First diagnosed in 1981, a year during which many current medical students were born, the human immunodeficiency virus (HIV) has accompanied us down a long and frustrating road. All of our hurdles taken into account, the daunting scientific battle that we face in coping with this disease continues to be eclipsed by the social and political tug-of-war that is being fought globally to ensure equitable and appropriate care for those living with the virus. While the images may differ, this lamentable state of affairs continues to plague resource-rich and -poor countries alike.

In the United States, 2004-2005 marks a critical period in this history due to the third round of negotiations for reauthorization of the government's landmark legislation dealing specifically with HIV/AIDS care and treatment. Enacted in 1990, the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, which provides the lion's share of financial support that states, cities, and institutions need to combat HIV/AIDS in the United States, comes up for reauthorization by the US Congress later this year.

With the lives and welfare of millions of Americans at issue -- to say nothing of the ripple effect that US action on HIV has traditionally had internationally -- the clinical care community's efforts to ensure appropriate reauthorization of (and funding for) the Ryan White CARE Act will take on unparalleled significance this year. The act, which must be reauthorized no later than every five years, requires collective maintenance and refurbishing in this instance as never before.

More than 20 years into our struggle, and with no cure or viable vaccine for HIV on the immediate horizon, it is incredibly important that care providers walk hand in hand with the patient community to ensure that the challenges inherent in both living with and treating this infection and its myriad complications are duly reflected in the act that is reauthorized. With that in mind, the International Association of Physicians in AIDS Care (IAPAC) recently joined forces with domestic US organizations to launch a multi-pronged Ryan White CARE Act reauthorization campaign.

Beginning with an inaugural community summit held last month during the 11th Conference on Retroviruses and Opportunistic Infections (CROI), IAPAC, the HIV Medicine Association (HIVMA), American Academy of HIV Medicine (AAHIVM), AIDS Institute, Association of Nurses in AIDS Care (ANAC), National Association of People with AIDS (NAPWA), and Physician Assistant AIDS Network (PAAN) initiated what will be a one-year-plus campaign to present the voices of care providers and patients to US policy makers and their constituents.

IAPAC and our partner institutions have taken an unprecedented step to put forward a harmonized message around current needs and priorities in the fight against HIV/AIDS in the United States. More will be forthcoming in this regard on a regular basis over the course of 2004, and into early 2005.

IAPAC is intent on playing a strong facilitating role in channeling the voices of our association's 6,900-plus US physician members, whom I encourage to pay close attention to both the IAPAC Web site at and the IAPAC Monthly for important updates and news about opportunities to become involved at the federal, state, and local levels in activities that will be planned for the upcoming year.

These opportunities, and efforts for which we sincerely request active participation, will range from briefings before the US Congress, to planned, clinical day-visits for political representatives, to expert testimony regarding HIV care. All of these activities that IAPAC will unfold, both independently and in harmony with partner organizations, intend to present to legislators the impressions and requests of those who are tasked with the responsibility of ensuring wellness for patients with HIV/AIDS: You, the care and support providers.

While it is always on my mind as the chief executive officer of an association representing the interests and concerns of care providers globally who are at the side of those living with HIV/AIDS, this is a particularly poignant time for me to reiterate IAPAC's sincerest appreciation for the leadership of our members across the globe, and for your continued demand that IAPAC be a vehicle to bring your clinical and social expertise to the table. We have no greater satisfaction than to assist in making sure that our members are well equipped to deliver the best available care and treatment for their patients and are supported in achieving continued safety and comfort both within the clinical setting and in professional life.

From the outset of the Ryan White CARE Act reauthorization campaign, I want to thank you in advance for the leadership that I know many of you may be counted on to provide. And, I reiterate to you our standing request that you continue to submit to us your concerns, your requests, and your statements of need.

José M. Zuniga is President/CEO of the International Association of Physicians in AIDS Care (IAPAC), and Editor-in-Chief of the IAPAC Monthly_._