This Week in Washington

1. Healthcare Budget Numbers Revealed in House and Senate

2. Senate PEPFAR Reauthorization Legislation Introduced

3. Capitol Hill Briefings

4. Coalition for Health Funding Hosts Briefing

5. Homeless Study Looks at HIV Issues

Announcements

1. March 10th Is National Women and Girls HIV/AIDS Awareness Day

2. HRSA Provides 2008 Ryan White HIV/AIDS Program Meeting Information

3. Upcoming Connecting to Care Trainings

4. SAMHSA Accepting Applications for HIV/AIDS Grants

5. Registration Open for AIDSWatch 2008

This Week in Washington

1. Healthcare Budget Numbers Revealed in House and Senate

The Senate Budget Committee passed a budget resolution on March 6^th that provided a $5.27 billion increase over fiscal year (FY) 2008 for the healthcare portion of the FY 2009 budget, which is called “Function 550.”  Function 550 covers most health spending except Medicare including spending on health services, research and training, and consumer and occupational safety. 

The House Budget Committee also passed a budget resolution on March 6^th which increased healthcare funding by $4.44 billion over FY 2008.  In both committees, the budgets passed along party lines.  The House and Senate are expected to vote on the budget resolutions on the floor next week and will then need to reconcile the two budgets in conference.  The President is opposed to any budget resolutions, such as these, that exceed the budget that he submitted on February 5^th.  However, since the Congressional budget is in the form of a concurrent resolution, it is not a public law and therefore will not be sent to the President for his signature. 

The Senate increase of approximately 10% is especially encouraging since it came very close to meeting the target recommendation of $5.3 billion by The Coalition for Health Funding.  AIDS Action belongs to the Coalition which is an umbrella organization for health organizations’ budget advocacy.  The increases in both sides are especially important because they mean that HIV/AIDS advocacy organizations will have a stronger ability to ask for increased funding for important HIV/AIDS programs such as prevention programs within the Centers for Disease Control and Prevention (CDC), the Ryan White CARE Act, and research in the National Institutes of Health.  The bills are expected to be voted on, in the full House and Senate next week. 

2. Senate PEPFAR Reauthorization Legislation Introduced

Today, March 7, Senator Joseph Biden (D-DE), Chair of the Foreign Relations Committee and Senator Richard Lugar (R-IN), Ranking Member of the committee, introduced the Tom Lantos and Henry Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008.  The bill will reauthorize the President’s Emergency Plan for AIDS Relief (PEPFAR) at $50 billion over five years for global programs for the prevention, care, and treatment of HIV/AIDS, tuberculosis, and malaria.  The other lead sponsors of the bipartisan bill are Senators Edward Kennedy (D-MA), Chair of the Health, Education, Labor and Pensions Committee and John Sununu (R-NH), a member of the Foreign Relations Committee.  The press release announcing the bill’s introduction stated that it closely resembles the PEPFAR reauthorization bill that was approved last week by the House Committee on Foreign Affairs.  The House bill, H.R. 5501, was summarized in last week’s Update.

The Senate Foreign Relations Committee has scheduled its mark-up of the reauthorization bill for Wednesday, March 12.  The press release from Senator Biden’s office can be found at: http://biden.senate.gov/newsroom/details.cfm?id=294431&&

The House Foreign Affairs Committee leadership has requested that a vote by the full House be scheduled for the week of March 10 but that vote has not been scheduled yet.

AIDS Action has expressed its support of the full House passing the PEPFAR reauthorization bill while noting that we are dismayed with some elements of the compromise bill.  Notable among AIDS Action’s concerns are retention of the “prostitution pledge,” the weakened support for linkage between PEPFAR programs and family planning programs, and the confusing reporting language that replaces the removal of the directive that one-third of prevention funds be spent on abstinence-only-until-marriage programs. 

AIDS Action’s statement follows.

AIDS ACTION URGES HOUSE ACTION ON PEPFAR REAUTHORIZATION

AIDS Action Council commends the House Committee on Foreign Affairs, under the leadership of Acting Chairman Howard Berman (D-CA) and Ranking Member Ileana Ros-Lehtinen (R-FL), for passing the Tom Lantos and Henry Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis and Malaria Reauthorization Act (H.R. 5501).  The bill, which represents a bipartisan agreement, reauthorizes the President’s Emergency Plan for AIDS Relief (PEPFAR), which expires September 30, 2008.  AIDS Action calls on the House leadership to bring the bill to the House floor quickly and urges House Members to adopt the reauthorization bill.  

