| January
30, 2004
This
Week In Washington
1 The CDC Coalition Meets with Dr. Julie Gerberding in Washington
2. Southern AIDS Coalition Holds Hill Briefing
In
the News
1. Bush’s Anticipated Budget Request for Global AIDS Relief Draws
Mixed Reviews
Announcements
1. Kaiser Family Foundation Brings Online Spotlight to Election
2004
2. NAPWA Invites HIV Positive Advocates and AIDS Service Organizations
Who Organize HIV Positive Advocates to
3. AIDS Vaccine Advocacy Coalition Launches Online Information
Clearinghouse
This Week in Washington
1. The CDC Coalition Meets with Dr. Julie Gerberding in Washington
On January 22, the Centers for Disease Control and Prevention
(CDC) Coalition, a group that monitors and supports the work of
the CDC, met with CDC Director Dr. Julie Gerberding to get an
update on the agency’s current public health activities as well
as future projects in the planning stages. As a member of the
coalition, AIDS Action attended the meeting.
Dr. Gerberding began the meeting by first thanking the meeting’s
attendees, emphasizing that it is because of the many U.S.-based
public health, non-governmental organizations that the CDC is
able to continue its important work. She made it clear that, as
the lead public health agency, the CDC works in a continuing partnership
with public health organizations, such as those in attendance,
to accomplish the ultimate goal of protecting the public health.
In fact, Gerberding expressed her wish that the CDC be considered
“the public health protection agency” in the U.S. This may now
be possible in a way that it never was before, she continued,
because the events of history have “opened a window” into the
CDC. Because of the many recent brushes with infectious and chronic
diseases in this country, and the agency’s high-profile role in
responding to these diseases, America is able to understand the
work of the health agency in a more comprehensive way than ever
before.
Dr. Gerberding was very optimistic about the current and future
work of the CDC, but she was also realistic about the agency’s
many opportunities for improvement. Although there is a great
potential for the CDC to have a significant impact on the nation’s
public health, there are many gaps in the system that might impede
this impact. Most importantly, there are many unmet health needs
being felt in communities all over the country. To fulfill these
needs, Dr. Gerberding said that the integration and furthering
of public health and behavioral health research at the National
Institutes of Health is key to improving the programming at the
CDC. In an effort to begin to address some of the gaps, the agency
has published a first-time report: The State of the CDC, Fiscal
Year 2003. This report is set to become a regular publication,
giving readers an update of the previous year’s activities at
the CDC. According the a the “Director’s Message” that Dr. Gerberding
wrote for the report, The State of the CDC 2003 “provides
information about how the CDC invested the funds entrusted to
the agency by the American people in three critical areas.” The
three areas are 1) modernizing the public health system, 2) preparedness
for unexpected attacks on the public health, and 3) concentrating
on programs that work.
The CDC has also been working on the development of a new strategic
plan, focusing on organizational restructuring with the goal of
making the CDC more efficient. When complete, the plan will explain
what the agency needs to do and how it needs to do it.
The basis for this plan is grounded in what Gerberding referred
to as an “outside-in” approach, meaning observations are being
solicited from stakeholders outside the agency in an effort to
understand how the CDC is perceived and how well its programs
are working. From this process, Dr. Gerberding was able to share
some preliminary conclusions on what actions will be necessary
to improve the CDC. They included increasing global responsibility;
altering business practices to increase efficiency; closely examining
the agency’s organizational structure, and increasing the access
to and usefulness of tools that the CDC makes available to the
public and, above all, continuing to recognize that the driving
force behind the work of the CDC is the goal of improving public
health.
Before the meeting concluded, AIDS Action staff was able to ask
Dr. Gerberding a question specifically about HIV. His question
was as follows: "Recognizing the increased interest in coordinating
care and treatment and prevention efforts in the U.S.—especially
in light of the new Advancing HIV Prevention initiative—what comments
do you have about the improvement of the coordination between
CDC and the Health Resources and Services Administration (HRSA)?"
