The Open Society Institute, a public policy research organization, recently released a comprehensive report on the state of HIV/AIDS in America. It suggests that President Bush has failed to effectively handle this devastating epidemic. Although the Office of National AIDS Policy, located in the White House, is responsible for domestic efforts to reduce new infections, it has a tiny staff and little if any authority. Because the nation lacks a single AIDS authority, the government hasn't been able to implement a national plan to combat the epidemic.
AIDS funding has been hamstrung under President Bush. The CARE Act, the government's major AIDS initiative, had its funding cut this year. HIV prevention funding for 2006 at the Centers for Disease Control (CDC) was slashed by $12 million. Last year, the administration cut $14 million from the Housing Opportunities for People with AIDS program, which provides housing subsidies for the poor. Dr. Jim Curran, a former CDC director, has warned that the nation's HIV/AIDS policy is "hampered by insufficient funding."
Recent estimates seemingly indicate that one in four infected with HIV is unaware of their condition. But this is merely an educated guess, because the Bush administration has never bothered to conduct annual, nationally representative surveys. Consequently, policymakers don't know the full extent of infection. And the CDC can't identify pockets of infection where concentrated interventions are necessary.
Although the United States is the world's leader in AIDS treatment, approximately half of those infected with HIV are not receiving regular care. This is partly due to the high cost of health insurance, which many can no longer afford. Although President Bush has been in office for six years, he has yet to deal with the skyrocketing cost of health insurance. Low Medicaid reimbursement rates, which discourage physicians from treating the poor, have also contributed to the lack of treatment. And Medicaid's eligibility requirements prevent most of those in the early stages of AIDS from receiving treatment, because they don't meet the definition of "disabled."
Federal law prohibits discrimination against those with HIV/AIDS, yet the Bush administration has done little to enforce the law. As a result, discrimination is a pervasive problem. A 2003 study demonstrated civil rights violations against people living with HIV/AIDS in employment, medical care, and housing. This has also inhibited access to care and treatment.
In recent years AIDS deaths have declined due to new drug therapies. Yet less than half of those who need drugs are receiving them. The federal government funds AIDS medication for the poor through AIDS Drug Assistance Programs (ADAP). But owing to budget cuts, 26 states that receive ADAP funding announced earlier this year that they were forced to impose waiting lists or take other steps to curtail distribution of the drugs. At least 20 states don't receive enough ADAP funding to cover all AIDS medications, and 11 can't cover the only drug approved to inhibit HIV.
While those infected with HIV are far better off in America than many other countries, it's clear that the Bush administration should be doing much more to defeat AIDS. In a 2005 speech President Bush said, "HIV/AIDS is a daily burden for our families and neighbors and friends." Mr. Bush has two more years to demonstrate that he truly understands this. But many of those living with AIDS do not.
