Remarks to the Ryan White All-Grantees Conference

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by HRSA Associate Administrator Deborah Parham Hopson

Washington, D.C.
August 24, 2010

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Today we celebrate the remarkable achievements of this year’s Ryan White Awards recipients. These awards mirror the heart and soul of our Program.  As you know, this year’s conference theme is “20 years of leadership, a legacy of care.” So, in many ways, we celebrate not only the outstanding accomplishments of this year’s recipients but also the great strides we’ve all made together over our 20-year history.

The work of addressing HIV/AIDS has never been for the fearful. It certainly isn’t today. The economy has not rebounded in so many of the communities you serve. Unemployment is at around 10 percent – creating additional pressures on your programs. So it’s tough out there. I know it is.  Yet, you continue to move mountains.

I think of places like the Bronx-Lebanon Hospital Center and people like Edward Telzak who helped build their first AIDS and infectious disease programs 20 years ago. This organization is delivering world-class care in the country’s poorest congressional district. A place where 1 in 3 residents struggles to buy food to eat.

I think of places like the Mile High Meth Project and people like Bob Dorshimer in Denver, Colorado. This organization is helping HIV-positive gay and bisexual men suffering from addiction overcome crystal meth and recover from the devastation it causes.

I think of places like Sacred Heart Southern Missions AIDS Ministry and people like Sister Betty Ann McDermott, who is trying to reach HIV-positive residents in rural Mississippi and conquer the stigma and fear that is so entrenched in her community.

And I think of you, all of you, in the audience who make up our Program. You all deserve a Ryan White Award. Because whatever the odds and whatever the circumstances, the Ryan White community has always done whatever it takes to serve the underserved and to reach the unreached. It was true when the Program was founded 20 years ago. And it is certainly true today.

Your depth of experience, your breadth of expertise, and your profound staying power are proving to be the keys to reaching people living with HIV/AIDS in today’s world.

In those early days, our predecessors jumped into the fray to do the work that others could not—or would not—do. That tradition of compassion, perseverance, and fierce determination is still alive and well today. It is wonderful to behold.

In the hallways and meeting rooms of this hotel, your vitality and energy are as palpable as ever. I can feel your commitment. I can hear passion in your voices when you talk about your work and your clients.

And I am so honored to be on the same team with you.

• You reach people with no insurance.
• You reduce health disparities.
• You help people adhere to complicated treatment regimens.
• You long ago figured out that care is about more than a pill.
• And you build relationships with other organizations so that patients have access to the essential services that they need.

Whatever the nature of the challenge, you seem to create opportunity. When a shift occurs in the demographics of HIV/AIDS, you find a way to respond to the new needs that emerge.

Take the issue of aging.  Unless you happen to specialize in adolescent care, the average age of your clients is a lot higher than it was several years ago. Along with the long-term effects of HAART, which we have had for nearly 15 years now, you are addressing issues like hypertension, diabetes, arthritis, and other age-related conditions.

Aging—and the care needs that go with it—is just one of the clinical realities making new demands on you. Some comorbidities, like addiction and mental illness, have been associated with HIV/AIDS for much longer. Yet even they pose new challenges. Meth, for instance, has dramatically altered the addiction treatment landscape and made HIV/AIDS care delivery more complicated and more costly.

I hear you when you tell me about the ever-changing demands that patient demographics and comorbidities place on you, your colleagues, and your organizations. It can seem like as soon as you develop a protocol for dealing with one problem, the nature of the problem shifts.

It isn’t easy to build the clinical programs necessary to address issues like these—and others like hepatitis C. Yet you have created access to clinical care that is more comprehensive than ever before. And you are masters at the art of changing with the needs of your clients. It takes personnel, time, money, and facilities.

The clinical care challenges you face aren’t occurring in a vacuum. They are occurring in a fiscal environment that no one across the political, social, or medical worlds is happy with.

• Health care costs are up.
• Resources are down for many, many non-profits.
• The Federal budget deficit has no quick fixes and it will limit increases in resources for many programs well into the future.

Despite all of these challenges, you have not backed down; your commitment has not wavered.

The achievements we’ve made this year as a program are impressive and, given the tumultuous environment in which they have been accomplished, nothing short of inspiring.

This year, the Ryan White HIV/AIDS Program, through organizations like yours, served well over half a million people.

In the last year for which we have complete data, 73 percent of our clients were racial and ethnic minorities.

88 percent of clients—that’s almost 9 out of every 10—had no private health insurance. 

In 2008, we distributed medications to more than 175,000 patients through ADAP.

We are currently conducting research on innovative, replicable models of HIV care. Our focus is:

• reducing health disparities in women of color,
• improving access to oral health care,
• establishing linkages between jail settings and HIV primary care, and
• expanding health information technology and electronic medical systems.

And through our AIDS Education and Training Centers and the more than 18,000 trainings they conducted, we’re creating a more knowledgeable care community today and preparing to incorporate treatment and care advances into our approaches for tomorrow.

To a great extent because of what we have learned through people like you, we are able to make extraordinary contributions abroad through our Global Program.

There is still more. We’re not only making strides as a program. We are serving as a model to the country on how to deliver comprehensive, holistic, and effective health care to the underserved. All the while, we’re raising the bar on health standards by establishing HIV/AIDS core clinical, case management, oral health, and ADAP performance measures.

It is clear that we are meeting our mandate to reach people who others don’t. Taken together, these accomplishments represent great leaps forward. Their result is simple to grasp: better health and quality of life for people who, without you and the Ryan White HIV/AIDS Program, would get sicker and die sooner.

Though we continue to face great struggles, we also stand on the precipice of great promise. The National HIV/AIDS Strategy will bring a new level of national attention and commitment to addressing an epidemic that most people don’t realize is still growing. As health care reform is implemented in the coming years, we can hope for better resources for our clients and for our clinics.

We know more today than ever about serving people living with a stigmatizing, marginalizing illness, and we have been given scientific understanding and treatments whose complexities and power were previously unimaginable.

Whatever lies before us, I believe it is informed by our past, and one of the reasons that we are here today is that a couple of people who disagreed about a lot of things put those differences aside to do the right thing.

I want to acknowledge Senators Kennedy and Hatch, who got the original Ryan White CARE Act through the Senate in 1990.  They were from opposite ends of the political spectrum and yet their collaboration set an example that we must draw on if we are going to chart a clear course through these tough times. If we reach beyond our diverse perspectives, we can build a richer, more fruitful Ryan White HIV/AIDS Program than ever.

Building a more fruitful program is what this week’s meeting is all about.

As we pay tribute this morning to some very special individuals who have made our program stronger, I want to thank all of you for your vision and commitment to seeing our work through. Thank you for leading by example and for making differences in the lives of people living with HIV/AIDS that are beyond measure.

Collectively, your achievements reach far beyond your community. Like Ryan White himself, your voices have been heard:

• by hesitant people who have now become our allies,
• by quiet communities who aren’t so quiet anymore about HIV/AIDS,
• by a country whose response to the epidemic is better than it ever has been, and
• by a world that can’t forget about HIV/AIDS because you simply aren’t going to let them.

The Ryan White Awards are given to people whose contributions call us all to a deeper and more abiding level of service. These awards also cast a light on the work that all of you here today are doing in community after community across this great country of ours.

For your fight against AIDS and for underserved people living with HIV disease, you deserve our Nation’s gratitude. As you go back to your homes at the end of this conference, I hope that you will always remember that you certainly have mine.

Thank you.