Mixed Verdict on Obama AIDS Plan

National strategy wins praise for “aggressive” vision, but lack of new funding draws flak

While activists have long sought a national strategy to address the domestic AIDS epidemic, an Obama administration plan for confronting that epidemic released on July 13 is drawing qualified praise, as well as some condemnation because it comes without additional cash to fund programs.

“It’s been nearly 30 years since a CDC publication… first documented five cases of an illness that would come to be known as HIV/ AIDS,” said President Barack Obama at a July 13 event that was streamed live on the White House website.

The president noted the prevention efforts and treatments that have been used to battle AIDS since then.

“The question is not whether we know what to do, but whether we will do it, whether we will fulfill those obligations, whether we will marshal those resources and the political will,” Obama said during brief early evening comments.

The strategy documents, which give only the broad outlines of the effort, were released earlier in the day. That release was followed by a blizzard of press statements that had reactions ranging from it being a “bold and historic framework for addressing HIV and AIDS,” according to the Human Rights Campaign, the gay lobbying group on Capitol Hill, to the New York City AIDS services organization Housing Works expressing “deep frustration and disappointment” with the strategy.

The strategy’s one concrete goal is to reduce new HIV infections, estimated at 56,300 a year by the federal Centers for Disease Control and Prevention (CDC), by 25 percent by 2015. Otherwise, the document calls for increasing access to care for people who are diagnosed with HIV and AIDS and for reducing the disparate outcomes among those who receive such diagnoses.

At an event earlier on July 13, also streamed live by the White House, Kathleen Sebelius, secretary of the US Department of Health and Human Services, said, in effect, that the strategy did not come with new funds other than the $30 million to implement it.

“We can’t expect this to be solved by a huge infusion of new resources,” she said.

Finding sufficient funds to support AIDS programs has been a battle for AIDS groups since the first days of the epidemic.

In a written statement, Paul Kawata, executive director of the National Minority AIDS Council, called the plan “aggressive” and said it “would certainly go a long way toward combating what continues to be one of our nation’s most troubling public health emergencies,” but “without the funds to carry out the President’s ambitious agenda, this falls significantly short of a strategy.”

AIDS Action, a Washington-based advocacy group, also praised the plan, but said that only “adequate, targeted resources and the engagement of multiple partners to produce actual results” would make the plan “the first truly effective, comprehensive national plan in response to the US HIV/AIDS epidemic, now in its 30th year.”

Comments by the president and Jeffrey Crowley, director of White House Office of National AIDS Policy, suggested that the administration may try to shift existing resources to communities that are most in need. Those would be gay and bisexual men and African Americans.

“Such health disparities call upon us to offer testing and treatment to the people who need it the most,” the president said, after noting that gay and bisexual men account for a small part of the population but “over 50 percent of the new infections,” and African Americans make up 13 percent of the population but three-quarters of the AIDS cases.

At the earlier event, Crowley was asked if responding to communities with greater need would mean aiding regions of the country that are hardest hit.

“When we talk about concentrating on communities at greatest risk, we recognize that geography is an aspect of that,” Crowley said.

Charles King, president and CEO of Housing Works, attended the earlier event and questioned why the administration is seeking to reduce new infections by only 25 percent.

“We think that is an achievable, but also very aggressive goal,” Crowley said. “I wish I could tell you that we set a goal of reducing infections by 50 percent, 75 percent, but how do we do that in such a short period of time?”

In 2001, the CDC announced it would cut new infections in half by 2005, but that goal was never achieved, largely because new HIV infections among gay and bisexual men continued to rise during that time.

Sebelius acknowledged that earlier pledges had fallen well short.

“The goals aren’t necessarily new, but the strategy for achieving them is new,” she said.