The scope and nature of the HIV/AIDS epidemic have drawn States, local governments, schools, academic institutions, private foundations, health care institutions, business leaders, community-based organizations, and the Federal government into many HIV-related activities. The Federal government, through its public health responsibilities in areas such as research, prevention, health care, and housing has seen a dramatic increase in its activities since the beginning of the epidemic. In FY 1986 the Federal government expenditures for AIDS research, surveillance, income maintenance, and care were $508 million. By FY 1996 that figure reached $7.3 billion.

In the past four years, under the leadership of President Clinton, the Administration has increased spending for AIDS research, prevention, income maintenance, and care by approximately 50 percent. Funding for the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act has increased by 158 percent since FY 1993. Support for housing specifically for people living with AIDS has increased by 96 percent in the same time period. AIDS-related research funding at NIH has increased by 40 percent and AIDS prevention funding at CDC has increased by 24 percent. Federal assistance for the purchase of AIDS drugs has increased by approximately 221 percent in the last two years. The National Institutes of Health Revitalization Act of 1993 provided the Office of AIDS Research with enhanced authority to develop and implement an annual AIDS research plan and budget. Approval of AIDS drugs by the Food and Drug Administration has been further accelerated. A community-based AIDS prevention planning process has empowered local communities to target resources toward innovative AIDS prevention programs. Eligibility for Social Security disability benefits for people with AIDS has been simplified and Federal laws prohibiting discrimination against people living with HIV and AIDS have been vigorously enforced.

As the epidemic continues, we must renew our vision for ending this epidemic. The sections that follow focus on six major policy areas: prevention, research, care and services, civil rights, international activities, and the translation of research advances into practice. They identify recent progress and future opportunities for further progress.

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