Dear Jerry - An Open Letter to Our Next Governor

jerry brown

Dear Governor-Elect Jerry Brown,

As you assume the governorship of California, we know you face a ballooning budget deficit and countless difficult decisions.  The road ahead is not easy.  But in the midst of this economic crisis, it is essential you not turn your back on our state’s most vulnerable citizens, including those living with or at risk for HIV. 

More than 160,000 Californians currently live with HIV or AIDS, and another 7,000 are newly infected each year.  This growing and complex epidemic demands that state leaders respond with substantial funding, appropriate legislation, and administrative action to treat and prevent what remains a devastating disease.  We believe you have the political courage and willpower to make this happen, and we stand ready to help, alongside our colleagues in the HIV/AIDS community.

The AIDS Drug Assistance Program, also known as ADAP, is the cornerstone of California’s public health effort to fight HIV/AIDS.  It provides life-saving medications to more than 37,000 low-income, uninsured, and underinsured people.  The program is essential and it needs to be protected.  A reduction in ADAP services will result in advanced HIV disease, increased co-morbidities, and even premature death for Californians.  Medications provided by ADAP also help to prevent the spread of HIV.  People on effective treatment can reduce their viral load (the amount of HIV in the blood) to undetectable levels.  Evidence shows an undetectable viral load makes HIV-positive people less likely to spread the virus to others.  For every new HIV infection we prevent, the state saves an estimated $600,000 in lifetime treatment costs.  San Francisco AIDS Foundation urges you to keep ADAP fully funded.

Looking ahead to the next four years, all Californians will be watching as you oversee the implementation of the Patient Protection and Affordable Care Act.  This is your moment—the largest expansion of health care coverage in more than 40 years.  For people living with HIV/AIDS, and other pre-existing conditions, the reforms to our health care system bring great hope.  Insurance companies will no longer be allowed to deny coverage for HIV-positive people. Through the expansion of Medi-Cal, more than 70% of uninsured people living with HIV/AIDS in the state will soon have access to comprehensive health coverage.  This is great cause for celebration.

But there is a flip-side, and San Francisco AIDS Foundation urges you to pay close attention to one major issue as reforms take effect.  For the last twenty years of the epidemic, the federally-funded Ryan White program has filled gaps in our health care system, providing vital care to people with HIV.  The program has created top-notch infrastructure, expertise, and treatment models.  But it has operated largely outside of the traditional medical system.  In order to ensure that advances made through the Ryan White program are not lost, a considerable amount of work must happen to integrate it into the larger health system.  We encourage your administration to work closely with the HIV/AIDS community to carry out a smooth transition. 

San Francisco AIDS Foundation is ready to be an active partner with your administration.  We are ready to collaborate during this time of financial hardship to make sure life-saving services are not scaled back or eliminated altogether.  We are ready to find new ways to target this disease, to radically reduce the number of new infections, and to expand access to proper care for all HIV-positive people. 

When you left the governor’s office nearly three decades ago, we were just in the early days of what would become an unimaginable health crisis—a crisis still with us today.  As you now return to the office, you have the opportunity to reverse the tide.  But it will take commitment, fortitude, and vision.  We hope you recognize that ending this epidemic will take bold steps, and California can lead the nation in creating new models to fight the disease. 

We hope you share our vision of the future, when HIV is a thing of the past,

San Francisco AIDS Foundation


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