D.C. Criticized for Not Treating AIDS as a Citywide Health Crisis

Report Describes Problem as Epidemic, Response as Anemic

The District's rate of HIV/AIDS is probably the worst of any major U.S. city, yet the city's response to the epidemic remains badly understaffed, poorly coordinated and especially lacking for youths and other at-risk groups, a report set for release today concludes.

An estimated one in 20 city residents is infected with the virus. In light of that, the 170-page study by the D.C. Appleseed Center for Law and Justice identifies HIV/AIDS as "one of the most severe health problems facing the District, both in terms of disability and lost lives."

It urges top city officials "to speak frequently, strongly and clearly" about the disease and to take "committed and strategic steps" to improve management of surveillance, prevention, funding and treatment.

Among several dozen recommendations, it calls for immediate creation of an executive-level commission to lead the turnaround.

"This challenge is of life-and-death importance," the report says. "Simply put, business cannot go on 'as usual.' The District's efforts to address HIV/AIDS have fallen far short and addressing the epidemic must move front and center as a priority of District government."

The study began in early 2004 at the request of the Washington AIDS Partnership and with the support of Mayor Anthony A. Williams (D). The mayor has questioned why tens of millions of dollars in annual programs was not having more impact. D.C. Appleseed, a public interest organization, worked with the law firm of Hogan & Hartson, which donated more than 4,000 hours of research and writing to produce the report.

Some findings echo recent criticism of the city's HIV/AIDS Administration. During hearings before the D.C. Council's health committee and in an audit released by the D.C. inspector general in late June, the agency was faulted for significant dysfunction in how it funded, monitored and reimbursed organizations that deliver services to residents with the virus.

Such problems were underscored late last month when an official with the federal Centers for Disease Control and Prevention flew from Atlanta when a key HIV prevention planning group sought "immediate assistance" because the health agency had failed repeatedly to provide data needed for the group to do its job.

Today's report, "HIV/AIDS in the Nation's Capital," shows more fully the breadth and depth of the situation. The Williams administration is not contesting its conclusions or recommendations, said Gina Lagomarsino, a senior adviser to City Administrator Robert C. Bobb.

"Certain of the findings we're beginning to work on," she said. "We think they are generally fair."

As of 2003, the District's AIDS rate was 170.6 per 100,000 residents -- up sharply from 119 in 2001. African Americans have represented an increasing percentage of new AIDS cases.

The incidence of District residents with HIV remains a rough estimate because of one crucial shortcoming: the city's dearth of epidemiological information.