The National Native American AIDS Prevention Center (NNAAPC) was founded in 1987 to stop the spread of HIV and related diseases and to promote better education and healthcare among American Indians, Alaskan Natives, and Native Hawaiians. After more than a decade, the Center still faces steep hurdles to meeting these public health goals.

Most of these public health problems of tribal and urban Native Americans hinge on the rampant underreporting of disease in tribal groups and the heavy cost of HAART and other expensive treatment regimens.

The first priority of the NNAAPC for is to improve disease surveillance among Native Americans. A recent Indian Health Service (IHS) survey found that the majority of the 94 tribes polled did not report infectious disease among their membersnot to the CDC, to the IHS, or to any state or local agencyeven though HIV/AIDS is known to be a significant health problem.

Other priorities of the NNAAPC involve easing the enormous cost of HIV treatment for Native Americans. New funding is urgently needed. While the AIDS Drug Assistance program (ADAP) funded state government programs for Medicare and Medicaid patients, that legislation left out IHS and tribal clinics that treated HIV patients. The IHS should be brought into ADAP now.

Healthcare coverage for Native Americans under the Ryan White Care Act is severely limited. The NNAAPC wants to change that by assuring that any reauthorization of the Act will cover the ongoing needs of Native Americans with HIV/AIDS and not just special projects. The Center is also focusing on programs to educate tribal officials about HIV and its impact on their limited healthcare resources.