"The conferees did the right thing by substantially increasing funding to the AIDS Drug Assistance Program, which is helping to prolong the lives of so many people with HIV and AIDS," said Seth Kilbourn, HRC's senior health policy advocate. "By also increasing funding for other HIV/AIDS programs, the conferees showed that they understand the need for a comprehensive and balanced approach to combating this epidemic."

However, the conference committee delayed until March 31 HHS Secretary Donna Shalala's authority to approve federal funding for needle exchange programs aimed at limiting the spread of HIV and AIDS.

"We are disappointed that the committee needlessly delayed the secretary's authority," Kilbourn said. "The science exists right now to demonstrate that needle exchange programs are effective and do not increase illegal drug use. This delay will only mean that more people will become HIV-infected."

The Human Rights Campaign called on Shalala to issue a report immediately stating that needle exchange programs are effective and do not increase illegal drug use. This would lay the groundwork for her approval of the use of federal funds on March 31.

"The debate on needle exchange has always been about reducing HIV and engaging a vulnerable and hard to reach population in a scientifically sound public health strategy," Kilbourn said. "We have come a long way in educating members of Congress on this issue and hope they do not use the next five months to demagogue these programs. The entire HIV/AIDS community deserves credit for preserving the secretary's authority to act. "

The conference committee approved $285.5 million for the AIDS Drug Assistance Program, a 71 percent increase over fiscal 1997. The bill also includes a 7 percent increase to $1.6 billion for AIDS research at the National Institutes of Health and a 14.9 percent increase to $465 million for emergency assistance grants to cities hardest hit by the epidemic.

"These are clear signs that Congress understands the importance of getting the new drugs, primary care and other services to people who might not otherwise be able to afford them," Kilbourn said. "We also welcome the increase for NIH research."

The conference committee also increased funding by 3 percent to $634 million to the Centers for Disease Control and Prevention's HIV prevention programs.

Kilbourn singled out Sen. Arlen Specter, R-Pa., and Reps. John Porter, R-Ill., and Nancy Pelosi, D-Calif., for their leadership on AIDS funding and needle exchange policy. "We are heartened to see Congress and the Clinton administration working in a bipartisan way to address the continuing needs of people living with HIV and AIDS," Kilbourn added.

A report released in July by the National Alliance of State and Territorial AIDS Directors and the AIDS Treatment Data Network found that more than half the 52 state ADAPs have had to impose limits to cope with increased demands and costs.

And in June, the federal government released the first proposed guidelines for using the new, more effective multi-drug therapies -- a move destined to strain ADAPs even more.