September 12, 2008
Fields, Long and Collins
More than 80 people gathered at the New York City LGBT Community Center Wednesday night to discuss the movement to implement a National AIDS Strategy. Organized by the Community HIV/AIDS Mobilization Project (CHAMP), the forum highlighted both the growing momentum around the idea of a National AIDS Strategy (NAS) as well as the numerous obstacles to putting one in place. The sticking points? Who will have input into the NAS and what the NAS will actually look like.
"Do I think there should be a National AIDS Strategy? I do. Did I sit in a room during the Clinton administration for three days [working to draft one]? I did. Do I want to do it again? I don't," said panelist A. Toni Young, of the Community Education Group in Washington, D.C. Other panelists included Chris Collins, the author of Blueprint for a National AIDS Plan, C. Virginia Fields, executive director of NBLCA and Charles Long, of the New York City AIDS Housing Network.
There have been calls for a National AIDS strategy since the beginning of the epidemic, as well as plans that have since disappeared. Advocates are hoping this time will be different. Fourteen months ago, Collins wrote Improving Outcomes: Blueprint for a National AIDS Plan for the Open Society Institute detailing what an effective plan would include. Leaders from seven large AIDS organizations—AIDS Action Council, ythe AIDS Foundation of Chicago, Balm in Gilead, the Black AIDS Institute, CHAMP, Gay Men's Health Crisis, and San Francisco AIDS Foundation—came forward to start the planning, which led to resentment among groups that weren't included. The working groups to draft and promote the plan are now open to the public. (To get involved, e-mail Collins at email@example.com)
Getting on board
Despite that initial dust-up, which has left residual wounds, more than 1,000 individuals and 300 organizations have signed on to the call for an NAS on nationalaidsstrategy.org.
After working with a group of women to write an "angry letter" to the planners, Young said "we realized we did support the concept, but we need more dialogue. And we've got to get on the train right now while it's still moving."
Barack Obama has already called for a National HIV/AIDS Strategy in his AIDS platform (though you'd be forgiven if you didn't know that—as noted at the meeting, you have to scroll the very bottom of his healthcare page to even find it). Obama reiterated his call for a National AIDS Strategy after the new CDC infection numbers were released. McCain has yet to call for a National AIDS Strategy.
Starting this weekend, the Stand Against AIDS kicks off. Mounted by the Campaign to End AIDS, the Stand is a multi-arm, multi-week advocacy road trip to the first presidential debate in Oxford, Mississippi on September 26, with the sole aim of obtaining commitments from Obama and McCain to take meaningful steps toward the creation of a National AIDS Strategy within 100 days of taking office.
Despite the new energy around the NAS, one thorny issue is what it will actually consist of. "I thought we'd come up here with an actual strategy and what the points need to be," an audience member at the CHAMP forum asked during the question and answer session.
NationalAIDSStrategy.org does not make specific demands about the creation and implementation of an NAS but its website does provide guidelines that "might" serve as blueprint.Those guidelines are to: Those guidelines include identifying and implementing the most effective treatment coverage approaches, an accountability timeline, pilot programs to address HIV among vulnerable populations and to address racial disparities, better federal guidance for states and requiring the Secretary of Health and Human Services to report regularly on the status of progress towards the plan's targets. (Click here for the full guidelines)
Collins noted in his remarks that the government and others outside the AIDS world need to be involved in the NAS discussion. "We see this as a strategy that has to be owned by the government," he said. But Collins also said that just having a plan is a waste if it doesn't actually achieve anything, pointing out that both the Clinton White House and the Centers for Disease Control and Prevention have had national AIDS plans that were more like "wish lists" than strategies.
"It's not just about getting rid of destructive policies like the ban on needle exchange and abstinence-only education. It's not new money here or there. It has to be all of those things but more than that," Collins said. "We need to hold the government accountable and hold ourselves accountable to make that happen."
Some NAS supporters looked to the precedent of demanding national AIDS plans from countries that receive PEPFAR funding. "We find it ironic that the U.S. requires fifteen nations getting PEPFAR to make plans, but we need to have one here," Fields said.
But the PEPFAR argument isn't as persuasive when foreign countries' plans are actually dissected (some are only half a page long). Although countries are required to write a plan, U.S. money is going to community-based organizations on the ground that aren't actually following the plan.
"I don't think any of us want the National AIDS Strategy sitting on the shelves," Long said. He also said (and Fields concurred) that this conversation is a waste if it doesn't lead to actual action and results. "I will refuse this invitation in ten years if we're still talking about this. I'll be busy that day," Long said.
Confronting our own demons
Another issue on the table at the forum was the need for people living with HIV and various constituencies to be included in the NAS process.
Young said that AIDS organizations ought to confront the realities of the epidemic, including the rates of recidivism in the black community and the fact that the AIDS communities' power brokers represent the same demographics as those at the beginning of the epidemic. "One of the things that's happened in the last 10 to 15 years is that the epidemic has changed, but the power dynamic hasn't," Young said.
Long agreed that the power structure doesn't reflect those infected and affected by HIV . The only HIV-positive panelist, Long told the crowd, "Being a part of the AIDS movement does not make you a person living with AIDS. Too often, there are not people living with AIDS at the table. Or groups working with youth have no young people at the table," he said. Long then challenged the group to "confront your own demons."
Long noted, "If black and Latino communities don't confront homophobia and classism, we're not going to have a productive conversation. If the gay community doesn't confront racism and classism, we're not going to have a productive conversation. I hear how young people don't' get it, because they haven't watched their friends die. But they don't know the world without AIDS, and they might have seen their parents die."
McCain or Obama?
One thing was clear at the forum: It was a pro-Obama crowd. Robert Banks began his remarks by saying, "In light of the events of the last few weeks I have to say how good it is to be in a room of community organizers—one of the most valuable professions known to human kind," a reference to Vice Presidential nominee Sarah Palin's swipe.
"God forbid if Democrats don't win in November, we're still going to push the next administration. This is our government too. These are our dollars too. We are ready to do whatever's necessary," Fields said.
There was also an awareness that Obama wouldn't necessarily wave a a magic wand over the NAS. "I don't care if it's, McCain or Obama. It's not going to be an easy fight. We have a lot of young people saying it's a manageable disease. And if I have to be here in 10 years I will," Young said.