San Francisco Chronicle - Thursday, July 27, 2000
Carolyn Lochhead, Chronicle Washington Bureau

The bill, co-sponsored by Rep. Tom Coburn, R-Okla., and Rep. Henry Waxman, D- Los Angeles, calls for a gradual shift over five years to focus on HIV infections rather than full-blown AIDS cases. The bill also would change the funding formula in an attempt to shift funds to areas where the disease is rising. The current act, officially titled the Ryan White Comprehensive AIDS Resources Emergency Act, will expire on September 30.

The Senate also passed, by unanimous consent, legislation that would increase spending to combat international AIDS and tuberculosis epidemics. It was sponsored by Sen. Barbara Boxer, D-Calif.

Under the current Ryan White formula, San Francisco receives approximately twice as much money per AIDS case, roughly $5,000 a year, as other cities, including Oakland, even as the path of the epidemic has spread across the country and shifted to heterosexual demographic groups, particularly women and minorities.

AIDS groups in San Francisco warned that the formula shift could slash San Francisco's Ryan White funds by as much as 25 percent in five years.

Rep. Nancy Pelosi, D-San Francisco, voted for the overall bill, but strongly objected to the formula change.

"As advocates for people living with the disease, we should be emphasizing that the solution to the continuing AIDS crisis is to increase overall funding rather than to redistribute existing dollars," Pelosi said.

Coburn predicted that rapidly rising federal funding for the Ryan White money that goes to cities -- which has increased by an annual average rate of 24 percent since 1991 -- will continue, so that San Francisco could wind up with no absolute cut in funds, even as its share of the total falls.

Local AIDS groups sharply disagreed, saying funding would have to double over the next five years for San Francisco to stay even. Many AIDS activists applauded some of the changes in the House bill, particularly the focus on tracking HIV rather than AIDS.

Dennis Dison, spokesman for AIDS Action, said his group's policy committee "said some years ago that we want to see a shift to HIV data rather than AIDS data."

Jim Driscoll, national AIDS policy adviser for the Log Cabin Republicans, a gay group, said the House measure would "upgrade prevention, improve accountability and attempts to make Ryan White programs more responsive to minorities and women as well."

Driscoll said that when the Ryan White law was enacted a decade ago, San Francisco was the center of the AIDS epidemic, so the law "was written in a way that was very favorable to San Francisco. That becomes very difficult to maintain as a broader and broader constituency nationally has to be served by the program."

The Senate version of the bill contains a smaller formula change that would have less of an effect on San Francisco's funding.

E-mail Carolyn Lochhead at lochheadc@sfgate.com.
000727
SC000712

Always watch for outdated information. This article first appeared in 2000. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2000. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .