal year (FY) 1999 to $43.8 million in FY 2003, the CAEAR Coalition Foundation report noted. “Public health officials on the front lines of this epidemic have witnessed firsthand how the Minority AIDS Initiative has expanded access to care for people of color living with HIV/AIDS and strengthened the role of minority organizations that served them, Antigone Hodgins, executive director of the CAEAR Coalition Foundation stated. She continued: “By focusing public attention on the needs of disproportionately affected minority communities, the MAI has served as a lifeline in urban areas hardest hit by the epidemic.”

In reporting on the level and use of MAI funding, over fifty percent of the grantees reported “significant challenges” implementing the MAI initiative. These include the collection of outcome data at the client level, the requirement that capacity-building activities be linked to outcome data, and accommodating shifting federal requirements regarding the use of MAI funds. Yet, Hodgins noted, “Title I-funded communities continue to rise above the challenges they face in an effort to make sure that these funds improve the lives of people of color living with HIV/AIDS and expand care available to those most in need.”

To access the full CAEAR Coalition report, link to http://www.caear.org/docs/maireport.pdf.

2. D.C. to Increase Free Condom Distribution to Prevent HIV
On Tuesday, December 2, The Washington Post announced an unparalleled plan by Washington, DC officials to install dispensers, which will offer condoms for free, in select government offices. The initiative is part of the capital city’s efforts to reduce HIV transmission; the city currently has the highest incidence of HIV in the nation.

The D.C. plan is to place more than fifty dispensers in city offices that are visited by the public, such as the Department of Motor vehicles and the D.C. Housing Authority. According to The Washington Post, city officials had indicated that they knew of no other city or state that has distributed prophylactics so broadly from within government buildings.

Over the next twelve months, the city also plans to distribute about 550,000 condoms, 45,000 dental dams and 30,000 female condoms in other venues, including public schools. The D.C. government, which has been providing free condoms to beauty salons, barbershops, and nightclubs, will step up these efforts as well.

Although the plan was greeted with enthusiasm by D.C. Council members and HIV-prevention advocates, it received sharp criticism from others, including Deborah Simmons, a columnist with The Washington Times. On Friday, December 5, she wrote, “Gone are the days when men had to visit a drug store to buy condoms—behind the counter and next to the nudie mags. Nothing is hush-hush. Everything (disgusting and morally wrong) is out in the open.” She added, “The D.C. government’s liberal policies encourage pregnant teens to strut with their huge bellies, worrying not one iota about who will nurture her off-spring because there always is a good government program to take care of them.” She later opined, “Condom promotion has its place. But the government should not be its chief promoter, encouraging bad behavior.”

This Wednesday, December 11, The Washington Times followed up this opinion piece by printing a letter that was submitted by A. Cornelius Baker, executive director of Whitman-Walker, the leading HIV service provider in the Washington, DC area and an AIDS Action Council Board member. In his letter, Mr. Cornelius countered, “Like it or not, many unmarried people and people young and old in non-monogamous relationships are sexually active. For example, studies show that approximately two-thirds of high school students have engaged in sexual intercourse by the time they graduate.” He also noted, “There are more than 15 million new cases of sexually transmitted diseases in the United States every year. That statistic alone is indication of the serious consequences of unprotected sex. Providing sexually active people of any age with access to comprehensive sexual health education and information, including the importance of correct and consistent use of condoms, is a sensible and responsible way to help sexually active people protect themselves against HIV infection. Simply giving away condoms is not going to stop the spread of HIV, but it is a critical component of HIV prevention.” In conclusion, Mr. Baker informs readers, “The answer [to HIV] is to face the fact that we are all sexual beings who need both information and the tools necessary to prevent HIV infection.”

To read the article on D.C.’s HIV prevention plans, link to http://www.washingtonpost.com/wp-dyn/articles/A26814-2003Dec1.html; to read the column by Deborah Simmons, go to
http://www.washingtontimes.com/op-ed/20031210-083123-5469r.htm; and to read A. Cornelius Baker’s letter to the editor, visit
http://www.washingtontimes.com/op-ed/20031204-083400-5602r.htm.

Announcements
1. AIDSVote Invites Individuals/Organizations to Endorse HIV Platform
On World AIDS Day, December 1, 2003, HIV service, advocacy, and research organizations launched a new Web site in anticipation of the 2004 presidential election next year. The Web site, AIDSVote.org, offers recommendations on how the next president can improve HIV related public policy, both domestically and globally. The policy recommendations have been developed and/or endorsed by numerous HIV advocacy, service, and research organizations. The site’s organizers have also submitted questionnaires to the candidates to fill out, and the responses they receive will be shared on the Web site. AIDSVote.org invites organizations and individuals to visit the Web site, and review and endorse the platform.

“Visit AIDSVote.org now to see what dozens of the leading HIV/AIDS organizations demand of our next president and to endorse the platform, said Paul Feldman of the National Association of People With AIDS—one of AIDSVote’s endorsers. He continued, “Come back to AIDSVote.org in a few weeks to see how presidential candidates respond to questionnaires which will demonstrate the extent of their knowledge and commitment to ending the AIDS pandemic.”

To learn more about AIDSVote, link to http://www.aidsvote.org.

2. PACHA Subcommittee to Host Town Hall Meeting
The Department of Health and Human Services has announced that the International Subcommittee of the Presidential Advisory Council on HIV/AIDS (PACHA) will host a town hall meeting. Open to the public, the meeting will be held in Washington, DC on Thursday, December 18 from 1 p.m. to 5 p.m. in the National Press Club’s Main Ballroom (on the 13th floor). The National Press Club is located at 529 14th Street, NW. Directions to the National Press Club can be obtained on the Press Club Web site at http://www.press.org/ or by calling (202) 662-7500.

Information about PACHA and the draft town hall meeting agenda will be posted on the Council's Web site at http://www.pacha.gov/.

For further information on the meeting, contact Josephine Bias Robinson, acting executive director, Presidential Advisory Council on HIV/AIDS at the Department of Health and Human Services, 200 Independence Avenue, SW,
Room 701H, Washington, DC 20201. She can also be reached by phone at(202) 690-5560.

Please call the OHAP office, (202) 690-5560, to register if you are interested in attending.

3. Solutions in Correctional Health Care Explored
The American Correctional Association (ACA) will be holding an event in New Orleans, LA on Monday, January 12 at 2:15 p.m. (CST). Entitled Correctional Health Care Solutions Through Partnerships will bring together leading experts from both the public health and correctional communities to discuss health providers, inmate organizations, and community advocacy groups to improve the health of the nation’s inmate population. ACA will also make the event available online at http://www.aca.org.

Featured speakers will include the Honorable Vice Admiral Richard H. Carmona, MD; MPH, FACS, Surgeon General of the United States; and Ed Thompson, MD, MPH deputy director for public health services, Centers for Disease Control and Prevention. Both will discuss issues relating to the role of public health in providing services to populations both within and leaving correctional settings, including HIV. Also featured will be Patricia L. Caruso, director of the Michigan Department of Corrections, who will represent correctional administrators; the Honorable Jacquelyn Barrett, sheriff of Fulton County, GA, who will represent local detention/jail administration; and Dr. Fred Maue, chief of clinical services for the Pennsylvania Department of Corrections.

For more information about th e event, contact Joe Weedon, ACA’s director of Government Affairs, at (301) 918-1885 or by e-mail at joew@aca.org.

The AIDS Action Weekly Update
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