The 12 Cities Project

On February 11, 2011, spoke with Dr. Ron Valdiserri, Deputy Assistant Secretary for Health for Infectious Diseases in the Department of Health and Human Services about the 12 Cities Project. The National HIV/AIDS Strategy asks all of government including the Department of Health and Human Services to do a better job coordinating our program activities. So, in the 12 cities, we’re working very hard to bring together prevention, treatment, and care, which are all programs that are housed in different Federal agencies, but they all serve the same populations. So, the 12 Cities is working to bring those programs together in terms of planning for unmet need, as well as responding to unmet need with enhanced prevention services, improved diagnostic services, and efforts to maintain people in care.

It grew out of a program that CDC funded to enhance prevention activities in the 12 cities in the United States that represented the largest share of people living with AIDS—approximately 44% of all AIDS cases in these 12 cities: Atlanta, Baltimore, Chicago, Dallas, Houston, Los Angeles, Miami, New York City, Philadelphia, San Francisco, San Juan, and Washington, D.C. So you can see these are very diverse, very different communities, but what we’re attempting do in those communities is build on top of the CDC effort and bring other components of the Federal government into that process—bring in the programs that provide HIV treatment and care for people living with HIV, bring in those programs that provide mental health and substance abuse services, bring in programs from the Indian Health Service, for instance. Also bring in some of the Federally-funded research activities that can help us better understand how we can evaluate outcomes in these 12 cities.

So what we’re doing, the 12 Cities Project is an expansion of an existing effort underway by the Centers for Disease Control and Prevention, to expand that to include other important components of the Federal Government. We are emphasizing that although prevention and treatment and care and programs that address substance use and mental health and even programs that fund Federal research, they’re all developed and delivered out of different, separate Federal agencies, but what we’re attempting to do is combine them in a virtual way that will result in improved services, more highly coordinated services for communities at risk in these 12 jurisdictions. Certainly the Centers for Disease Control and Prevention has a very important role to play, but they’re not the only player in this effort.

Health Resources and Services Administration or HRSA is intimately involved in this undertaking. The Substance Abuse and Mental Health Services Administration (SAMSHA) is a key player. The Indian Health Service, as well as the National Institutes for Health. Now there are a number of other important Staff Offices who will be involved as well, and we don’t won’t to forget the important partners at the local level: state and local health departments as well as community-based and non-governmental organizations who are involved in this effort. So there’s a broad variety of partners both at the Federal level, as well as at the local level, and that’s the way it needs to be.

The Strategy tells us that achieving the goals, achieving the vision of the National HIV/AIDS Strategy, will not only require improved effort from the Federal government, but improved support and effort from all sectors of society including local government as well at the private sector. It’s really important to remember that the National HIV/AIDS Strategy applies to the entire nation and not just the 12 cities we’re talking about. We’re using these 12 cities as a way to better understand what changes we can make both at the Federal level as well as the local level to improve our services for people living with HIV/AIDS or populations at high risk for HIV/AIDS across the country.

So, we intend to apply the lessons learned in the 12 cities across the United States so that all people in America can benefit from this improved and enhanced approach to combining HIV prevention, treatment, and care services. You can learn more information about the National HIV/AIDS Strategy by visiting And will continue to provide you with updates of the work surrounding the 12 Cities Project in the weeks and months to come.