The GOP’s midterm election gains and partisan disputes in Congress have put struggling HIV/AIDS programs in a precarious situation.
Republicans took control of the House of Representatives last week with promises to slash domestic spending and even attempt to repeal health care reform, prompting concern among advocates fighting HIV/AIDS.
But some advocates claim that funding for HIV/AIDS initiatives had historically enjoyed bipartisan support until the latest Democrat-controlled Congress failed to fund struggling programs, leaving thousands of low-income patients without life-sustaining drugs.
The GOP takeover ousted several powerful Democratic allies from key leadership positions, according to a post-election statement by Phill Wilson, president of the Black AIDS Institute (BAI).
Wilson put Democratic House Speaker Nancy Pelosi on “top of the list.” Rep. John Boehner of Ohio will replace Pelosi.
Wilson did not mention that activists have targeted Pelosi with protests for months as HIV/AIDS patients were put on waiting lists to receive free drugs.
Wilson points out that black Americans account for about half of the roughly 56,000 new AIDS infections in the United States each year, and the Republican’s midterm success will diminish the influence of the Democrat-controlled Congressional Black Caucus, which has supported HIV/AIDS programs in black communities.
But some AIDS activists are more critical of the Democrats.
In September, a coalition of advocacy groups gave the Democratic leadership a vote of “no confidence” for failing to adequately fund state-run programs that provide HIV/AIDS medications to low-income and uninsured Americans.
As of October, budget shortfalls in eight states had forced nearly 3,600 HIV/AIDS patients onto waiting lists to receive life-sustaining drugs from AIDS Drug Assistance Programs (ADAP), according to the Kaiser Family Foundation.
The lists have been growing for months.
The Obama administration recently infused $25 million into ADAP, but ADAP advocates want $126 million – an amount that GOP-sponsored legislation would provide, making Republicans the advocate’s surprising allies in the face of Democratic inaction.
“There is no real funding, no real leadership from President Obama, House Speaker Pelosi and Senate Majority Leader Reid on this,” said Michael Weinstein, president of the AIDS Healthcare Foundation (AHF), “The administration spends more in two hours on the war in Afghanistan than it spends on the AIDS drug crisis that is killing Americans here at home.”
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Brandon Macsata, CEO of the ADAP Advocacy Association (AAA+), told Truthout that the additional $25 million is already exhausted, and party politics has kept Congress from putting an end to the waiting lists.
In May, Sen. Richard Burr introduced a bill that would allocate $126 million from the stimulus package to ADAP. Burr represents North Carolina, one the eight states with ADAP waiting lists.
The bill never gained traction, and Macsata doubts it has a chance in the lame-duck session.
Macsata said Sen. Roland Burris (D-Illinois) reached across the isle and joined the bill’s Republican co-sponsors, but Senate Majority Leader Harry Reid stepped in and prevented the bipartisan support.
Burr told HIV/AIDS publication The Body that the lack of Democratic support for the bill was “shocking,” and he figured the Democrats did not sign on because “it wasn’t a Democratic idea.”
Macsata said the Democrats argued for an emergency supplemental, while deficit-weary Republicans wanted to dip into existing funds.
Reid’s office was closed on Veterans Day and has not responded to a request for a comment.
Pelosi, who represents San Francisco, is widely recognized as an important ally to the HIV/AIDS community, and her silence on the ADAP issue has also angered advocates.
“Just because you have been an ally in the past doesn’t mean you get a free pass,” Macsata said of Pelosi.
Pelosi’s office has not responded to a request for a statement, but her web site states that, under her watch, a House committee approved an additional $50 million for ADAP in 2011.
But Macsata said its going to take at least $375 million to get ADAP back on track, and allocating money for 2011 does nothing for the current crisis.
Pelosi’s replacement, Republican Boehner, has proposed deep domestic spending cuts that would slash up to $6 billion from the National Institutes of Health, according to Bloomberg.
But Macsata is not worried about the Republican takeover or Boehner’s record as strict social conservative. After all, he said, Boehner is from Ohio – one of the states with an ADAP waiting list that must be resolved.
“We don’t see this as a negative thing, there is a history of ADAP doing well under Republicans,” Mascata said.
ADAP provides drugs under the Ryan White CARE Act, a federal HIV/AIDS program enacted in 1990 and named for an Indiana teenager who contracted AIDS from a medical treatment.
Macsata said the largest increase in ADAP funding under the Ryan White ACT occurred in 1994 when Republicans controlled Congress.
The most recent reauthorizations of the Ryan White Act in 2006 and 2009 enjoyed healthy support from the GOP.
Republicans support ADAP because they know it’s cheaper to keep patients medicated and healthy than pay for intensive medical treatment down the road, Macsata said.
But Wilson contends that Ryan White CARE and discretionary programs like the HIV/AIDS prevention program at the Center for Disease Control could still fall under the axe as Tea Party-crazed Republicans seek to reduce the deficit.
Republicans are also seeking to repeal the health care reform. The new reforms have the potential to “broaden and strengthen the social safety nets” for low-income AIDS patients, according to Wilson.
While a full repeal is unlikely, Republicans are expected to attempt blocking funding to programs included in the new health care law.
Wilson sees this challenge as an opportunity to reach out to Republicans and show them how crucial funding the fight against AIDS is to their constituents.
Wilson points to the South, where Republicans made significant gains in the midterms. The South is also where the HIV/AIDS cases among black American are rising the fastest.
The southern states of Florida, Georgia, Louisiana, North Carolina and South Carolina have all put HIV/AIDS patients on ADAP waiting lists.
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