REPORTS

At the Crossroads

With the AIDS epidemic approaching the end of its third decade, the last year witnessed important developments on the national AIDS response and in efforts to address the epidemic in Black America. This report notes the highlights of what proved to be an eventful year, placing particular emphasis on the key challenges that remain for the AIDS response in Black America.

On July 13, 2010, President Obama released his National HIV/AIDS Strategy for the United States and the Strategy's federal Implementation plan. Development of a national AIDS strategy makes good on a promise then-candidate Obama made when he was running for President in 2008.

The Centers for Disease Control and Prevention in April 2009 launched Act Against AIDS, a five-year, multi-faceted communication campaign to reduce new infections and refocus attention on the domestic epidemic.

President Obama signed into law the most sweeping domestic legislation in almost 50 years. Entitled the Patient Protection and Affordable Care Act, the law broadly reforms America's health care system. The non-partisan Congressional Budget Office projects that the new bill will deliver health coverage to 32 million people who are currently uninsured and reduce the projected federal deficit over the next decade by $143 billion.

The Obama Administration took steps to rebuild the Office of National AIDS Policy, appointing Jeffrey Crowley, a longtime AIDS advocate, as director. The administration also revived the Presidential Advisory Council on HIV/AIDS, naming former CDC AIDS Director Dr. Helene Gayle to chair the group.

Several baseless policies that have been on the federal law books for years were finally removed. The ban on federal funding for needle exchange programs was repealed, as was the longstanding restriction against HIV-positive people from other countries to visit the U.S. Funding for abstinence-only programs for young people was stricken from the federal budget, although there is some leeway for communities to obtain federal funding for "experimental" programs that could include abstinence.

In sum, 2009 was a year of important achievements in the domestic fight against AIDS—the first such year in a long time. But the year also highlighted key challenges. AIDS funding remains stagnant and the historic federal budget deficit will make major additional funding increases tough to achieve. Meanwhile, the epidemic has largely disappeared from the front pages and the television newscasts, undermining AIDS awareness and impeding efforts to mobilize communities.

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