What Next? The Election and Black America’s AIDS Epidemic

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Last Tuesday’s election results have far-reaching implications for the nation’s response to the AIDS epidemic and other health related issues in Black America. While the national media has focused attention on the “Tea Party” mov

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Last Tuesday’s election results have far-reaching implications for the nation’s response to the AIDS epidemic and other health related issues in Black America. While the national media has focused attention on the “Tea Party” movement, most Republicans elected to Congress were mainstream conservatives. Yet all share a common political platform of deficit reduction, extending the Bush-era tax cuts, and hostility toward President Obama’s signature legislative achievement: health care reform. These realities jeopardize the progress we’ve made so far toward ending the AIDS epidemic in Black communities and improving general health outcomes for Black people. They underscore the urgent need to reinvigorate our efforts to compel the nation’s decision-makers to address a health crisis that isn’t going away.

Tuesday’s results present at least three major challenges to a stronger, more vigorous national fight against AIDS.

1. A Loss of Political Clout

Many of the strongest Congressional AIDS champions will no longer occupy key leadership positions. House Speaker Nancy Pelosi, who worked tirelessly to increase AIDS funding, will be replaced as by Rep. John Boehner of Ohio. Wisconsin Rep. David Obey’s retirement represents another loss. As chair of the House Committee on Appropriations Obey helped preserve and strengthen federal support for AIDS programs. The Congressional Black Caucus (CBC) has lost influence as well. For example, longtime AIDS champion Rep. Barbara Lee will no longer be a majority member on the House Appropriations Committee. The CBC has been instrumental in increasing federal support for AIDS programs in Black communities, establishing the Minority AIDS Initiative and working to fund essential AIDS services.

2. AIDS Funding at Risk

Second, the focus on deficit reduction will make it increasingly difficult to achieve funding increases to combat AIDS. The new Republican majority campaigned on a platform of reducing federal spending on discretionary programs, such as the Ryan White CARE Act, the HIV prevention program at CDC, and substance abuse and mental health services for people living with HIV. Federal money can’t solve every problem. But it’s hard to tackle a threat as big as AIDS without energetic federal support.

HIV prevention has long been under-prioritized. Federal funding for prevention services has declined during the last decade, and prevention programs account for only three cents of every AIDS dollar the federal government spends. The fact that more than 56,000 Americans (nearly half of them African American) become newly infected with HIV each year offers compelling proof that you don’t get what you fail to pay for. We can’t turn the epidemic around in Black communities without stronger federal support for HIV prevention. President Obama has proposed one of the first increases in HIV prevention spending in the last decade, but the fate of this proposal remains unclear.

Additional funding is also needed to keep low-income HIV-positive Americans healthy. As a result of funding shortfalls, nearly 3,600 Americans who need AIDS drugs cannot obtain them–a problem certain to grow without additional federal support. Congressional willingness to appropriate additional funds for AIDS Drug Assistance Programs could mean the difference between life and death.

3. Health Care Reform in Jeopardy

Third, the new Republican House majority states its commitment to repealing health care reform legislation. Although this is unlikely, the G.O.P. may seek to withhold funding to implement key provisions. Health care reform has the potential to dramatically broaden and strengthen the safety net for low-income Black people living with HIV. Black Americans are far more likely than others to lack health coverage–a major reason why HIV-positive Blacks are less likely to receive life-preserving HIV-fighting treatments. By expanding Medicaid, establishing new mechanisms to broaden private coverage, and prohibiting discriminatory practices by the private insurance industry, the health care reform bill will enable many currently uninsured Black people living with HIV to obtain the coverage they need.

Additionally, it authorizes community-transformation grants to build capacity in underserved communities and a major new public health fund to train and deploy community health workers to address issues such as inadequate HIV testing rates, insufficient linkage to care and treatment for people who test HIV-positive, and support services to help patients adhere to treatment.

Where Do We Go Now?

These challenges are disheartening. But, Black Americans have never given up, even when facing long odds. Importantly, we must avoid making assumptions about the new Republican representatives. After the 1994 elections, when Republicans swept away a Democratic Congressional majority, AIDS advocates helped educate the new members. Some of the movement’s most enduring successes occurred when President Bill Clinton occupied the Oval Office and Republicans controlled Congress.

You can take responsibility for ending the AIDS epidemic in Black communities by helping your elected representatives—whether experienced or new—understand the epidemic’s impact upon their district and by insisting that they address the needs of the most vulnerable among us. For example, HIV/AIDS rates among Black people are rising fastest in the South, where Republicans made some of their greatest gains.

Our work has never been more important. But, our agenda transcends political divisions. I remember emergency rooms full of people with AIDS, visiting people on their deathbed and weekly memorial services. No matter who just got elected, I’m not going back to that era.

Copyright 2010 NNPA

Phill Wilson is the President and CEO of the Black AIDS Institute, the only National HIV/AIDS think tank in the United States focused exclusively on Black people. He can be reached at PhillWilson@BlackAIDS.org.

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