House Approves More Than $1 Billion For HIV And AIDS

      WASHINGTON - Congress voted Thursday to provide more than $1 billion for AIDS care and prevention and to start disbursing the money to states and localities based on their number of people infected with HIV, the virus that causes AIDS, as well as those with AIDS itself.

      The five-year reauthorization of the Ryan White Care Act passed the House 411-0 in the morning and was approved by the Senate without dissent in the evening. President Clinton is expected to sign the measure.

      ``Targeting the disease on the front line will allow us to be proactive rather than reactive,'' said Rep. Michael Bilirakis, R-Fla.

      The Ryan White program authorizes federal money for care and medication for people who aren''t poor or sick enough to receive Medicaid but who don''t have private insurance.

      The program was named for a hemophiliac teenager from Kokomo, Ind., who contracted the disease through a tainted-blood transfusion and died of AIDS in 1990 at age 19.

      Rep. Tom Coburn, R-Okla., said the reauthorized program, which was launched in 1991 and updated in 1996, grants more money for women and minorities, among whom the disease is spreading fastest, as well as people in rural areas.

      The legislation includes $20 million to reduce HIV transmission from mothers to infants. It also authorizes $30 million for tracking the disease and encouraging HIV-infected people to notify their partners and it requires Ryan White recipients to get counseling.

      The measure cuts San Francisco''s share of the federal AIDS money by $7.5 million over five years, but that was far less than the $40 million over the same period that the House had approved earlier. The city now receives $35 million a year, or $175 million over five years.

      Rep. Nancy Pelosi, D-Calif., a longtime advocate for HIV/AIDS victims said she ``wholeheartedly'' supported the new legislation.

      ``We''re pleased with the compromise,'' Pelosi said in an interview after the House vote. She added she hopes that when Congress actually appropriates money to local jurisdictions, negotiators will ``be able to offset'' San Francisco''s cut by raising the overall funding levels for the Ryan White program.

      Pelosi also said the decision to distribute the money based on the number of HIV as well as AIDS cases by 2005, rather than solely on AIDS cases, will help San Francisco in the long run. Because of better treatment and new drugs, the city has seen a slowdown in the onset of AIDS.

      Coburn, a physician who is leaving Congress this month to return to his practice in obstetrics and family medicine, said the legislation will provide better access to treatment and early intervention.

      ``Now a significant number of women aren''t tested and hundreds of children are needlessly infected,'' Coburn said.

      He said the measure also will ``emphasize to those living with HIV that they have a responsibility not to give it to anyone else.''

      ``Forty thousand people this year are going to become infected with HIV,'' he said. ``It doesn''t have to happen.''

      Rep. Henry A. Waxman, D-Calif., said the new funding formula seeks to target funding better to cities and states where HIV infection is spreading fastest, while minimizing disruptions in patient care in cities like San Francisco with long-established AIDS patients.

      ``This overwhelming bipartisan support shows Congress understands how critical it is to the health and welfare of the country,'' Waxman said.

      Coburn said in an interview later that Congress should require physicians to notify the Centers for Disease Control of every HIV case. That information is not currently recorded.

      ``We all know how to handle this disease and we''re not doing it,'' Coburn said. He also said that sexually active people who are HIV infected and don''t inform their partners ``should be put in jail.''

      Ryan White money helps about half a million people each year. Since 1991, the act has distributed $6.4 billion to states and local governments on the basis of a federal formula that counts AIDS cases - but not cases of HIV.

     

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