May 23, 2008
PLANNING MAKES PERFECT
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National AIDS-strategizing on the Hill |
The U.S. response to the AIDS crisis is a largely patchwork system with little accountability. And the U.S. still hasn't buckled down and created a plan to address the epidemic, even though it demands national strategies from all countries receiving Presidential Emergency Plan for AIDS Relief (PEPFAR) funding. At a Congressional briefing Tuesday, Rep. Maxine Waters (D-CA) and a diverse group of AIDS advocates spoke to a packed house of more than 100 Congressional staffers and advocates about the need for the next president to create a national AIDS strategy. Sens. Barack Obama and Hillary Clinton have both called for a comprehensive plan to fight AIDS domestically, though Sen. John McCain has not.
"Many AIDS organizations and elected officials have been trying different ideas for a long time now, but often without research to back it up," Waters told the Update. "And as a nation, our response to the epidemic has not been a consolidated effort with clear-cut goals and missions."
The call for a National AIDS Strategy will be heightened at the Campaign to End AIDS' "Stand Against AIDS," where hundreds of people with AIDS and their allies will descend on the September 26 presidential debate in Oxford, Mississippi to demand that the next president create a national AIDS strategy in the first 100 days of his or her term.
Panelists at Tuesday's briefing included David Holtgrave, a researcher at Johns Hopkins University; Mario Perez, director of the Office of AIDS Programs and Policy at the Los Angeles County Dept. of Public Health; Phill Wilson, executive director of the Black AIDS Institute; Kathie Hiers, CEO of AIDS Alabama, Terrell Halaska, former deputy chief of staff to Secretary Tommy Thompson; and Marjorie Hill, CEO of Gay Men's Health Crisis. They discussed the problem of AIDS in the U.S. ranging from stigma to the lack of coordination among stakeholders to the disproportionate effect of the epidemic on blacks and Latinos. But despite all of their urgings that the U.S. needs to create a blueprint, they did not lay out a blueprint, but are rather demanding Congress and the next administration draft a plan with evidence-based measurable goals to fight the epidemic.
We want the next administration to own the plan so they're held accountable," said Rebecca Haag, executive director of the AIDS Action Council and the briefing's moderator.
AIDS Foundation of Chicago associate director David Munar, one of the organizers of this effort, agreed. "Advocates, of course, need to guide the process, but the plan needs to be led by the federal government."
A united AIDS advocacy community?
The recent push for a national AIDS strategy grew out of last year's Open Society Institute report "Blueprint for a National AIDS Plan for the United States," which outlines what a comprehensive plan should include such as:
- drafting comprehensive and measurable holistic HIV/AIDS treatment and prevention goals independent of "hot-button policy debates such as school-based sexuality curriculum" that arise around Ryan White funding cycles ;
- limiting the number of goals related to fighting AIDS and setting and enforcing clear priorities for reaching those goals in different sectors of society ;
- making the HIV/AIDS prevention and treatment needs of African-Americans a primary focus, and dividing up prevention and treatment needs for different African-Americans communities;
- making the federal government responsible for coordinating HIV/AIDS efforts among local and state governments, community organizations and business;
- requiring the Secretary of Health and Human Services to report regularly on the status of progress towards the plan's targets .
Leaders from the AIDS Action Council, AIDS Action Committee, the AIDS Foundation of Chicago, Balm in Gilead, the Black AIDS Institute, the Community HIV/AIDS Mobilization Project, GMHC, and San Francisco AIDS Foundation thought that the OSI report shouldn't just sit in a box somewhere and started a petition calling for such a plan on nationalaidsstrategy.org. To date, more than 240 organizations and 875 individuals have signed on. And through prompting from an http://www.aidsvote.org survey, both Clinton and Obama committed to creating AIDS plans.
But with only eight brand name AIDS organizations seemingly in the driver's seat, some other advocates worried different populations would be lost in the shuffle. Housing Works president and CEO noted that at a planning session of some 40 head honchos at U.S. AIDS organizations (who were flown into New York by the Ford Foundation to discuss mobilization around an AIDS strategy), none currently received federal entitlements that the plan would discuss. "Even those of us in the room who were HIV-positive all have private health insurance," King said.
And the 2005 Ryan White Reauthorization process is still raw in the minds of advocates who were forced to fight among themselves for pieces of a shrinking pie.
"A lot of folks in the community feel left out the process of planning for the national AIDS strategy and had their feelings hurt," said Kathie Hiers, CEO of AIDS Alabama.
But Munar said calling for a national AIDS strategy was in no way envisioned as an elitist undertaking. "At the time it seemed like the right decision [to start small with the planning] and it wasn't meant to be malicious, but it created suspicion," he said. "But this is not about my organization, it's about my country, and we want as much involvement as possible to make this succeed."
Hiers agreed. "I think it's a no-brainer that the U.S. should have a domestic strategy. But I would encourage people not to let the details encourage the momentum so we can prioritize health care for vulnerable populations. We need to shift the priorities to deal with HIV in America."
And as Waters pointed out, a national AIDS strategy, with proper funding dollars attached, could lessen competition among regions and populations now fighting for limited resources. "AIDS in the United States does not get enough funding and not enough attention and not enough ability to implement what should be done. A national strategy will guide how and where we should be fighting the epidemic."