REBECCA HAAG, the new executive director of the AIDS Action Committee, has been on the job for about three weeks (though she previously served on the AAC’s board of directors for six years). The last executive director, Michael Duffy, the highly regarded former chair of the Massachusetts Commission Against Discrimination, abruptly resigned his one-year tenure after an internal memo criticizing his performance was made public. Amid these personnel moves, the agency is trying to regain its footing after absorbing brutal cuts from the state — over the last 18 months, state funding for AIDS and HIV programs has been slashed by 37 percent. It’s also trying to figure out how to keep delivering services even as private donations have plunged: in 1992, the annual AIDS Walk sponsored by the AAC raised a record $3.2 million. Over the last five years, however, revenues raised via the walk have fallen from $2.3 million in 1998 to just $1.4 million last year.

It would be a mistake to look at the dramatic nature of Duffy’s departure and Haag’s ascension, as well as plummeting private donations, and conclude that the organization has lost its way. The AIDS Action Committee is dealing with the same issues facing every AIDS service organization in the country. The slumping economy, AIDS fatigue (the much-hyped phenomenon in which volunteers, private donors, and government agencies are simply sick of dealing with AIDS), and the dangerously false impression that protease inhibitors have turned AIDS into a chronic disease that’s as manageable as diabetes, have all created a climate in which it’s hard to marshal support for ongoing care of people with AIDS and HIV.

The organization, which provides housing assistance and free counseling in nutrition, AIDS treatment, and substance abuse to more than 2500 clients, has made some tough, but responsible, decisions to deal with falling revenues and cutbacks from the state. AAC has pared back its offerings to clients by cutting its frozen-meals program, which distributed meals to people living with HIV, and its signature Buddy Program, which matched volunteers who assisted with chores like laundry and meal preparation with people sick with AIDS. The AAC has also eliminated a program that provided free beds, microwaves, hot plates, and other household goods to people with HIV who were trying to set up apartments. It canceled its hepatitis C case-management program. And it no longer holds its annual community-recognition awards, which provided a much-needed morale boost to volunteers — the backbone of AAC’s programs — because the event did not bring in any money.

But the need for services remains as great as ever. And the AAC, New England’s largest AIDS service organization — and its oldest, marking its 20th anniversary this year — still does excellent work. " We are an organization in transition trying to respond to the fact that the disease has changed, " Haag notes.

Indeed. Much of the public’s attention to AIDS today is drawn to dramatic global statistics: worldwide, 42 million people are infected with HIV; five million were newly infected in 2002. Nearly 30 million of those living with HIV reside in sub-Saharan Africa, where four countries have seen the percentage of their adult populations infected with HIV rise above 30 percent: Botswana (38.8 percent); Zimbabwe (33.7 percent); Swaziland (33.4 percent); and Lesotho (31 percent). Not surprisingly, those numbers have rightly directed attention to the crisis of AIDS in Africa. On Tuesday, President George W. Bush called on Congress to approve his request of $15 billion in funding to fight the spread of AIDS in Africa.

Yet much work remains to be done locally. In the United States, approximately one million people are believed to be infected with HIV, nearly a quarter of whom aren’t aware of their HIV status. In Massachusetts, where two people are newly infected with HIV every day, there are approximately 22,000 people living with HIV — as many as 8000 of whom aren’t aware of their infection. Here, the main issues are helping people with HIV maintain rigorous therapy regimens. Cuts in funding " have a real impact on people [living with HIV] and their families, " says Haag. " AIDS is a very complicated disease. Clients need the right level of support services. The drug-therapy program requires incredible discipline. If you miss any one of the pills for any one day you risk harming your ability to fight off the virus. Many people have other issues in their lives: they don’t have appropriate housing, they can’t find jobs, they’re dealing with substance abuse. It can be very difficult for them to stay within the regimen without support. "

The AAC, which is a national leader in AIDS case management, excels in the slow, plodding, methodical business of keeping people with HIV alive. The organization needs — and deserves — your support. You can help out by participating in the 18th annual AIDS Walk. Donate money to a walker, or walk yourself. You can also volunteer at the event. This year’s walk takes place Saturday, June 1. Sign-up sheets are available at www.aidswalkboston.org, by calling (617) 424-WALK, or by e-mailing walkinfo@aac.org.

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