Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
San Francisco Chronicle - November 12, 2006
Sabin Russell
What could happen: Cities such as New York and San Francisco have more people living with HIV than ever. Current legislation to reauthorize the Ryan White Care Act would strip $50 million from California and $78 million from New York over the next five years, shifting those and other urban dollars to the rural South, where new rates of HIV infection are highest. The $2.1 billion reauthorization bill passed the House, but stalled in the Senate.
AIDS advocates say that about $200 million more would keep the urban programs afloat. The Bush administration could try to push the bill through in the lame duck session, but the Republican proposals are more likely to be shelved and redrafted when the new Congress convenes in January.
Meanwhile, Bush's overseas AIDS relief program comes up for reauthorization by Congress. Democrats generally approve of the plan but strenuously oppose rules that require one-third of funding for prevention to pay for programs that promote sexual abstinence until marriage.
Look for a big fight over abstinence-only programs, and for Democrats to block rules that limit condom distribution to high risk groups and require relief recipients to sign a pledge opposing prostitution. Democrats will probably seek an expansion of the program and a rewriting of rules so that contributions to the U.N.-inspired Global Fund to Fight AIDS, Tuberculosis and Malaria can be increased.
Bottom line: San Francisco alone stands to lose $10 million to $24 million in federal AIDS money during the next five years under the domestic proposal, but incoming House Speaker Nancy Pelosi is unlikely to let that happen. Among her allies will be Sen. Hillary Rodham Clinton, D-N.Y., whose opposition to Republican proposals stalled reauthorization this summer. But the budget deficit will make coming up with new money difficult.
When it comes to overseas AIDS relief, Democrats will pursue more money and fewer restrictions. Republicans are unlikely to yield on abstinence but may loosen the purse strings on one of the Bush administration's foreign policy successes.
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