Since its establishment in 2003, PEPFAR, the U.S.’s global AIDS initiative, has made significant progress in and achievements towards the global fight against HIV/AIDS.  The bill passed by the committee builds on PEPFAR’s progress and makes important improvements to the global AIDS initiative.  The bill increases the authorized spending level to $50 billion over five years.  The bill moves the program from an emergency focus to a focus on sustainability.  The bill broadens the focus to other parts of the world heavily impacted by HIV/AIDS.  The bill calls for continued emphasis on HIV prevention and the care and treatment of people living with HIV/AIDS, continues to give prominence to the vulnerabilities faced by women and girls, recognizes the importance of linking HIV/AIDS programs to programs for food security and nutrition, and calls for efforts to strengthen health care infrastructure, especially the training of health care professionals and community health care workers.  The bill eliminates the current abstinence-only-until marriage directive for the spending of prevention funds.  Unlike the original 2003 legislation, the bill recognizes the vulnerability to HIV among men who have sex with men (MSM) and calls for HIV prevention programs that target MSM and care and treatment programs for MSM living with HIV/AIDS.      

As a compromise, the bill is not perfect, as Acting Chair Berman noted in his remarks before the committee vote.  AIDS Action is dismayed over several elements of the bill, notably the retention of the “prostitution pledge” and replacing the abstinence-until-marriage directive with an ambiguously worded requirement that 50% of funds for HIV sexual transmission prevention be spent for “behavior change programs,” including abstinence, delay of sexual debut, monogamy, fidelity and partner reduction but leaving out condom use.  AIDS Action is also very troubled that the linkage of HIV/AIDS programs to family planning programs has been weakened and that the linkage to reproductive health has been eliminated from the bill.  A bipartisan agreement is important to achieving reauthorization but it should not compromise the science and evidence-based integrity of HIV/AIDS programs.  AIDS Action will continue to call for further changes that address these and other disturbing elements as PEPFAR reauthorization moves through Congress.

The essential point is that PEPFAR reauthorization should move forward.  The committee bill that honors the legacies of Representatives Lantos and Hyde should be considered and adopted by the full House.

3. Capitol Hill Briefings

On Monday, March 3^rd, a panel was held reviewing the religious and moral case for repealing the federal ban that prohibits states from using their share of HIV/AIDS prevention money on needle exchange.  The event was keynoted by Delegate Eleanor Holmes Norton (D-DC) who spoke about Washington D.C.’s successful struggle to be allowed to spend its own local tax funds on syringe exchange and related programs. 

Following Representative Norton, the speakers included Mary Jo Iozzio a professor of Moral Theology at Barry University in Florida representing Society of Christian Ethics, William Martin, a senior fellow for Religion and Public Policy at the James Baker Institute at Rice University, John Johnson Domestic Policy Analyst for the Episcopal Church, the Rev. Michael T. Bell the senior pastor at Peace Baptist Church in Washington, D.C. and Charles Thomas, executive director of the Interfaith Drug Policy Initiative (IDPI).  The speakers noted that a number of faiths had issued statements in support of the issue.  Naomi Long from Drug Policy Alliance moderated the event.  AIDS Action’s Bill McColl was quoted in Congressional Quarterly’s coverage: http://cqpolitics.com/wmspage.cfm?parm1=5&docID=hbnews-000002681120.

On Tuesday, March 4^th CARE USA held a briefing in their CARE USA Public Policy Series to release “The Future of PEPFAR: Comprehensive Approaches, Sustainable Results”.  Helene Gayle, President and CEO of CARE USA opened up the session and thanked those gathered for coming. 

One of the authors Janet Fleischman, Senior CARE Consultant spoke at the session.  She explained that CARE USA primarily focuses its global HIV work on preventing new infections, especially among the most vulnerable; mitigating the impact of the pandemic on economic development and community well being; and increasing affected families access to high quality care and support for their disease.  Millicent Obaso, CARE USA Regional HIV/AIDS Advisor for East and Central Africa explained the importance of CARE USA in providing assistance to the orphans and vulnerable children who are cared for through the community initiatives that must be sustained.   

