Earlier this month, communities around the globe marked World AIDS Day with speeches, vigils, and education programs. Given the crisis in this country and around the world, work to stem the spread of the virus and support those who are infected should be our focus every day of the year. As we all gear up for 2006, now is a good time look back over 2005 - specifically with respect to progress made on HIV issues at the state level, as well as the key challenges for the coming year.
Over the last few years, the Legislature has faced a number of issues involving HIV. In 2003, then-Governor Gray Davis proposed co-payments and fiscal limits on the AIDS Drug Assistance Program, and in 2004 Governor Arnold Schwarzenegger proposed capping the program's enrollees. Each of these proposals was beaten back, and this past year the governor proposed full funding for the program. This next year there will be program growth, and we must be vigilant to ensure that the program is not challenged in the state budget.
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HIV prevention
I worked hard this year as chair of the Assembly Budget Committee to restore HIV prevention funding to the levels of five years ago. During that time, California's HIV prevention programs have suffered major cuts, scaling back local prevention efforts. This year's $5.6 million funding increase will help rejuvenate HIV prevention programs in the Bay Area and across California.
While I'm proud of the progress made in reversing five years of cuts, this victory is not yet permanent. The governor took a good step in supporting these funds, but his budget signing message indicated this was a one-year increase and next year we will have to fight to maintain this increase as well as make sure that HIV programs move with the times - taking on prevention efforts that address the crystal meth epidemic and other trends that challenge good HIV prevention.
Funding for ADAP
In addition to basic funding for ADAP, the state budget provides funding for viral load and HIV resistance testing. Without adequate funding for this program, we are unable to collect important clinical data to ensure participants in ADAP are receiving the best and most cost-effective treatment available.
Last year, I co-authored AB1367, a pilot program created for pharmacies that serve Medi-Cal HIV/AIDS patients to evaluate the effectiveness of medication therapy management services. The bill passed the Legislature and was signed into law.
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Needle exchange programs
This year, needle exchange programs legislation by Assemblywoman Patty Berg (D-Eureka) was signed into law, finally lifting the requirement that local governments declare a public health emergency every two weeks in order for a needle exchange program to operate.
However, the governor vetoed my bill (AB1597, co-sponsored by the Drug Policy Alliance and the San Francisco AIDS Foundation), which would allow state-funded local needle exchange programs to buy syringes using their state-sourced grants - rather than have to raise funds privately. This requirement is burdensome to street-level needle exchange programs, and defeats the purpose of state grants to prevent the spread of HIV.
As a founding board member and former executive director of the Santa Cruz AIDS Project, which managed similar prevention programs - and in my role with the budget committee - I understand the setback for prevention efforts caused by this veto. Given the average cost for lifetime HIV care is between $154,000 and $196,000, the ability of these programs to purchase an adequate supply of sterile hypodermic needles and syringes is essential to California's ability to further reduce the transmission of HIV and other blood-borne diseases, and relieve public cost for care and treatment. Unfortunately, needle exchange programs will have to fundraise from the community for at least one more year to buy syringes for their programs - taking away from their focus on fundraising for the programs themselves.
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In the coming month, legislative action will begin. Engaged and active, we can make a critical difference locally and statewide. Please stay involved and join me in advocating for a level of state prevention and services that meet the need in California.
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At a ceremony in Sacramento earlier this month, Assemblyman John Laird received the "Leadership in AIDS Policy Award" from the California Conference of Local AIDS Directors. Laird (D-Santa Cruz) is one of the first two openly gay men elected to the state Assembly and he serves as chair of the Assembly Budget Committee.
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