Beyond the Debt Ceiling: A Way Forward in HIV

By jschneidewind on July 29, 2011 in Policy/Advocacy, Uncategorized

Jimmy Schneidewind

by Jimmy Schneidewind, Public Policy Associate

Sitting around and waiting for the outcome of the debt ceiling circus can be a bit maddening in more ways than one, particularly if you don’t derive pleasure from witnessing dysfunction  or if you work in a field like public health and HIV programs that are likely to suffer at the hands of deep spending cuts. As Congress continues to back their way into a debt ceiling compromise, one thing has become quite clear: deep spending cuts will be made. Although it is easy to get caught up in every twist, turn, and non-action by our elected representatives, this type of behavior will likely increase your blood pressure and can also be disempowering if you overlook the progress that has been made in the fight against HIV when funding streams unpredictable. Certainly money is what makes it possible to scale up effective programs and interventions as well as protect essential safety net programs like the Ryan White Care Act that serves as the payer of last resort for low-income people living with HIV. However, it is clear that at least for the foreseeable future as we continue to struggle through a stark economic climate and an even starker political climate, we need to be ready to move forward and make the most with whatever resources we have available to us.

Here is a list of 5 ways to maximize the impact of your organization or your own personal advocacy efforts without having to rely on Congress:

1. Align your goals and work with the goals of the National HIV/AIDS Strategy (NHAS)

For the first time in our country’s history, we have a comprehensive strategy to fight HIV that includes metrics, a timeline, and specific jobs for specific governmental agencies. The Strategy sets some ambitious goals, including lowering the incidence of HIV by 25%, and increasing the number of diagnosed Blacks, Latinos, and gay and bisexual men by 20%, all by 2015. HIV organizations and advocates around the country have an important opportunity, nay, an obligation, to be faithful to the principles of the Strategy. In four short years, we could all see a major difference in the epidemic if we work toward a common vision.

2. Concentrate your efforts on the areas and populations that are hardest hit by HIV

Although this is a component of NHAS, it warrants being highlighted. Based on evidence and data, the Strategy identified certain demographics that are disproportionately at risk for HIV. Among the most prominently mentioned were Blacks, Latinos, and gay and bisexual men (MSM). MSM account for 53% of new HIV infections in the United States, though they only make up an estimated 4% of the general population. Hispanics and Blacks combined make up 27% of the general population but together carry 63% of the burden of new infections. It is simply not possible to make a noticeable dent in the epidemic if we do not focus our efforts on these and other vulnerable populations.

3. Share, Collaborate, and Coordinate with other like-minded organizations

An implicit and explicit purpose of NHAS is to ensure that all HIV organizations and advocates, as well as other sectors like housing and education are working together to achieve the goals of NHAS. The days of combating HIV as a makeshift hodge-podge of disconnected HIV organizations are over. In order to win this battle, we must become leaner, smarter, more effective, and wider-ranging with our efforts as an HIV community, and we can only do that if we begin to look to each other for support in areas where we do not specialize. Unlike our lawmakers in Washington, we must realize that “collaboration” and “coordination” are not dirty words. The Ryan White Care Act has been so effective at providing care to people living with HIV because it acknowledges that people living with HIV require a breadth of services including treatment, housing, dental care, nutritional services, transportation, education, and more. It may be a tall task for a single organization to encompass all of this, but if we act as a community, it is quite possible for us as a community of multi-sector organizations and agencies to provide the services and advocacy that people living with HIV deserve.

4. Strengthen, inform, and enlarge your base

There are currently 1.1 million people living with HIV in the United States. Add this to the countless others who are not HIV positive but are deeply invested in the fight against HIV, and you have a caucus that is not small by any definition. Think of what a difference it would make if all these people were educated, inspired, and armed to go out and make their voice and presence heard. Just imagine what we could do! Regardless of the way in which you or your organization engages in HIV issues, an area of concentration has to be growing your base of constituents and then capacitating them to go out, find others, and advance our national HIV agenda.

5. Support successes and effective interventions

Successes and advances in the field of HIV are made all the time and we need to make sure that the whole world knows about it. Over the past year we have seen significant progress in biomedical research like microbicides, PrEP (pre-exposure prophylaxis), and treatment as prevention, all of which have made people think that a functional cure or a safe, effective vaccine is actually possible. Policy advancements have also made a difference, including the lifting of the federal ban on syringe exchange programs, which helped lead to a noteworthy reduction in incidence in Washington DC, the reauthorization of the Ryan White Care Act, the passage of the Affordable Care Act, and the unveiling of NHAS. As organizations and advocates, it is our job to act as a megaphone for HIV communities and report their success stories and if lawmakers are unaware of the benefits of HIV funding or the important impact of their policy decisions, then we have no one to blame except ourselves.

Surely more needs to be done and more funding is always welcome and necessary, but there will be no time to despair if funding streams shrink; we need to move forward with the vehicles available to us, just as we always have and always will.

1 Comment

Post a Comment

We'd love to hear what you think about this piece! Submit your comments below and join the discussion.

You must be logged in to post a comment.

< Back to the blog