Ever since AIDS was first recognized as a grave new disease, it has raised a host of complex social, ethical, economic, legal, and political issues. The Foundation played an early and very important role not only in educating the public and policy makers about HIV/AIDS, but in calling on government to allocate the resources needed to address the emerging epidemic and, through expert testimony, in helping the courts protect the civil rights of all those affected by HIV/AIDS. amfAR was a galvanizing force in securing government support for critical HIV/AIDS research, prevention education, and treatment programs, as well as in promoting vigorous enforcement of protections against AIDS-related discrimination.

Given the qualifications of the respected scientists, physicians, and public health experts on its Board and advisory committees, the Foundation soon established itself as a trustworthy and highly regarded advocate of rational and compassionate AIDS-related public policy. As such, amfAR was instrumental in securing the passage of key federal legislation, including the Hope Act of 1988, the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990, the Americans With Disabilities Act of 1990, and the National Institutes of Health (NIH) Revitalization Act of 1993, which strengthened NIHís Office of AIDS Research. In 1986, the Foundation was the first to press Congress to establish an AIDS drug assistance program (ADAP) to help people with HIV/AIDS cover the high cost of anti-HIV drugs. amfAR has persevered in its support for this vital program, which continues to operate with federal assistance to states under Title II of the Ryan White CARE Act. ADAP increased from $30 million in fiscal 1987 to $461 million in fiscal 1991 ó for a cumulative total of nearly $1 billion in federal support that has assisted many thousands of Americans with HIV/AIDS.

amfAR has been a pioneer in supporting research, training, and policy development. This involved providing funds in areas for which they were not traditionally available or in areas that were politically sensitive. They were early leaders and continue in that role.

ó James W. Curran, M.D., M.P.H., Dean of Emory Universityís Rollins School of Public Health, former U.S. Assistant Surgeon General, and former director of the CDCís Division of HIV/AIDS Prevention
Today, the staff of amfARís Sheldon W. Andelson Public Policy program, and the highly qualified volunteers who support it through public statements and invited testimony in Congress, continue the Foundationís advocacy efforts in support of sufficient and well-coordinated funding for HIV/AIDS research, including vaccine research; effective prevention strategies; expanded access to care and treatment; and the protection of the human rights of all people affected by HIV/AIDS. In these efforts, amfAR often works in coalition with other national AIDS and health organizations to present a united front speaking on behalf of people with HIV/AIDS, as well as those with other disabilities and life-threatening diseases.

Public policy activities have always constituted a relatively modest portion of the Foundationís overall program budget. But the results of amfARís steadfast advocacy have been impressive, both in leveraging increased government funding for research, prevention education, and support services, and in protecting civil liberties that benefit not only people with HIV/AIDS, but society as a whole.

In the past two years, amfAR has pursued a number of important public policy initiatives:
  • Recognizing the need for Secretary of Health and Human Services Donna Shalala to take a definitive stand on the efficacy of needle exchange programs (NEPs), the Foundation used the results of both amfAR-funded research and other well-documented studies to push for a firm determination on the scientific evidence to date. And, in April 1998, Secretary Shalala announced that conclusive evidence shows that NEPs reduce HIV transmission without increasing illegal drug use. However, despite this determination, and broad support for the efficacy of needle exchange among leading professional organizations and other government advisors, Congress remained unwilling to lift its ban on federal funding for NEPs. Today, the Foundation remains actively involved in efforts to educate policy makers that needle exchange is an essential component of an effective and comprehensive national AIDS prevention strategy.

  • During federal budget negotiations, amfAR was one of a select group of organizations invited to testify before the House of Representatives Appropriations Committee. The Foundationís testimony stressed both the need for increased funding for the National Institutes of Health and NIHís Office of AIDS Research and the importance of allocating federal funds to needle exchange programs. The recommendation to strengthen the NIH as a whole reflected the continued need for targeted and well-coordinated funding for HIV/AIDS research, as well as the recognition that basic-biomedical research benefits people with many diseases, including those with HIV/AIDS.

  • In June 1998, amfAR Chairman Dr. Mathilde Krim, Chief Executive Officer Jerome Radwin, Board member and Dean of Columbia Universityís Mailman School of Public Health Dr. Allan Rosenfield, and Jane Silver, amfARís Director of Public Policy, met with Vice President Gore to discuss new developments in AIDS research, the continued ban on federal funding for needle exchange programs, and the importance of a unified and unambiguous position statement from the Administration on the efficacy of NEPs.

  • In March 1998, the Foundation signed an amicus brief in the case of Bragdon v. Abbott, which helped win the landmark Supreme Court decision that individuals with asymptomatic HIV infection are protected from discrimination under the Americans With Disabilities Act (ADA). Preventing discrimination against people with HIV is indeed key to encouraging individuals to seek HIV testing and to avail themselves of early treatment as appropriate.

  • amfAR co-sponsored AIDSWatch, a major annual HIV/AIDS education and advocacy event that brings hundreds of constitu-ents to Washington, D.C., to urge their elected officials to support increased federal funding for essential AIDS-related programs.

  • amfAR supported and took part in the annual National AIDS Treatment Advocates Forum (NATAF), which brings together AIDS advocates from across the country to develop strategies related to HIV/AIDS research, treatment, and access-to-care issues.

  • The Foundation continues to offer student internships that provide hands-on Capitol Hill experience and help inform the next generation about the role they can play in pressing government to implement effective HIV/AIDS-related and other public health policy. Most recently, amfAR interns have completed research on the Food and Drug Administration (FDA) entitled ďA Review of HIV/AIDS-Related Drugs under the FDAís Treatment IND Mechanism and Analysis of the Information Gathered and Submitted to the FDA.Ē

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