Maryland Facing 40% Decrease in Federal Funding for HIV/AIDS Surveillance Activities

Maryland this year will face a 40% decrease in federal funding for HIV/AIDS surveillance activities, the state's AIDS Administration said recently, the Baltimore Sun reports. The state in 2008 was awarded $1 million for "core surveillance," which includes reporting HIV diagnoses and basic data about people who were tested. Maryland in 2007 received $1.8 million for HIV/AIDS activities. According to the Sun, the reduction eliminates funding for "incidence surveillance," which distinguishes new HIV cases from long-standing ones, as well as for "resistant-strain surveillance," which detects HIV/AIDS strains that resist certain antiretroviral drugs. Resistance testing, which began in 2001 under a federal grant, has shown that 10% of people who have tested HIV-positive have strains that are resistant to one or more medications, according to the AIDS Administration.

CDC has sent a series of communications about the funding cuts. The state AIDS Administration first learned of the cut in November 2007 and received paperwork last month with the grant amount. "I think the main issue is that we are third in the country for AIDS case rates, so I find it alarming that the CDC would jeopardize our surveillance system at a time when we obviously have a significant burden of the epidemic," Heather Hauck, director of the state AIDS Administration, said.

Hauck said the state depends heavily on federal funding for HIV/AIDS services. If the state is forced to cut back on surveillance activities, it might have difficulties directing services to the most vulnerable regions or groups, according to Hauck. Hauck also said that the funding reductions could ultimately affect that state's Ryan White Program grant. The federal government currently provides about $65 million annually to Maryland through its Ryan White Program. According to the Sun, the grant is based in part on the number of new cases in a particular state, which depends on the state's surveillance ability.

CDC spokesperson Nikki Kay declined to address the reduction but said grants are "time-limited" and not meant to continue automatically. States competing for renewed funding underwent an "objective review process," Kay said, adding, "Unfortunately, in 2008, Maryland did not receive funding for some of these time-limited projects, resulting in a decrease in its total award" (Bor, Baltimore Sun, 2/13).