At the United Nations General Assembly Special Session on HIV/AIDS in June 2001 the United States signed the Declaration of Commitment on HIV/AIDS, pledging to improve its response to the domestic epidemic. But when the United Nations convened this year in May to mark the 25th anniversary of the first reported AIDS cases, a watchdog group published a scathing report that outlines how the United States has badly failed to meet those goals.
The report, published by the Public Health Watch HIV/AIDS Monitoring Project of the Open Society Institute, lambastes the U.S. response to HIV at home as uncoordinated'and in desperate need of a clear plan whose specific goals for prevention, treatment, and support are based on proven techniques. The report highlights the fact that only half of those Americans who need antiretroviral treatment actually receive it, that the number of new U.S. HIV infections occurring each year has remained stable for a decade, and that the disease still devastates marginalized populations, particularly minorities and the poor.
On the treatment front, the Open Society Institute backs a recent report by the Institute of Medicine that recommends the creation of an entirely new government entitlement program focused on HIV in addition to the expansion of the existing federal bedrock of support'Medicaid, Medicare, and the Ryan White Act. But the recommendation comes at a time when federal lawmakers are reluctant to open government purse strings for AIDS programs: Ryan White has suffered from multiple years of flat funding, many AIDS Drug Assistance Programs across the country have waiting lists because of budget shortfalls, and nearly all state Medicaid programs are slashing spending.
Chris Collins, the report's author and a Public Health Watch consultant, says the most important way to warm U.S. policy makers to the idea of spending more money on HIV treatment is to re-engage the public in the domestic AIDS crisis. 'I think most Americans don't know just how dysfunctional and unsuccessful the current treatment program is,' he says. 'Part of what we need to do'and our challenge'is to let people know that, for all the successes, the system is not successful with a great many Americans living with HIV.'
63%: The percentage of Americans who say the United States is doing too little to fight HIV at Home'up from 52% in 2004. Source: Kaiser Family Foundation