Phill Wilson: What the Election Means for the Response to AIDS

America Has Voted

By Phill Wilson -

Founder and CEO of the Black AIDS Institute
Tuesday’s elections redrew America’s political map. The results also have far-reaching implications for the nation’s response to AIDS in Black America, underscoring the urgent need to renew and reinvigorate efforts to compel the nation’s decision-makers to address a health crisis that isn’t going away.
Riding a wave of anger and anxiety, Republicans swamped Democrats in Congressional races, winning more than 60 races and retaking the House of Representatives for the first time since 2006. The Democratic majority in the Senate was also sharply reduced. At the state level, Republicans now control a majority of governor’s offices in advance of the redrawing of Congressional districts that occurs every decade following a new national census.
The country continues to grapple with the aftermath of the most severe and protracted economic downturn since the Great Depression. Although the Great Recession is technically over, unemployment remains near 10%, economic growth is tepid, and the foreclosure crisis continues to spread. Anger over bailouts of banks and auto manufacturers combined with concerns regarding the federal deficit to turn a flood into a tsunami against the Democrats.
The national media has understandably focused a great deal of attention on the “Tea Party” movement. Whether winning Republicans wear the “Tea Party” banner or not, they all share a common political platform of deficit reduction, extension of the Bush-era tax cuts, and hostility toward the signature legislative achievement of President Obama’s first two years, the health care reform bill.
What Election Results Mean for the National AIDS Response
Tuesday’s results present at least three major challenges to the fight against AIDS.
First, many of the strongest Congressional AIDS champions will no longer occupy key leadership positions to advance an AIDS-friendly agenda. At the top of the list is House Speaker Nancy Pelosi. As a result of the Republican takeover of the House, Rep. Pelosi will be replaced as Speaker by Rep. John Boehner of Ohio.
Second, 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. HIV prevention has long been under-prioritized. More than 56,000 Americans (nearly half of them African American) become newly infected with HIV – compelling proof that you get what you pay for (or that you don’t get what you fail to pay for). We simply won’t be able to turn the epidemic around in Black communities without stronger federal support for HIV prevention. Eight states have waiting lists for their AIDS Drug Assistance Programs (ADAPs), 20 have imposed restrictions to contain costs, and 13 are considering new cost containment measures. Nearly 3,600 Americans who need AIDS drugs are currently unable to obtain them. Every forecast suggests that this problem is certain to grow unless additional federal support is forthcoming. Given changes in governorships and state houses, it is highly unlikely that state legislatures will do much to address the needs of ADAP programs. For thousands of Americans living with HIV, Congressional willingness to appropriate additional funds for this discretionary program could mean the difference between life and death.
Third, the new Republican majority in the House will enter power with a commitment to repeal the health care reform legislation enacted earlier this year. Although it is unlikely that Republicans will be able to muster the votes needed to repeal the bill so long as a Democrat occupies the White House and control the senate, G.O.P. critics of health care reform may well seek to withhold the funding needed to implement key provisions of the legislation.
Where Do We Go?
These new challenges are disheartening. But AIDS advocates have never given up the fight, even in the face of long odds. America’s health shouldn’t be a political football. Americans of all political persuasions – Democrat, Republican, independent, and tea party – should be able to unite around the conviction that all people deserve a fighting chance to live and to contribute to their community. It is our job to lead that effort.
We have crossed this bridge before. After the 1994 elections, when Republicans swept away a Democratic majority in Congress, AIDS advocates took to work and helped educate the new Congressional majority about the AIDS crisis. Some of the most enduring successes of the AIDS movement occurred when a Democrat occupied the Oval Office and Republicans controlled Congress.
Tuesday’s election results point the way toward opportunities to educate the new Republican majority. For example, the South is a region where Republicans made some of their greatest gains. The South also happens to be the region where HIV/AIDS rates among Black people are rising the fastest. It is vital that we help new Congressional leaders from the South understand what the epidemic is doing to their districts and work together to devise new solutions to these challenges.
Our work has never been more important. The challenges appear daunting at first glance, but our agenda is one that transcends political divisions. It is time for all of us to roll up our sleeves, get to work, and insist on national solidarity to address the needs of the most vulnerable among us

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