Dr. Gerberding’s comments were vague because, by her own admission,
the two agencies haven’t yet figured out how they will work toward
improved coordination. She is aware however of the importance
of this coordination, and they are moving forward on this collaboration
carefully, recognizing the challenges raised by the differences
that exists between the two agencies’ organizational cultures,
the need to build trust at both the organizational and individual
levels, and managing the shifting roles of key personnel at the
agencies. AIDS Action will continue to track the development of
these agencies’ coordination plan.
To read the The State of the CDC, Fiscal Year 2003, link
to http://www.cdc.gov/CDC.pdf.
2. Southern AIDS Coalition Holds Hill Briefing
On Thursday, January 29, the Southern AIDS Coalition sponsored
a hill briefing entitled, “HIV/AIDS and STDs in the South: Challenges
and Opportunities.” AIDS Action attended the briefing.
The Southern AIDS Coalition is a broad-based coalition of advocates,
consumers, state health departments, community-based and national
organizations, and industry partners whose mission is to advance
and develop solutions for the shared issues of persons living
with HIV and other sexually transmitted diseases (STDs) in the
southern states. The coalition consists of representatives from
the District of Columbia and each of the 14 states that follow
as w: Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana,
Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee,
Texas, Virginia, and West Virginia.
The coalition’s Hill briefing was intended to raise awareness
among lawmakers of the HIV and STD crisis that is emerging in
the South. Dr. Gene Copello, co-chair of the coalition and executive
director of The AIDS Institute, opened the meeting with brief
remarks about the origins of the coalition. He shared that the
coalition originated from a working group of State AIDS directors
from the south, but it has since become more broad-based.
Dr. Copello’s opening remarks were followed by a presentation
by Jennifer Kates, director of HIV policy for the Kaiser Family
Foundation. Ms. Kates presented an overview of the current epidemiology
of HIV in the South, and how it compares to data from the rest
of the U.S. She explained that, while the South represents 36%
of the U.S. population, it accounts for 44% of new HIV infections.
The South is also the only state that has continued to see its
AIDS case rate increase in the past five years; the case rates
for all other regions in the U.S. have either leveled off or dropped.
It is important to note, however, that the data Ms. Kates presented
is based on the U.S. Census Bureau’s definition of the South,
which includes two states that are not a part of the Southern
AIDS Coalition: Maryland and Delaware. Despite this distinction,
it was clear from the data presented that the South is in the
midst of a public health crisis that demands an adequate response.
Following Ms. Kates presentation, Kathie Heirs, CEO of AIDS Alabama,
a community-based organization located in Birmingham, spoke about
one of the key barriers in the provision of HIV-related prevention
and care services in the South. These barriers include the lack
of affordable housing. She said that the available and affordable
housing stock in the South meets only 12% of the demand, and that
68% of low-income Southerners pay more than 50% of their income
for housing (the recommended federal guideline is 30% of income).
She concluded that since 50% of people living with HIV have needed
housing assistance at one time or another, it is critical that
lawmakers work to increase the availability of affordable, accessible
housing in the South.
Patrick Lee, director of the North Carolina Council for Positive
Living, also provided commentary on the South’s HIV epidemic.
He spoke about some of socioeconomic and cultural factors that
continue to be barriers to the provision of HIV-related prevention
and care services in the southern region. Mr. Lee discussed how
the extreme poverty and illiteracy that plague the rural South
are persistent barriers to people learning about HIV and, if they
are positive, accessing medical care. He also spoke about the
impact of culture and race on the understanding of HIV in the
South. He shared examples from his own experiences as an African-American
man in North Carolina and how distrust, denial, stigma, and discrimination
all play a role in the lack of awareness and knowledge about HIV
in many communities in the South, particularly in rural areas.
The briefing’s final speaker was Beth Scalco, administrative director
of the HIV/AIDS Program at the Louisiana Office of Public Health.
