Mississippi is just one of several mostly rural states across the South with a dearth of resources for HIV and AIDS patients.

“Here, there’s no support group, no case management. There’s no daily reinforcement,” said Webb, 52, who has been HIV-positive for two decades.

Activists and the health care providers cite a need for more federal and state funding for outreach and drug assistance programs, as well as transportation for patients who have to travel from small towns to get care. That’s the message they’ll deliver when a top White House aide holds a rare community discussion Monday in Jackson.

Jeffrey S. Crowley, director of the White House’s Office of National AIDS Policy, said the meeting will highlight two realities of the national epidemic – the significant number of cases in the South, and how the disease disproportionately affects minorities.

The spread of the disease in the South has been attributed to numerous factors, including poverty and a social stigma that discourages many from getting tested or seeking treatment.

Patrick Packer, executive director of the Southern AIDS Coalition and a moderator for the discussion, wants to pose this question: “Why is it that the South is not getting its fair share of federal money based on the epidemic?”

The South leads the nation in the percentage of AIDS-related deaths. Yet, the region ranks last when it comes to overall federal dollars spent on an HIV-infected person at $6,565 a year, according to the coalition.

Forty-six percent of new AIDS cases in 2007 were in the South, according to the latest figures from the U.S. Centers for Disease Control and Prevention. Twenty-five percent of the new cases were in the Northeast, and 17 percent in the West, two regions with the nation’s largest metropolitan areas that have for many years received most of the federal money.

However, the South stands to get more funding.

President Barack Obama signed the $2.2 billion Ryan White HIV/AIDS extension act last month, which continued funding for rural areas, putting the South second in federal money behind the northern region. Activists said it’s still not enough to keep pace with the new cases.

Debbie Konkle-Parker, a nurse practitioner in Jackson, said the act also added federal money to the South in 2006, but didn’t put rural areas on the same level as big cities.

“The inequities were pretty huge,” she said. “People were spending (Ryan White) money in New York City to do journal writing conferences, and in Mississippi, we couldn’t even get people to the clinics.”

Konkle-Parker said Mississippi has about eight public clinics to treat the majority of the 9,000 HIV patients in the state.

The current economic crunch has exacerbated the situation. Some states, like Kentucky, have cut funding for HIV/AIDS programs. The state had been contributing $250,000 a year prior to 2007, but now almost no state money is set aside for the AIDS Drug Assistance program, said Sigga Jagne, a program manager for the Kentucky Department of Health.

There are 1,277 enrolled in Kentucky’s program with 100 more on a waiting list, she said. Arkansas and Tennessee also now have waiting lists for the program, which is mostly federally funded but receives some state money. Packer said funding cuts have led to the waiting lists.

“We’re already disproportionately impacted by poverty and high rates of umemployment. It’s important for people who are HIV positive to be provided with life-sustaining drugs,” Jagne said.

Anna-Lise Williamson, an AIDS researcher at the University of Cape Town, told The Associated Press that the clinical vaccine trial that began Monday would continue with U.S. money. But she said South Africa’s Department of Science and Technology had stopped funding her research this year and the utility Eskom’s contract for funding ended last year and was not renewed.

Even though South Africa’s science minister appeared at a ceremony launching the vaccine trial with Williamson and lauded her research, neither he nor Eskom immediately returned calls seeking comment about funding.

At the ceremony, one of 36 healthy volunteers was injected Monday before officials and journalists in Cape Town’s Crossroads shantytown. The event was also attended by American health officials who gave technical help and manufactured the vaccine at the U.S. National Institutes of Health.

“For vaccine development presently, the South African AIDS Vaccine initiative has no money,” Williamson said. “If we do not continue working on this, we will never have a vaccine… it’s incredibly important that we keep working.”

The South African vaccine, developed at the University of Cape Town, targets the specific HIV strain that has ravaged South Africa.

During nearly 10 years of government denial and neglect, South Africa developed a staggering AIDS crisis. Around 5.2 million South Africans were living with HIV last year – the highest number of any country in the world. Young women are hardest hit, with one-third of those aged 20-to-34 infected with the virus.

AIDS vaccine researchers have met so many disappointments some activists are questioning the wisdom of continuing such expensive investments, saying the money might be better spent on prevention and education.

