You may have to hold your nose. But by voting
for prez you'll help pick the next commander-in-chief of the world's
war on AIDS. Doug Ireland reviews the candidates' records and
rhetoric as you race for the polls.
As members of the AIDS community prepare to
cast their presidential ballots, they're not helped by the fact that
the mainstream media have given precious little coverage
to the candidates' positions on the epidemic. In fact, of the
four contenders for the White House, only two have made any attempt
at all to address the issues of most concern to those living with, or
fighting against, HIV.
Pat Buchanan, the ex-GOP ideologue who has taken
over the Reform Party, has long been one of America's leading homo-
and AIDS-phobes. In the early years of AIDS, when it was widely considered
a "homosexual disease," Buchanan repeatedly blasted gays as the "pederast
proletariat" who "have declared war upon nature, and now nature is exacting
an awful retribution -- AIDS," a view he held well into the '90s. In
his syndicated column, Pitchfork Pat constantly used AIDS to emphasize
his antigay crusading, even writing that then-mayor of New York City
Ed Koch and then-governor of New York Mario Cuomo should "be held personally
responsible for the spread of the AIDS plague" unless they banned the
Big Apple's annual Gay Pride parade. And while in this year's campaign
he has toned down the rhetoric on AIDS, Buchanan stands by what he has
written and said in the past. Fortunately, most voters now understand
that Pat has brown shirts in his closet -- the Hitler-coddling sympathies
in his last book (A Republic, Not an Empire [Regnery Publishing,
Inc./Washington]) were so well publicized that even disgruntled blue-collar
voters attracted to his phony far-right nationalist populism were turned
off. He won't be much of a factor in the race.
The Republican candidate, Gov. George W. Bush,
has been engaged in an election-year image makeover, moving to the rhetorical
center in his quest for votes. Bush's April meeting with Log Cabin Republicans
and other gays got plenty of publicity, but in his subsequent press
statement, AIDS went unmentioned. In his only formal remarks on the
epidemic, prepared by campaign staff earlier this year for the website
Numedx (Nutrition, Medicine, Exercise and More for PWAs, http://www.numedx.com/),
Bush confined himself to generalities: "government investment to help
find a cure for AIDS," encouraging "pharmaceutical companies currently
conducting research and development on drugs to combat AIDS" through
extension of tax credits, and the Ryan White CARE Act. But Bush also
declared that he "opposes legalizing marijuana for medical purposes,"
and he has expressed skepticism about U.S. financial help to fight the
African AIDS pandemic, arguing that "before we spend money . . .
we must be careful that corrupt governments do not squander [it]."
Except for calling for more money for the failed
"abstinence only" approach to sex education and for promising to grant
more money to religious groups to do this work, Bush's campaign website
is also silent on AIDS. That silence mirrors his record as governor:
Until he became a presidential candidate, Bush never uttered the word
AIDS in public, even though during his time in office the state
of Texas has risen to fourth in the number of recorded AIDS cases, moving
up to just behind New York, California and Florida. Gov. Bush appointed
as his health commissioner Reyn Archer, MD, who had no public health
background and whose principal qualification was that he was acceptable
to the Christian right. Commissioner Archer opposes condom use because
"it's not what God intended," and was behind the Bush administration's
decision to order mandatory names reporting to the state health department,
a decision widely criticized by AIDS groups for deterring people from
HIV testing. Even as Texas infection rates soared, Bush's spending on
AIDS remained static through 1999, at a paltry $18 million (despite
the record state budget surpluses of which he continually boasts). Given
his track record in Texas, and since Bush has said that, if president,
he would spend the bulk of the current trillion-dollar-plus projected
U.S. budget on tax cuts, there is little hope that a Bush White House
would produce any serious increase in AIDS spending.
Finally, throughout his political career, Bush
has been beholden to the Christers, those political-religious primitives
who dictated the Archer appointment. For example, under Bush, the Texas
GOP adopted a platform plank to exclude people with infectious diseases
from the Americans With Disabilities Act, which would have stripped
it of protections for HIVers. In his current campaign, Bush has become
more deeply indebted to the Jerry Falwells and Pat Robertsons who helped
him defeat John McCain in the GOP primaries. And while these Christian
Right leaders -- hungry to retake the White House from the Democrats
-- are prepared to tolerate Bush's rhetorical repositioning in order
to win in November, when President Bush makes his appointments they'll
be calling in their chits to stack the federal agencies dealing with
AIDS with conservatives.
Bush's vice-presidential choice, Deadly Dick
Cheney, had a scabrous AIDS-phobic record during his decade in the House.
He voted against the AIDS Federal Policy Act of 1988 -- the first major
bill to fund HIV testing and counseling -- which passed 367 to 13; he
was one of only 37 House members to vote to cut funding for AIDS research
that same year; he voted to ban federal funds for the District of Columbia's
HIV/AIDS insurance program. Cheney also voted repeatedly for amendments
by John Birch Society chair Rep. Larry McDonald (D-GA) that would have
prevented federal money being spent to fight antigay and anti-HIV discrimination,
and has introduced his own amendments adding antigay rhetoric to other
All this explains why a spot-check by POZ
of 25 AIDS service organizations, advocates and activists turned up
not a single one who could stomach the thought of casting a vote for
Bush. For most sentient voters, only two possibilities are worth considering.
