Washington, D.C.--Congressman Eliot Engel (D-NY) spoke at the White House Office of National AIDS Policy Community Discussion on the National AIDS Strategy, held at the Columbia University Medical Center in the Washington Heights community of northern Manhattan, on December 4. Other speakers included Jeffrey Crowley, Director of the White House Office of National AIDS Policy and Rosie Perez, actress and HIV/AIDS advocate.

Rep. Engel is a senior member of the Energy and Commerce Committee, and serves as Chairman of the Foreign Affairs’ Subcommittee on the Western Hemisphere and on the Energy and Commerce’s Subcommittee on Health. He has been a vocal proponent for increased HIV/AIDS treatment over the years.

Below are his remarks from the event:

“We appreciate the Administration holding this key forum in New York City. While HIV/AIDS has unfortunately grown in many areas of the country, our city remains the epicenter of the crisis, with more AIDS cases than Los Angeles, San Francisco, Miami, and Washington D.C. combined.

“For too many of us in this room, we learned early on just how devastating the disease could be, long before it even had a name. I remember those early days in 1981 when rumors were going around about a mysterious, serious illness. Then there was the rush to label and dissect it as a gay disease, and one that IV drug users contracted, when we know now how wrong we were-and how many people across NY and the country were actually at risk. My wife, Pat, and I had a close friend who died of the disease early in the 1980’s, back when our ability to treat HIV was so limited, and the disease progressed so rapidly and cruelly.

“As the country learned more about HIV/AIDS, and our communities came together and rallied for tolerance, for treatment and for a cure, we never thought, that nearly 30 years later we’d be where we are today with over 120,000 people in the state infected, many unaware of their status.

“Today, HIV is the third leading cause of death below age 65 in New York City. In no surprise to anyone, HIV is also the health problem with the largest racial disparity; 80% of new AIDS diagnoses and deaths are among African-Americans and Hispanics.

“New York’s experience demonstrates that a national HIV/AIDS strategy must acknowledge that there is not one national epidemic but local epidemics, all of which need to be addressed differently. There are significant differences across the nation in terms of affected populations, need, capacity, and resources. The Strategy must offer flexibility to states to tailor plans to their particular needs, resources, and epidemics.

“The Obama Administration’s commitment to creating a real National AIDS Strategy is an extension of what so many in this room do every day, work to ensure the best targeting of resources for evidence-based prevention, access to care, treatment and awareness.

“The federal government can, and must, do better. Our federal financing of HIV care is fragmented and fails to provide sustained access to quality HIV care in this country. I proudly fight for federal dollars for New York for HIV/AIDS every single day. It’s troubling to me that in years past, such as during the Bush Administration’s 2006 Ryan White CARE reauthorization, limited federal funding became a ‘food fight’ between states and localities for life-saving medical care, medications, and support services for our uninsured and underinsured. Fortunately, in 2009, with the strong support of President Obama, we were able to enact a more generous Ryan White bill based on the community consensus proposal to which so many people in this room contributed.

“There’s a lesson here, in focusing on areas where there is need and potential for improvement, the National AIDS Strategy should not expect efforts and resources in existing program areas to be reduced in order to support its goals and objectives.

“Some of our federal programs are embarrassingly outdated. Under current Medicaid rules, people with HIV must become disabled by AIDS before they can receive access to Medicaid-provided care which could have prevented them from becoming ill in the first place. In the House Health Reform bill, I changed that by getting my bill, the Early Treatment of HIV Act, included to modernize the Medicaid program and bring it in line with federal treatment guidelines.

“Even more significant is that our shared goal of comprehensive and affordable health reform is closer than ever to being realized, and will go a long way towards providing the access to care so central to a National AIDS strategy. Affordable health care for all Americans is finally within reach after years of navigating a difficult maze of public programs, such as Medicaid, Medicare, and Ryan White, which do not serve everyone. Of course, this is coupled with a private insurance market which has aggressively blocked people with chronic, pre-existing conditions for care. These are some of the barriers to care faced by so many people with HIV, and which are about to be shattered.

“With the enactment of health reform, no longer can people be denied access to care for pre-existing conditions, no longer will there be co-payments for preventive care and wellness, and no longer will there be caps on what the insurance companies will cover. We should have done this years ago.

“I look forward to hearing your ideas about how the federal government can best partner with you to reduce HIV incidence, reduce HIV-related disparities and increase access to care. It’s fitting that as we commemorated World AIDS Day earlier this week that we can join together this evening and formulate a new direction for our nation’s HIV/AIDS policy.”