Meet the four Bible-thumpers setting second-term U.S. AIDS policy
I’ve got the will of the people at my back,” George W. Bush declared two days after his reelection—and his new chutzpah soon extended to AIDS. Ignoring a December report from Rep. Henry Waxman (D-Calif.) that declared abstinence-only education dangerously misguided, Bush proposed in February to fatten the domestic abstinence budget by $38 million. With proposed cuts to funding for Medicaid, AIDS housing and HIV care looming, he has also appointed an abstinence obsessive, a former big-pharma lobbyist, a wild-card governor and an rarely-present AIDS czar to his AIDS policymaking regime. Activists: Get to know thine enemy before getting ready to rumble.
The Fearsome Foursome Domestic Policy Adviser Claude Allen, former deputy secretary of Health and Human Services (HHS), was called “the eyes and ears of the conservative shadow government at HHS” by Ernest Hopkins of the San Francisco AIDS Foundation. A fanatical antiabortionist, Allen ran secret meetings at HHS to shift HIV prevention from risk reduction (condoms, needle exchange) to risk avoidance (“just say no to sex and drugs”). Adrienne Verrilli of the sex-ed group SIECUS says, “Now a man who discounts science in favor of ideology can push abstinence at the White House all day, every day.” He’s poised to funnel megabucks to broader faith-based initiatives—and away from science-based programs.
HHS Secretary Mike Leavitt, while governor of Utah, OK’d a budget blocking a $250,000 federal prevention grant because one curriculum mentioned masturbation. Yet he pushed conservative Utah lawmakers to maintain Medicaid funding and vetoed an abstinence-only education bill. Terje Anderson, director of the National Association of People With AIDS, suspects Leavitt was brought to HHS as an enforcer: Despite his state record, his clout as a former red-state governor may help sell deep Medicaid cuts. He’s also versed in Bushspeak, promising to “seek [God’s] help” in leading HHS.
AIDS Czar Carol Thompson has been nearly invisible since her appointment last May. Compare Clinton’s czar, Sandy Thurman, who hit talk shows to talk up AIDS—Thompson has made only two public appearances and won’t meet with key AIDS players. Her first loyalty may not be PWAs: She worked for PhRMA, the powerful drug lobby, and then for the Office of the U.S. Trade Representative, famous for putting patents before patients. She says she wants the Ryan White CARE Act to focus on a “core set of clinical services”—a possible push to defund nonmedical needs—but most of her remarks cheerlead Bush’s “compassion and generosity” on global AIDS.
Cochair of the Presidential Advisory Council on HIV/AIDS (PACHA) Anita Smith has led two conservative AIDS organizations that promoted abstinence education and mandatory HIV testing of pregnant women. “She’s as nice a person as you would ever want to meet,” says Hopkins, “but her agenda is downright harmful.” Smith frequently visits HHS, too, finding her way into key AIDS policy discussions. A favorite of the administration, Smith’s current outfit, the Children’s AIDS Fund, recently found itself in a scandal for winning a multimillion-dollar grant to do education in Uganda, despite the fact that its proposal was deemed “unsuitable for funding” by a review panel.
Campaign Shock and Awe Already reeling from Bush’s first-term rollback of community-based prevention, AIDS advocates now fear Bush’s assault on Medicaid, which he seeks to cut by $60 billion over 10 years. According to Lei Chou of the AIDS Treatment Data Network, half of all HIVers on treatment rely on Medicaid. He predicts increasing numbers will turn to already-stressed AIDS Drug Assistance Programs, the future of which hinges on full funding for the Ryan White CARE Act, up for renewal September 30.
Bush’s ever-growing anti-condom prevention policies also top the list of concerns. Last spring, PACHA endorsed Uganda’s “Abstinence, Be faithful, use Condoms” prevention model—with an inordinate emphasis on “A”—for domestic use. Verrilli says the CDC’s adolescent division, which used to support condom education, broke precedent by giving grants to abstinence-only powerhouses the Abstinence Clearinghouse and the Medical Institute for Sexual Health, one of the sources for distorted data on condom failure. Insiders talk of a continued exodus of prevention experts from the CDC, led by longtime research head Ron Stall, who at press time told POZ that CDC policy barred his direct comment.
It’s Now or Never How will activists rally? Anderson says they’re torn between “pointing fingers and telling the truth” and “playing [the Bushies’] game.” Still, hope lives: In November, New York City ASO Housing Works opened a national advocacy office in DC and is planning weekly PWA visits to Capitol Hill. SIECUS is reinvigorating its www.NoNewMoney.org to fight abstinence funding. And this winter, more than 75 groups launched the Campaign to End AIDS, to culminate in DC this fall. Says Julie Davids, a Campaign organizer, “It’s time to make the case that the difference between good and bad policies costs lives.”