The report can be found at the link below http://www.care.org/newsroom/articles/2008/03/20080304_CARE_PEPFAR_report.pdf

Finally, also on March 4^th, the The Center for Strategic and International Studies (CSIS) HIV/AIDS Task Force sponsored a luncheon event to discuss the recently released CSIS report, “Combating the Twin Epidemics of HIV/AIDS and Drug Addiction: Opportunities for Progress and Gaps in Scale.”  The presenting authors Dr. Robert Heimer, Ph.D. and Traci C. Green, M.Sc. from the Yale University School of Public Health provided information about ongoing efforts to provide opioid maintenance treatment in 12 countries.  Although opioid maintenance has the highest success rates of keeping addicted individuals in treatment, it remains controversial and difficult to implement.  Among other examples of difficulties in starting a program, at least one of the countries altered their laws to allow maintenance, but did not alter their laws regarding importation of drugs which created a long delay before that law was changed as well.  Dr. Eric Goosby, M.D., CEO and Chief Medical Officer, Pangaea Global AIDS Foundation and Dr. Caroline Ryan, M.D of the Office of the Global AIDS Coordinator reacted to the discussion.  Phillip Nieburg, M.D., a Senior Associate, CSIS Task Force on HIV/AIDS and J. Stephen Morrison, Ph.D. the Executive Director of the CSIS HIV/AIDS Task Force moderated. 

The study can be found at:

http://www.csis.org/component/option,com_csis_pubs/task,view/id,4306/type,1/

4. Coalition for Health Funding Hosts Briefing

On Friday, February 29^th the Coalition for Health Funding hosted the briefing, “The Leading Challenges for the U.S. in the Coming Decade-Prevent, Prepare, and Invest.”  AIDS Action was a cosponsor of the event. Speakers included Dr. Georges Benjamin, Executive Director of the American Public Health Association and Dr. Jeffrey Levi, Executive Director of the Trust for Americas Health.  The forum focused on the need to raise the profile of public health particularly since there have been steady erosions in the public health budgets across the country. Dr. Benjamin and Dr. Levi exposed the health risks of our society and the true need for the public health field. According to them, the field needs investment to encourage prevention, preparedness, and provide for a healthier society in which individuals are given the opportunities and knowledge to advocate for themselves. The speakers stressed the slogan of “Prevent, Protect, and Live Well.”

Dr. Georges Benjamin discussed the broad future of the issues of public health for the next twelve years and how he believes the changes and lack of funding will consequently affect our communities. Dr. Benjamin explained that our actions today and our lack of preparedness will negatively affect our future.

He believes that there should be a vision of a “Healthy Global Society,” suggesting that good public health creates a community benefit that will lead to an improved quality of life and a reduction of government and community health related costs. He added that prevention, preparedness, and sound health have a hefty price, but in the end there is a need to spend more money on the prevention side.  He expressed hopes that will result in spending less money on the treatment side since we would have prevented many illnesses through our prevention strategies.

Dr. Levi said that the federal government should be used as tool to reach public health goals. He stressed the interconnectedness all the organizations and programs represented at the briefing and suggested that they motivate one another and influence the federal government to create a healthier America. Dr. Levi said we must continue to find the balance between the support of the public and sustenance from the government. Once this balance is met maybe the leading challenges in public health will not be so difficult to handle.  According to Dr. Levi and Dr. Benjamin we all can be effective public health communicators and become stronger advocates for the populations we serve. They left the audience with a vision of a Healthy Global Society that can become a reality with a message of prevention and wellness.

5. Homeless Study Looks at HIV Issues

The Wall Street Journal reported on a study released at the National Housing and HIV/AIDS Research Summit in Baltimore.  AIDS Action has been told that “the middle of the report is specifically on HIV/AIDS and how housing stabilization for 201 HIV+ individuals compared to 201 who had "standard of housing" (i.e., services as usual) reduced long-term health care facility utilization by 50% and saved at least $500,000 in healthcare costs.”

AIDS Action was not able to find a link to the direct study however once such a link becomes available we will send it to readers.  The full Wall Street Journal article is available here, although a subscription is required. 

http://online.wsj.com/article/SB120477350786615859.html

Announcements

1. March 10th Is National Women and Girls HIV/AIDS Awareness Day

March 10^th is National Women and Girls HIV/AIDS Awareness Day.  Activities raising awareness and encouraging women and girls to be tested and if positive to seek treatment and care are taking place throughout the United States.  The lead agency for the event is the Office on Women's Health in the U.S. Department of Health and Human Services (HHS).  For more information go to:  http://www.hhs.gov/aidsawarenessdays/days/woman/index.html

2. HRSA Provides 2008 Ryan White HIV/AIDS Program Meeting Information

On March 6, 2008, the Health Resources Services Administration HRSA announced that the 2008 Ryan White HIV/AIDS Program Meeting website was now live.  The website will allow participants to register, submit workshop and poster abstracts, and reserve hotel rooms.