A new report says HIV vaccine research funding worldwide decreased for the first time since 2000, with investments of almost $1.2 billion in 2008, down 10 percent from 2007.

South Africa was also the site of the biggest setback to AIDS vaccine research, when the most promising vaccine ever, produced by Merck & Co. and tested here in 2007, found that people who got the vaccine were more likely to contract HIV than those who did not.

South African scientists working on the latest vaccine had to overcome deep skepticism from their political leaders, who had shocked the world with their unscientific pronouncements about the disease. Williamson said South Africa, at the heart of the epidemic, must press ahead with trials to test the safety of the vaccine.

“We have got the biggest ARV (anti-retroviral) rollout in the world and still hundreds of people are dying every day and getting infected everyday,” she said.

Williamson’s vaccine also is being tested at a trial of 12 volunteers in Boston that began earlier this year, said Anthony Mbewu, president of South Africa’s government-supported Medical Research Council that shepherded the project.

“It is being very well tolerated, no adverse events, so it is going very well,” Williamson said Monday.

The trial started in the U.S., partly to allay any criticism that the United States was collaborating in an AIDS vaccine that would use Africans as guinea pigs.

The government decided it was important to develop a vaccine specifically for the HIV subtype C strain that is prevalent in southern Africa “and to ensure that once developed, it would be available at an affordable price,” Mbewu said.

Some 250 scientists and technicians worked on the latest vaccine project.

Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Disease and a leading AIDS researcher, said the South African scientists received more money from his institute’s research fund than any others in the world except the U.S. The U.S. had paid to produce the vaccine.

He called it “the most important AIDS research partnership in the world.”

But he warned “There are extraordinary challenges ahead,” referring to the years of testing needed now that South Africa has reached the clinical trial stage.

At an international AIDS conference in Cape Town, Vice President Kgalema Motlanthe emphasized Sunday night that the clinical trials were being held “under strict ethical rules.”

Mbewu said the crisis in South Africa more than justifies the expenditure on AIDS research. AIDS strikes men and women alike in Africa, where the epidemic is fueled by the many people who have sex with several people at the same time.

In the 1990s, South Africa’s then-President Thabo Mbeki denied the link between HIV and AIDS, and his health minister, Manto Tshabalala-Msimang, mistrusted conventional anti-AIDS drugs and made the country a laughing stock trying to promote beets and lemon as AIDS remedies.

Williamson, a virologist, said the scientists had to fight constant controversy, including international organizations that tried to stop the state utility Eskom from funding the project. Eskom gave “huge amounts” regardless, she said.

“International organizations told Eskom that this was a terrible waste of money, that putting money into South African scientists was like backing the cart horse when they need to be backing the race horse,” she said.

Even her research director told her she was wasting her time.

“Most of them just made us more determined to prove them wrong,” Williamson said.

National Black HIV/AIDS Awareness Day was observed across the country on the weekend. African-Americans face the most severe rates of HIV infection in the nation.

The latest estimates indicate that while blacks make up just 12 percent of the U.S. population, they account for nearly half of new HIV infections and almost half of the more than one million Americans estimated to be living with HIV.

“The harsh reality is that one in 16 black men will be diagnosed with HIV at some point in their lifetime, as will one in 30 black women,” said Dr. Kevin Fenton, Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

Sixty-three percent of new infections among black men occur among men who have sex with men. Further, there are troubling signs of a worsening epidemic among young black MSM, as HIV diagnoses in this population have increased dramatically in recent years. Black women are also disproportionately affected by HIV, with infection rates 15 times as high as those of white women.

“To turn the tide, we all must continue to confront the realities of this disease in African-American communities,” said Fenton in a statement.

“While race itself does not increase risk, high prevalence of HIV and other sexually transmitted diseases in black communities means African-Americans face a greater risk of HIV infection with each sexual encounter than other groups. Stark realities of some African-Americans’ lives – including poverty and limited access to health care – increase the likelihood of HIV infection. Stigma and homophobia also contribute to keeping HIV alive in black communities.”

But Fenton also said that recent evidence shows there is progress being made.

