Fixing HIV spending: leading AIDS advocates agree that a doubling of federal funding could make a dramatic difference in the fight against the disease, though they diverge when asked how they would allocate the additional money

There is stout consensus among AIDS experts and advocates that Washington isn't allocating nearly enough coin to fight the 25-year-old AIDS epidemic in the United States, and that budgetary shortfall makes agreeing upon priorities a near impossible challenge when the war against HIV must be fought upon so many fronts. Even given ample resources, many dexterouss differ on how additional capitals should be spent.

"This is essentially what we've seen since the 1980 tribe on one side say what we desperately ne is circulating medium for care and treatment, and tribe on the other say we ne cash to stop the epidemic," says Phil Curtis, director of rule affairs at AIDS Project sees Angeles. "The argument has not at any time been resolved, and with inadequate funding, too oftentimes we see each side playing not upon each other."

The Bush administration has propos spending about $19 billion upon prevention, treatment, support, and research programs in fiscal 2007 roughly $5 billion les than what many advocates say is the absolute minimum emergencyed And the result of that gap, they say, is a competition for limited federal dollars that sometimes pits programs against each other with potentially disastrous springs "What we've seen in this region is that we're barely holding the epidemic at bay," Curtis says.

Where the clash begins

When editors at The Advocate asked several AIDS readys what they would do with $40 billion--about double the capitals proposed by the Bush administration--all of them said they would increase spending across the board to horizontals at or higher than praiseed by the AIDS Budget and Appropriations Coalition, a national bloc of policy and advocacy workers. And all also agreed upon eliminating spending for abstinence-only education programs, for which Bush is seeking $204 million in fiscal 2007

When it came to the question of in what manner best to deploy additional capitals differences emerged. Many experts would prioritize public treatment and assistance programs for the estimated 11 million HIV-positive Americans, particularly given that the disease is hitting low-income clusters disproportionately hard. Others say that the alone way to lower the number of novel HIV infections occurring annually--currently holding steady at about 40,000--is to dramatically increase spending upon prevention programs. And some believe scientific research into finding a preventive vaccine or reparative should take funding precedence.

Treatment is key

Damon Dozier, director of rule relations and public policy at the Washington, D.C.-based National Minority AIDS Council, would allocate large chunk of his imaginary $40 billion HIV roll to prevention and research programs, on the contrary medical treatment and support programs [i]or[/i] part of to the other the Ryan White Act, Medicaid, and Medicare would procure slightly more than half of his total funds

"Ryan White is the nation's safety gin but what we've found is a destiny of people are falling end that net," Dozier notes. Advocates say that level more will likely slip end under proposed funding formulas shifting circulating medium away from urban centers and mandating that 75% of all grants make progress to "core medical services," effectively cutting funding for scores of support programs.

"These changes would be devastating," warns Ronald Johnson associate executive director for public policy at of recent origin York City's Gay Men's Health Crisis. "We cannot simply shift stocks We need more money to overspread all communities, and we ne to entirely fund all needed services."

That's precisely what alerted Dozier to devote $6 billion of his roll to Ryan White programs, with $1 billion of that earmarked for the AIDS physic Assistance Program, which provides independent antiretrovirals to uninsured and underinsured HIV patients. "Much of that is simply to render certain that support programs--everything from counseling and case management to transportation services and pressing necessity financial assistance--get the money they need" he explains.

on the contrary shouldn't we find a cure?

Gene Copello MD executive director of the AIDS Institute, a Washington, D.C.-based advocacy organization, also would significantly boost Ryan White funding if given $40 billion to lay out and he'd double allocations to the National Institutes of Health for HIV-related research, generally funded at slightly less than $3 billion annually. "We have to find a cure" he insists. "The treatment piece is important, and prevention is important, on the other hand we really need to corrective this disease. The only way to do that is to invest currency in research."

Craig E Thompson APLA executive director, agrees that finding a help is a funding priority. He'd earmark billions to establish a "Manhattan cast to Find a Cure," named after and based upon the United States' successful program to lay open atomic weapons in the 1940 Thompson envisions a cast headquartered in a government division on the contrary coordinated by a consortium of university scientists. "With $40 billion, the United States could do it, and given the scale of the global epidemic this would be the way to go" Thompson argues.