HRSA states that the meeting will be held August 25-28, 2008 in Washington, DC and is being co-sponsored by HRSA/HAB and the American Academy of HIV Medicine (AAHIVM).  Once again, two meetings will occur simultaneously: 1) the Grantee Meeting; and 2) the 11th Annual Clinical Update.  The Clinical Update is sponsored by the International AIDS Society-USA (IAS-USA).  The meeting theme, "New Era, New Act," reflects a focus on implementing the 2006 Ryan White legislation as well as ongoing efforts to seek ever better ways to deliver HIV care to the underserved.  We make a difference for over half a million people each year and owe much of our success to our creativity and adaptability to change.

The conference website provides all the information you need to get ready for the meeting, such as: key deadline dates; instructions for registering and submitting abstracts for workshops and poster sessions; and reserving hotel rooms.

Access the site at:
http://www.ryanwhite2008.com/

3. Upcoming Connecting to Care Training

AIDS Action is accepting registration for an upcoming Connecting to Care training. Participants in the two-day session have an opportunity to review agency programs with the specific objective of evaluating how successful these activities are in addressing “unmet need.”  Additionally, hands-on group exercises are provided in a stimulating and creative environment that will help the participants build the skills necessary to strengthen existing activities and create new ones that connect HIV+ people to care. Limited financial support is available to participants needing to travel to attend the session. Dates: Dallas, TX March 26-27. For registration information, please email Dea Varsovczky, dvarsovczky@aidsaction.org.

4. SAMHSA Accepting Applications for HIV/AIDS Grants

The Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications for grants for their Fiscal Year (FY) 2008 Targeted Capacity Expansion Program for Substance Abuse and HIV/AIDS services. The program is focused on substance abuse treatment programs servicing people with HIV/AIDS in the African American, Latino/Hispanic and Other Minority Communities.

This program aims to enhance and expand substance abuse treatment and/or outreach and prevention services that are provided in conjunction with HIV/AIDS services in the African American, Latino/Hispanic, and other racial and ethnic communities highly affected by the epidemics of substance abuse and HIV/AIDS.

Public and private non profit organizations are encouraged to apply. Grantees must ensure that they will use methods to reach out to high-risk substance abusers in racial and ethnic communities and will launch efforts to address the needs of one or more of the following populations: 

        Women, including mothers and their children,

        Adolescents (ages 12-17) and/or young adults (ages 18-24),

        Injecting and at-risk non-injecting drug (including alcohol) users and their partners, including men who have sex with men, and

        Individuals released from incarceration within the past two years.

It is expected that $19.8 million in grants will be available to fund up to 50 grants. The average annual award amount is expected to be up to $450,000 per year for grantees providing treatment services, and up to $350,000 a year for grantees providing outreach and pretreatment services.  Grants for both types of services could last up to 5 years.

Applications are available by calling SAMHSA’s Information Line at 1-877-SAMHSA7 [TDD: 1 800-487-4889] or by downloading at http://www.samhsa.gov/Grants/2008/ti_08_006.aspx .  Applicants are encouraged to apply online using www.grants.gov.

Applicants with questions about program issues should contact David C. Thompson at 240-276-1623 or david.thompson@samhsa.hhs.gov. For questions on grants management issues, contact Kathleen Sample at 240-276-140 7 or kathleen.sample@samhsa.hhs.gov. Applications are due on March 27, 2008.  

5. Registration Open for AIDSWatch 2008

Registration is now open for AIDSWatch 2008, taking place in Washington DC from April 28-30, 2008. AIDSWatch is a grassroots advocacy program, organized by the National Association of People With AIDS (NAPWA), which brings HIV positive people and their supporters to Washington DC to meet their elected Members of Congress. AIDSWatch participants are given the opportunity to educate their legislators on the need for an improved governmental response to the domestic HIV epidemic. This year’s AIDSWatch will focus on the need for improved treatment accessibility, science and evidence based prevention, and increased appropriations for HIV/AIDS programs.

NAPWA says, "We invite all persons infected and affected by HIV in America to join us in 2008 to allow your voice to be heard in our nation's capital. Please revisit the website frequently for updates about the 2008 program and registration."

To learn more and to register, please visit: http://napwa.org/index.php?option=com_content&task=view&id=19.

The AIDS Action Weekly Update
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