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I spent much of my spare time over the summer not relaxing at the beach but reading and scoring grant proposals that had been submitted for funding to the Children Affected by AIDS Foundation. This was my first venture at taking on such a project. At various times I felt overwhelmed (by the sheer immensity of the task), powerful (realizing the control I held over these organizations' bottom lines), and humbled (both for having been asked to participate as a reviewer and for being able to have such an intimate peek into the magnitude of monetary need that these agencies have). Each faces a unique set of funding obstacles, yet all had a problem that was common among them: the inability to rely as heavily as they had in the past on state and local governments as a source of income. AIDS service organizations nationwide are scrambling in these tough economic times to prepare for their worst fears next year, but some are already feeling it. According to Ana Oliveira, executive director of Gay Men's Health Crisis, 'The economic environment has presented many challenges for GMHC and other organizations. Reduced public and private revenue has resulted in a corresponding reduction in private donations and government funding. This is part of a downward economic trend that began in 2002. This year, GMHC did need to make budget reductions that will affect our ability to meet the expanding needs of our clients. However, we still have been able to steer a steady financial course during these difficult economic times. If the forecast for further economic constraints next year becomes a reality, it is likely that there will be catastrophic consequences in the nonprofit and social services sectors of the economy. In addition, the impact of new cuts in funding on those we serve will be dire.' Another area where funding problems are so obvious is the AIDS Drug Assistance Program, which provides for the cost of medications for uninsured and underinsured individuals. The state-run arms of this program are seeing their worst situations since protease inhibitors were first marketed back in the mid 1990s. But as reporter Benjamin Ryan discovers in this issue's cover story, there are some tactics that ADAPs can use to help alleviate the strain on their budgets. Also in this issue'which marks the fifth anniversary since HIV Plus began publishing'we wrap up our series 'The USA Today,' in which we have been taking regional overviews of the effects HIV has had on the country. We hope you have found this series helpful, especially if others' successes or problems helped you, as patients and caregivers, to adjust your health care plans for the better. We would even enjoy hearing from you about it. So until next time, stay aware and stay well.
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