AIDS on the home front

November 30, 2007

Tomorrow's annual pause to reflect on the devastating impact of AIDS marks a bittersweet development. Despite signs that the global epidemic may be leveling off, the infection rate in the United States remains stubbornly constant.

A visit to Maryland today by President Bush underscores, though, that the decades-long struggle against HIV-AIDS on the home front has lost its urgency as a public health issue.

In honor of the World AIDS Day observation tomorrow, Mr. Bush plans to visit a Mount Airy church that helps finance an orphanage for children in Namibia who have lost their parents to the disease. He is expected to discuss his proposal for doubling federal spending over the next five years for global AIDS prevention, care and treatment.

Meanwhile, just a few miles down the road lies Baltimore, where the spread of AIDS is growing faster than in any other city in the nation but Miami. Prevention money is also a critical need here - as in neighboring Washington - but federal spending for the home-front battle has dropped in recent years, by 19 percent if inflation is factored in.

The answer by no means is to slight global AIDS programs, which some advocates contend should be expanded beyond Mr. Bush's $30 billion proposal. But the epidemic that started in the U.S. has not let Americans out of its grip, and they must not be forgotten.

The good news in global AIDS statistics comes about in part because of a more accurate analysis of the data, which now suggests predictions of pandemics in India and China were overblown. The better methodology also reveals that the infection rate is slowing - and may have peaked in 1998, giving medical officials hope that the disease will ultimately be conquered.

Statistics in this country, though, are depressingly unchanged. About 40,000 Americans contract HIV-AIDS every year, as they have since 1990. Most at risk are intravenous drug users, sex workers and their partners, and men who have sex with men. While Baltimore ranks second highest among cities, Maryland ranks third highest among states in the rate of new infections.

City and state officials are moving, finally, to identify and coordinate various public and private prevention programs in Baltimore as a first step toward making them more effective. Among the challenges is breaking the link between drug use and unprotected sex that leads to HIV.

But better organization can't completely overcome the need for greater financial resources. A light may be visible at the end of this dark tunnel, but the battle with AIDS at home must be waged more fiercely than ever.

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