June 22, 1999
The Honorable Albert Gore, Jr.
Vice President of the United
States
Washington, DC 20501
Dear Mr. Vice President:
Your record and the record of the Clinton administration on AIDS issues is certainly a strong one and we appreciate the priority you attach to addressing the growing needs of people living with HIV and AIDS. Your leadership on issues like Medicaid expansion and increased funding for federal HIV and AIDS programs clearly demonstrate your commitment to fighting and ending this epidemic.
I write to you today because we have some concerns regarding both U.S. domestic and international AIDS policy, which we would very much like to discuss with you and your staff. We were very disappointed, as you know, with the administration's decision last year to certify the efficacy of needle exchange while, at the same time, continue the prohibition on the use of federal funds for these life saving programs. That decision was, in our view, contradictory and has not resulted in any less congressional interference in the issue. Congress prohibited the use of even local and private funding for needle exchange in the District of Columbia last year, and several new bills threaten to similarly restrict programs in other cities around the country. To be clear, more people will become HIV infected and die as a result of those congressional actions and a unified, clearly articulated Administration position will be essential to reverse and/or stop them.
Unfortunately, the focus on needle exchange over the last two or more years has taken vital attention and energy away from a broader discussion of HIV prevention and, to some extent, HIV care and treatment. Over 40,000 people in this country become infected with HIV each year, and no evidence suggests that this number is declining. Despite that alarming statistic, the United States does not have a comprehensive and well-funded plan to reduce or eliminate new HIV infections. The steady rate of new HIV infections combined with the dramatic reduction in AIDS deaths clearly means that the number of Americans living with HIV is rising rapidly. A comprehensive plan to address the health care needs of that population, increasingly made up of people of color, women, and other groups with historic difficulty accessing health care, is essential. The Ryan White CARE Act, still a vital part of any plan, cannot and was not designed to meet that level of demand. Despite your call to action, Medicaid expansion is not yet a reality.
Regarding international AIDS policy and funding, HRC supports H.R. 772, the Hope for Africa Act, sponsored by Rep. Jesse Jackson, Jr. An estimated 47 million people around the world are living with HIV and one quarter of all children have been orphaned by AIDS in many sub-Saharan African countries. The United States has a moral obligation to assist foreign countries and generously support international efforts to reduce and end such devastation.
As you well know, HIV and AIDS have overwhelmed entire cities and countries around the world to the point that economic development has ceased. To ignore the connection between economic development and health is counter-productive and we very much support the essential linkage between these two issues in Rep. Jackson's bill. H.R. 772 appropriately sets forth an inclusive approach to addressing the HIV pandemic in Africa by including provisions on debt relief, health care infrastructure development, and adherence to international agreements on intellectual property. Those key components will help ensure not only the wider availability of AIDS drugs, but also the basic health services necessary to successfully administer them.
HRC is also in strong support of increasing the U.S. investment in global HIV and AIDS prevention and care efforts, such as those funded through the U.S. Agency for International Development. In addition to the policies included in H.R. 772, this basic funding must also be part of an overall strategy to address the global AIDS crisis.
It is our view that HIV and AIDS prevention and treatment strategies, whether in South Africa, rural Nebraska, or urban America, must include targeted and sustained prevention messages, knowledge of HIV status, the provision of basic health care and supportive services, and of course, AIDS-specific drug treatments. We acknowledge and appreciate the work that you, President Clinton, Secretary Shalala, Sandra Thurman and many others in the Administration have done to address those issues. No other Administration has done as much. However, a great deal more needs to be undertaken as the epidemic changes, and in many ways worsens both here in the United States and around the world.
Your relationship with South African President Mbeke, your leadership position within Administration, and of course your role as a presidential candidate, combine to make your position and plans to address these issues essential to developing sound and comprehensive policy. We would welcome the opportunity to discuss these issues with you in greater detail. Thank you very much.
Sincerely,
Elizabeth Birch
Executive Director