Ms. Scalco spoke about the funding and infrastructure-related
barriers that exist in the South. Seventeen million Southerners
lack health insurance, which impacts their ability to access any
form of medical care. In addition, southern Medicaid programs,
many of which were inadequate to meet the needs of people living
with HIV in the first place, have faced serious funding cuts as
the states grapple with ongoing fiscal crises. Six southern states
also have restrictions and/or waiting lists in the AIDS Drug Assistance
Programs (ADAP)—which only furthers the problem of access to appropriate,
HIV-related care and treatment. Finally, Ms. Scalco raised the
issue of the poor health infrastructure that exists in many places
in the South. The limited pool of providers, combined with an
overall lack of capacity, has made forced many Southerners to
travel for hours to get care, assuming they can even find adequate
transportation to and from their appointments.
The briefing concluded with Dr. Copello reemphasizing the critical
needs of the southern states as they confront the twin epidemics
of HIV and STDs. He revealed that the coalition has proposed that
Congress appropriate an additional $120 million dollars in funding
for prevention, care and treatment, and housing as an emergency
supplemental to the federal funding that the states already receive.
According to Dr. Copello, the members Southern AIDS Coalition
will be taking this request to Members of Congress in the coming
weeks and months in an attempt to raise awareness about the importance
of adequately responding to the needs of the southern states.
AIDS Action encourages its member to stay apprised of this and
other advocacy efforts related to HIV in the U.S.
In the News
1. Bush’s Anticipated Budget Request for Global AIDS Relief Draws
Mixed Reviews
In last week’s issue of The Weekly Update, it was reported that
President Bush is expected to request $2.7 billion for global
AIDS programs, including the Presidents Emergency Plan for AIDS
Relief (PEPFAR), when he releases his fiscal year (FY) 2005 budget
on Monday, February 2. On Thursday, January 29, The New York
Times (NY Times) indicated that the anticipated $2.7 billion
in funding would include an increase for bilateral programs (programs
managed by the U.S. government and implemented in other countries
to $2.5 billion, up from $1.9 billion. Over all, however, the
$2.7 billion would represent a reduction in “Bush’s pledge to
eventually spend more than $20 billion on these programs.” According
to The NY Times, this scaling back will “[put off] for
several years the fulfillment of his pledges to eventually spend
more than $20 billion on these programs.”
The Global Fund to Fight AIDS, Tuberculosis, and Malaria would
be hard hit by such a reduction, Congressional officials warned
The NY Times; the fund would receive $200 million from
the U.S., which is a $350 million cut in funding from this year.
The President’s request for the Millennium Challenge Account,
(a new program that that makes U.S. aid, including AIDS relief,
contingent upon the ability of developing countries to meet the
U.S. criteria for good government) will drop from the $3.3 billion
expected this year to $2.5 billion.
Yet despite these more modest figures, The NY Times noted
that President Bush’s AIDS programs for developing nations represent
“a big leap from those of the Clinton administration.” And some
people are duly impressed by the U.S. commitment to global AIDS
Relief. For example, in The NY Times, Patrick Cronin,
the former assistant administrator at the United States Agency
for International Development, said that ‘…this is a serious commitment,
and these figures are still very good.’
Others seem to doubt that the U.S. will reduce its contributions.
In a phone interview with The NY Times, Richard G. A.
Feachem, the executive director of the Global Fund, reminded that
the U.S. “is the single largest donor to the fund.” He continued,
‘The United States is a very generous supporter, and I do not
believe it will diminish its contributions and will fully support
the excellent work we are doing in 121 countries.’
Still others are urging higher financing of global AIDS programs.
Executive Director Jamie Drummond of DATA, an organization created
by the musicians Bono and Bob Geldof to help Africa overcome the
challenges of debts, AIDS, and trade, pledged, ‘We will work with
Congress to increase the contribution to [the Global] fund.’ John
Brennan, spokesman for Bread for the World said President Bush’s
figures “are still short.” He then added, ‘…and I believe the
president should live up to his original promises.’
To read The New York Times article on which this news
brief is based, go to http://www.nytimes.com/2004/01/29/politics/29AIDS.html.
