The 12 Cities Project

An important component of the HHS National HIV/AIDS Strategy Operational Plan is what is known as “the 12 Cities Project.” The HHS-wide project supports and accelerates comprehensive HIV/AIDS planning and cross-agency response in the 12 U.S. jurisdictions that bear the highest AIDS burden in the country.

We have touched on the project in some prior posts, but I recently spoke to Dr. Ronald Valdiserri, Deputy Assistant Secretary for Health, Infectious Diseases, to learn more about the project and its importance for helping the nation achieve the Strategy’s goals. View Dr. Valdiserri’s video below.

We have also prepared an overview (PDF) of the 12 Cities Project.

While this initiative represents is a significant component of the HHS NHAS Operational Plan, it is by no means the only activity HHS is undertaking to pursue the Strategy’s goals. To be sure, HHS is actively pursuing more than 175 actions specified in the first NHAS Federal Implementation Plan plus many additional ones set forth in its Operational Plan.

In the coming weeks and months the blog will be featuring updates about how all of these activities, including the 12 Cities Project, are unfolding.

HHS 12 Cities Project


  1. We hear a lot about these same jurisdictions. They continually get increased funding but seem to never produce positive results. How long do the rest of us have to wait before we receive support? It is ridiculous that we have to continue pouring millions of dollars into these agencies and get no results while the rest of us are left to produce results with NO FEDERAL SUPPORT. It is not fair that our tax dollars are being used to support agencies and programs that do not provide any benefit to us. When will they rest of us see support coming our way?

    • Michael Pitkin says:

      Robert I agree.. I believe there should only be a base “core” of services for all who are living with HIV(before there are specialty services).

      S.F. is gloated with so many service organizations providing duplicate services(this should not be allowed). There are so many services I am not allowed to have, because I can not belong to the right “minority group” or service organization.

      I beleive the other 60% of people living with HIV, in the rest of the nation, need to write the President, HRSA and the CDC demanding equal access for basic “core” HIV services for all.

  2. Caroline I Maldonado Resto says:

    Im from Puerto Rico, and we are part of 12 cities. This initiave represents a great opportunity to all the skateholders to do something regarding this desease, not just in our city, but throughout all the Nation. “Unity make us stronger in any setting”

  3. Hi – I’m in Miami and I’m excited about this initiative. @Robert Lampkins, my organization is all about cross promotion and supporting other community based organizations (in our state and out)in the fight against HIV and AIDS. If you would like any educational materials or videos, please message me. I look forward to working together as I am sure that our goals are mutual.

    • Robert,

      I am the Chair of the Board of Directors for the recently-founded Miami AIDS Project (MAP). MAP is a non-profit providing capacity building, evaluation, and community research services to other CBOs in South Florida. It’d be great to connect and work together.

  4. It is great to see the comments about unity and cross promotion. However, it also takes dollars to put plans into action. When all of the dollars continue to flow to the same organizations in the same cities, it does the rest of us no good. The cities that are part of the 12 Cities Project all have numerous organizations duplicating services. Also, when determining need, the number of cases must not be the main factor. Larger areas will always have more numbers but that does not mean they have higher need. Government, private foundations and corporate dollars continue to pour into the larger urban. Smaller and rural areas are left to provide services with no support. If an agency is a large urban goes down, there are a number of other alternatives to step in and take their place. However, in smaller areas one agency is normally tasked with providing services. If one agency suffers, the entire community suffers.
    People in large urban areas as well as decision makers must realize that numbers do not necessarily mean the need is greater. If that is the case, smaller areas would never receive anything. As it stands currently, the overwhelming majority of funds are given to the same agencies in the same jurisdictions. Unity is great as long as we are all sharing. However, when we continue to be excluded from opportunities, I find it difficult to think that we are united. No one, nor any agency from any large city (I am only 90 minutes outside San Francisco) has ever said that they are willing to take fewer dollars so that other areas can receive financial support. If so, then I will be the first in line to say send the money my way.