“In a promising sign that prevention efforts are working, a major CDC study recently found that new infections among blacks have remained roughly stable for more than a decade – despite the growing number of people living with HIV who can potentially transmit the disease. New infections have also declined among several transmission groups in which African-Americans are disproportionately represented – babies born to HIV-infected mothers, intravenous drug users, and heterosexuals.”

Still, nearly 25,000 blacks still become infected with HIV every year.

In 2007, CDC spent $300 million – more than half of its domestic HIV prevention budget – on fighting HIV in African-American communities. And through the Heightened National Response to the HIV/AIDS Crisis among African-Americans, CDC is working with black leaders and public health partners to expand the reach of existing prevention programs, develop new interventions and research, increase testing, and mobilize black communities.

“As a nation, we must recognize the HIV epidemic for the crisis that it is,” Fenton said. ” In our communities, we must work to confront the stigma that prevents too many of those at risk from seeking testing, treatment and support.”

Campaigning in Virginia, McCain suggested earmarks are particularly shameful at a time when families are struggling with rising food, gas and home mortgage costs. He vowed again to veto any bill that contains such funding.

“I got an old ink pen, my friends, and the first pork barrel-laden earmark, big-spending bill that comes across my desk, I will veto it. You will know their names. I will make them famous and we’ll stop this corruption,” McCain said during a rally at a park in suburban Washington, D.C.

Palin has sought $197 million worth of earmarks for 2009, down about 25 percent from the $256 million she sought in the 2008 budget year. As mayor of tiny Wasilla, Alaska, she hired a lobbyist to seek federal money for special projects. Wasilla obtained 14 earmarks, totaling $27 million, between 2000-2003, according to Taxpayers for Common Sense.

Democratic presidential candidate Barack Obama hasn’t asked for any earmarks this year. The Illinois senator sought $311 million in such funding last year. McCain, an Arizona senator, doesn’t seek earmarks for his state.

Undaunted by his running mate’s ties to earmarks, McCain said: “I’ve fought corruption, and it didn’t matter if it was Democrats or Republican, and so has Sarah Palin.”

Palin said she has “championed earmark reform” as governor and “reformed the abuses of earmarks in our state.” Now, she said, she is ready to join McCain in Washington “so we can end the corrupt practice of abusive earmarks after all.”

The practice of earmarking – lawmakers inserting special requests for money for home-state projects in spending bills – is a longtime anti-Washington bugaboo for politicians running for office. Many find that, once in office, requests from constituents for help on a particular project is too tough to resist and support bringing that kind of money home to their states and districts.

“John McCain’s idea of changing Washington is a vice-presidential candidate who, as governor, requested more pork per person than any other state in the country,” said Obama campaign spokesman Tommy Vietor.

Still, McCain and Palin’s attack on earmarks in the face of those she has requested joins other statements by the vice presidential nominee that have been widely debunked:

-Palin routinely claims to have put an end to Alaska’s infamous “bridge to nowhere,” even though she supported the project during her gubernatorial campaign and turned against it only when it became a national embarrassment and Congress threatened to cut its funding.

-Palin has claimed that she put the governor’s jet on the Internet auction site eBay, and McCain has said it was sold at a profit. However, the jet was never sold via eBay.

-Palin says she eliminated the governor’s chef from the state budget, yet she gave the person another job in state government.

McCain aides said Thursday’s event attracted the biggest non-convention crowd of his campaign, with local officials reporting an estimated 23,000 at the event. People filled the grass and hillsides to make a sea of red, as the state GOP exhorted everyone coming to wear the hue in a sign of support for the party, and they often drowned out the candidates’ words with chanting.

Judging by shouts from the crowd, the enthusiasm seemed driven primarily by the presence of Palin. She has electrified both McCain’s campaign and the party since he announced her as his running mate almost two weeks ago.

The reaction was significantly different in Philadelphia.

McCain made a solo trip for a round-table discussion with half a dozen female business leaders at the Down Home Diner. The appearance, inside a bustling indoor downtown marketplace, formed a sharp contrast with the earlier joint show, as the arrival of both McCain’s bus outside and him inside was greeted by loud Obama crowds.

The Republican could barely be heard over the Obama cheers by the women he met, or by reporters when McCain made a statement after.

“Pennsylvania is a battleground state, as we can tell,” he said with a small smile.