Announcements
1. Kaiser Family Foundation Brings Online Spotlight to Election
2004
Kaisernetwork.org, the Kaiser Family Foundation's health policy
news has announced the creation of a new online resource that
provides easy access to the presidential candidates' positions
on critical health policy issues, as well as election-related
news and analysis. The resource, “Election 2004 Issue Spotlight,”
will be updated regularly to include new information and developments
throughout the campaign cycle.
Features include:
- Candidate profiles, including issue statements, speeches,
audio/video interviews and transcripts, news coverage, and additional
resources on all major candidates.
- A searchable archive of public opinion questions on health
issues related to the election.
- A reference library of election Web sites and publications.
- Multimedia resources, including Webcasts of interviews, discussions,
and debates.
- Election-related health news headlines.
To access the Election 2004 Issue Spotlight, link to http://www.kaisernetwork.org/spotlight/election2004.
If you have any questions about this resource, call (202) 347-5270
or e-mail webmaster@kff.org.
2. NAPWA Invites HIV Positive Advocates and AIDS Service
Organizations Who Organize HIV Positive Advocates to Join Its
Network
As part of its work to strengthen efforts to secure high quality
care and treatment and to raise public awareness and understanding
of HIV, the National Association of People With AIDS (NAPWA) is
inviting all HIV positive advocates, as well as AIDS Service Organizations
whose work includes advocacy by or feedback from people living
with HIV, to join the NAPWA Action Network.
Through the NAPWA Action Network, individuals and organizations
will build capacity and increase their opportunities to communicate
with other HIV positive leaders who are working to affect positive
change, especially in legislation, at the national, state, and
local levels. The Network will also provide its committed advocates
with a means to share information and strategize collectively
as well as help to educate its participants on current trends
in policy, generate better responses from their policymakers,
and succeed in influencing policy.
The NAPWA Action Network will also inform participants about AIDSWatch,
an annual event that brings hundreds of HIV positive people and
their supporters to Washington, DC for advocacy training and meetings
with Members of Congress. AIDSWatch 2004 (to be held from Monday,
May 17 to Wednesday, May 19) will also offer capacity-building
events to its participants and will coincide with NAPWA’s annual
fundraiser, scheduled for Sunday,
May 16.
To join the NAPWA Action Network or to learn more about it, contact
Aryka Chapman, NAPWA’s outreach coordinator, by e-mail at achapman@napwa.org
or by phone at (202) 898-0414, ext 116.
3. AIDS Vaccine Advocacy Coalition Launches Online Information
Clearinghouse
The AIDS Vaccine Advocacy Coalition (AVAC) announced its "soft
launch" of a new, online AIDS Vaccine Clearinghouse. The
Clearinghouse Web site contains a compendium of writings on AIDS
vaccine research, introductory information on HIV, and answers
to frequently asked questions in eight, major topic areas, including:
science, ethics, policy and global access. Each topic includes
"top pick" documents. Some documents and links are available
in French, Portuguese, Spanish, and Thai.
.
The Clearinghouse is a work in progress, and AVAC looks forward
to hearing ideas from Clearinghouse users on how to improve the
site. In addition, AVAC encourages users to submit documents and
translations for posting. Next spring, AVAC will conduct a more
formal launch of the Clearinghouse.
To visit the AIDS Vaccine Clearinghouse, link to www.aidsvaccineclearinghouse.org.
The
AIDS Action Weekly Update
The Weekly Update is written with a mind toward the interests
of AIDS Action members. If you read the Weekly Update and value
the information you receive through this service but are not yet
a member of AIDS Action, we invite you to learn more about AIDS
Action membership and its benefits by contacting Ryan Palsrok
at AIDS Action (202) 530-8030, ext. 3015 rpalsrok@aidsaction.org.
As a national advocacy organization dedicated to shaping
fair and effective AIDS policy, AIDS Action is committed
to advocating for everyone who is affected by HIV/AIDS until
it’s over—until HIV transmission is arrested, until people
living with HIV/AIDS get the care and support they need,
and until a cure is found. |
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