  5. Thank you for your comments to my post. However, it takes more than unity or educational materials to address the issues we are facing. We need dollars as well. Material and unity do not pay for the staff to do the actual prevention work. Areas such as mine have been so under funded that we are unable to keep up with the increasing demand for services. HHS provides a multitude of grants that are directed toward large urban centers. However, numbers should not be the only determinant as to who needs assistance. If that was the case, small jurisdictions would never receive a dime (which by the way is the case). Impacts on organizations in smaller areas are actually higher than in the larger jurisdictions. The reason is that we have fewer resources and fewer agencies to provide services. Each of the 12 cities has a number of agencies duplicating services. Why not consolidate some of these organizations so that more money is available to organizations in smaller jurisdictions? Additionally, larger areas benefit from corporate, individual and private foundation funding that we are unable to access. If we really want to talk about unity, then please, some of the organizations that are receiving millions of dollars in federal funding, share it with us. We don’t need materials, we need money. We would like to provide a unified front but as long as the disparity exist and some of us are shut out of receiving a fair share, I find it difficult to want to speak of unity. HHS, CDC, SAMSHA, etc., have all failed to provide support to communities in my area yet our tax dollars are used to provide support to agencies that provide no benefit to my community. There has never been a national organization that has received funding, reach out to my community. Agencies serving the San Francisco Bay area have never supported my community, even though we are 60 minutes away. California AIDS Ride provides million of dollars to San Francisco and Los Angeles agencies, but not a single dime to us. Yet they ask for our support. Disparity exist on many levels. We have a system of have and have not. The 12 cities project is an example of this. HHS provided not a single dollar to any community based organization in Central California. CDC handed out 61 million dollars in funds in California and not a single dollar was awarded here in the Central Valley. If we are serious about helping and unity, then let’s say it like it is and address this issue. I cannot support projects or organizations that continue to provide benefit for those who already have resources while overlooking the rest of us.

    • @Robert…I understand your frustration when it comes to services being duplicated. This kind of thing will just undercut different population groups in urban areas but more so in the rural areas; Just for the simple fact of the location of a agency. As an woman of color affected by this epidemic and now working in the feild, I see that women are so underserved when it comes to getting services and care. So until HRSA and CDC understand that “EQUAL ACCESS” to care across the board is one of the ways to help communities fight this battle..

  6. I think we have to consider that many of these jurisdictions do not only serve the larger urban area, but also the smaller areas such as surrounding counties. In Philadelphia, my city experienced cuts last year, but our smaller counties that are funded were held harmless because of sustainability. Although these cuts resulted in programs ending and doors closing, Philadelphia withstood the cut. I hear what you are saying, but urban areas cannot be ignored because their dollars affects everyone (increases and decreases).

  7. We have had funds shifted from our areas to support larger urban areas. We have never seen funds shifted to us nor do any organizations in these large urbans support our area. In fact, we are restricted from accesses funding from foundations and and corporations because we are not in one of the larger counties. The recent California HIV Initiative by AIDS United, formerly National AIDS Fund, excluded any agency outside of Metropolitan Los Angeles and the San Francisco Bay Area counties. In large urban areas some programs should probably shut their doors. Many of them are duplicating services to the same populations. It would be a more sound decision to consolidate funding and reduce cost than to continue funding multiple agencies so that agencies in smaller counties are able to receive funding also. No urban dollars affect my area. In fact, they do more damage than good because they take dollars away but do not put anything back in by way of services, assistance or funding. We are in fact providing more to the large urbans as dollars that we should get are shifted to support them.

  8. Donald Babb says:

    The link to the overview of the 12 Cities Project(PDF)does not work.

  9. Mike Harris says:

    Hello all, I recently launched a non-profit organization aimed at STI/HIV prevention. I’ve given a number of presentations to church organzations/schools/Indiana Institute Training and have had some success at getting the word out. But I want to do more, by that I mean have a greater impact. DOes anyone have some advise they can lend me that will get me going in the right direction as far as what’s most effective for your organization or ways to get more active instead of waiting on the phone to ring so to speak?