This World AIDS Day, the HIV Medicine Association (HIVMA) is celebrating the good news from the United Nations Joint Program on HIV/AIDS (UNAIDS) that the global case count is lower than previous estimates. However, in the United States, this good news is tempered by President Bush’s veto of the annual funding bill that provides resources to fight the domestic HIV/AIDS epidemic—programs that have faced stagnant funding throughout the Bush administration despite the continued growth of the epidemic.
An estimated one in four Americans infected with HIV does not know it, and the HIV/AIDS epidemic in the United States is growing most rapidly in poor, disenfranchised communities of color. The funding bill President Bush recently vetoed included increases to support the Centers for Disease Control and Prevention (CDC) in implementing routine testing in health care settings and to help ensure that care is available to those who test positive by increasing support for HIV medical clinics funded under the Ryan White program. Research demonstrates that knowing one’s HIV status and keeping one’s viral load low with antiretroviral drugs are two factors that lower the risk of spreading the virus.
But President Bush’s veto means the modest increases contained in the bill funding these measures are now in jeopardy. As the epidemic continues to grow, funding for programs to serve those most in need must grow as well. Flat funding of critical AIDS programs translates into more new infections and more Americans without access to lifesaving medical care and drug therapies.
The president also is threatening to veto another bill providing budget increases for global HIV/AIDS and other infectious diseases programs, including funding for the Global Fund to Fight AIDS, Tuberculosis, and Malaria. The United States has taken a leadership role in efforts to control the global HIV/AIDS pandemic, and a veto would place this role in question.
U.S. leadership in the global HIV/AIDS arena stands in stark contrast to its treatment of people with HIV/AIDS wishing to travel to the United States. Last year the president promised to start a process to lift restrictions on people with HIV traveling to this country. But the rule the administration recently proposed falls significantly short.
The new proposed rule continues to ignore long-standing statements from the U.S. Public Health Service that admitting people with HIV/AIDS into the country would not pose a significant risk to the U.S. population. It does not change the fact that, unlike people with any other manageable, chronic disease, people with HIV must demonstrate that they will pose no cost or risk to public health while in the United States. The proposed rule continues to impose a burdensome and stigmatizing process on people living with HIV/AIDS seeking to enter the country.
This World AIDS Day, the theme is leadership at all levels of society. HIVMA calls on the Bush administration to exercise positive and consistent leadership in fight against HIV/AIDS. On the one hand, the President’s Emergency Plan for AIDS Relief has put the United States at the forefront of the fight against HIV/AIDS in the developing world. But on the other hand, the president’s leadership on HIV/AIDS at home is strikingly lacking. HIVMA urges the president to immediately support the necessary funding for both domestic and global federal HIV/AIDS programs, and to lift restrictions against HIV-positive travelers to the United States.
HIVMA is the professional home for more than 3,600 physicians, scientists and other health care professionals dedicated to the field of HIV/AIDS. Nested within the Infectious Diseases Society of America (IDSA), HIVMA promotes quality in HIV care and advocates policies that ensure a comprehensive and humane response to the AIDS pandemic informed by science and social justice. IDSA is a professional society representing more than 8,000 physicians and scientists who specialize in infectious diseases. For more information, visit our websites: www.hivma.org and www.idsociety.org.