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The Early Years (1991—1995)

The Comprehensive AIDS Resources Emergency (CARE) Act of 1990 brought hope in an environment of loss. By the end of 1991, the first year in which grants were distributed, 156,143 people had died of AIDS in the United States.*

“Death was everywhere, and it was constant,” remembers Sheila McCarthy, director of policy and branch chief of the policy branch for the HIV/AIDS Bureau Division of Science and Policy. “I went to meetings time after time in which someone I had expected to see around the table had now died.”

The new CARE Act was implemented with breathtaking speed. HRSA quickly created the administrative mechanisms mandated by the new law. A united force of governments, providers, and entire communities rapidly expanded existing programs and built new ones from the ground up.

Services were offered where there had been none. Comfort and treatment were now provided to people who had had nowhere to turn. With a boldness and energy that defines the American spirit in times of crisis, the Nation responded to AIDS—an epidemic that in the first years of the CARE Act demonstrated its full and terrible power.

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