Honoring Ryan White's Legacy

It's been almost 10 years since new AIDS drugs transformed HIV infection from a near-certain death sentence to a manageable and chronic illness for people with access to quality health care. In that decade the promise of a longer, richer, and healthier life infused hope in millions of people across the globe.

But hope gave way to complacency, on the part of the government as well as individuals. HIV infection rates continue to soar unabated, and access to life-prolonging AIDS drugs and vital treatments and services remains elusive for far too many men, women, and children living with HIV in America, Africa, and elsewhere.

While the challenges around HIV and AIDS have changed, the epidemic remains one of the great health care crises of modern times. Just think about these simple facts:

• Today, two thirds of all HIV and AIDS diagnoses in America are among people of color. In fact, a recent study by the Centers for Disease Control and Prevention confirmed that in five major cities, 46% of black men who have sex with men are HIV-positive and two thirds of these men do not know their status.
• Current federal Medicaid law covers protease inhibitors only for people who have an AIDS diagnosis. Put simply and tragically, that means under Medicaid rules, the drugs that prevent HIV from progressing to AIDS are dispensed only to people who already have AIDS. That's like requiring fire extinguishers only in buildings that are already on fire.
• Every hour, two young people become infected with HIV. Perhaps it's because they're not getting the unvarnished truth about how HIV spreads. Perhaps it's because their sex partner isn't getting adequate treatment and counseling. Perhaps it's because they mistakenly think there's a cure. But one thing's certain: Every year in the United States 20,000 young people are infected, and that is a national tragedy.
• The global epidemic rages without pause. According to a Kaiser Family Foundation fact sheet, HIV is the leading cause of death worldwide among people age 15 to 59. And of the 3.1 million people who died of AIDS complications across the globe in 2004, more than half a million were children.

On September 30 the Ryan White Comprehensive AIDS Resources Emergency Act, America's life stream to men, women, and children living with and at risk for HIV, expired, threatening to unravel one of the nation's most critical health care safety nets. While basic spending on HIV and AIDS will continue, resources remain inadequate, and there won't be a structure and blueprint for fighting HIV and AIDS with the fortitude needed to meet today's epidemic. Among the most urgently needed priorities in the Ryan White CARE Act are continued delivery of treatment and services like housing, dental care, nutrition, and access to life-prolonging AIDS drugs.

Renewal will help ensure that communities can direct money and resources in ways that meet the specific needs of that community and an assurance that people living with HIV are part of that decision-making. A new version of the CARE Act must also continue to help meet the special needs of women and children, including prevention of transmission of the virus from mother to child.

The gay population responded with courage and bravery to the early years of the AIDS epidemic, when we were sometimes abandoned by our families, our friends, our doctors, and our government. Today, gay, lesbian, bisexual, and transgender Americans must continue to face this threat head-on. Almost half of all new infections in the United States are the result of male-to-male transmission. Meanwhile, science-based prevention funding at the Centers for Disease Control and Prevention has been flat for years. We must fulfill our historical duty to help fight the epidemic in all affected communities, particularly among people of color and around the globe.

When Ryan White was first diagnosed with AIDS, he bravely symbolized the need to conquer the stigma and fear that surrounded this epidemic. Today, he is a symbol of hope and the best instincts of the American people. Let's honor his legacy by reauthorizing the CARE Act so the fight against AIDS will be as strong as he was.