One is a principled protest vote for Ralph Nader, the legendary consumer
advocate who is running as the Green Party candidate, hoping to put
pressure on the Democrats from the left by starting the process of building
an independent political movement outside the corporate-dominated major
political parties. AIDS-wise, Nader's positions are nearly unexceptionable.
He's the only candidate who advocates "universal national health care
from the cradle through the nursing home with a single-payer system
like Canada's," "realistic sex education" in the public schools; needle
exchange; medical marijuana; federally imposed price restraints on AIDS
meds developed with taxpayer dollars' and having the U.S. make or license
the World Health Organization to produce drugs at the cheapest possible
Most people in the AIDS community would applaud
Nader's positions; the concern is about political strategy. Polls taken
over the summer suggest that in some states -- Michigan, Wisconsin,
Oregon and California, for example -- Nader could take enough votes
away from Vice President Al Gore to tip the balance to Bush; indeed,
shaking up the two-party endgame is one of Nader's goals. But not a
single AIDS advocate POZ spoke with for this article said he
or she intended to vote for the Green candidate. They were unfamiliar
with Nader's AIDS-related proposals, in part because his underfunded
campaign has only one-hundredth the money the major parties do, and
in part because its focus on the domination of corporate power has eclipsed
his forward-looking positions on everything else, including AIDS.
It is the fear of George W. Bush that appears
to dominate the electoral cogitations of the overwhelming majority in
the AIDS community, who seem trapped in the traditional definition of
"pragmatism." Eugene Jackson, policy director of the National Association
of People with AIDS, says he's voting for Gore because "a Democratic
administration will always be more sensitive to average Americans than
a Republican one," adding, "Clinton/Gore have provided more services
to people living with HIV/AIDS." Larry Kessler, executive director of
the AIDS Action Committee of Boston, says he's probably voting for Gore,
"but I'm nervous about him. We need a leader with real convictions,
born of a strong central core, and I don't know where Gore's center
is. He's not much better than Clinton, but Bush scares me." Even an
AIDS radical like the indefatigable writer and activist Larry Kramer
says, "The gap between what we need [for AIDS] and what we're likely
to get is separated by such a huge chasm that it's almost silly to ponder
it." He adds: "Neither one of those assholes [Bush and Gore] are going
to give us dipshit. Clinton has been all talk and no action . . .
but I just worry about the Supreme Court, so I suppose that'll get my
Gore's website gives him credit for every administration
action on AIDS, as well as for many congressional initiatives (just
as he did himself for everything from the Internet to Love Story).
While it is true that discretionary domestic spending on AIDS through
the Health and Human Services Department has increased from $2.1 billion
in fiscal year 1993 to $8.5 billion in 2000 (a significant increase,
even when adjusted for inflation), it's also true that Congress appropriated
more than the administration asked for in each of those years. And while
Gore and the administration have been crowing about the gargantuan budget
surpluses, their fiscal 2001 budget requests provide for only modest
increases in AIDS spending: a paltry $125 million for the Ryan White
program (an 8 percent increase) and a $105 million increase for HIV-related
research at the National Institutes of Health (a 5.2 percent increase).
Naturally, Gore and his website neglect to mention
the long list of deplorable administration betrayals: Clinton's failure
to implement the sensible recommendations of President Bush's AIDS advisory
council, let alone of his own; his commitment to, and militarization
of, the failed war on drugs, with its emphasis on punishment and interdiction;
his immovable opposition to needle exchange; persecution of doctors
who prescribe medical marijuana; emphasis on abstinence-only sex ed
in the schools; the ban on immigration by HIVers. This list is not complete.
Gore was the administration's point man during its years of political
and economic blackmail to prevent poor countries from making cheap,
generic versions of AIDS drugs (only partially ended this year in response
to highly publicized protests), and among his campaign advisors is a
phalanx of pharmaceutical company lobbyists.
Connecticut Sen. Joe Lieberman, Gore's running
mate, also has a decidedly mixed record. While he has consistently voted
for Ryan White funding and is a cosponsor of the Employment Non-Discrimination
Act (ENDA), his Senate career has been strewn with PWA-hostile votes.
He has voted to ban immigration by HIVers, to criminalize HIV transmission
in a variety of circumstances, and has flip-flopped on the issue of
needle exchange, voting against it in the past three years. Lieberman
has also voted repeatedly for Jesse Helms-inspired amendments (known
as "no promo homo") barring federal funds from being used to "promote
or encourage" the acceptance of homosexuality (inhibiting realistic
safe-sex ed), voted against domestic-partner health benefits for the
District of Columbia and voted for the Defense of Marriage Act. Lieberman
rakes in cash from the pharmaceutical and insurance industries -- no
friends of PWAs -- and has voted as their loyal serf. Moreover, his
partnership with former Reagan education secretary Bill Bennett in censorious
moralizing against sex in the arts and media feeds the anti-gay crusading
of the Christian Right's media monitors.
Perhaps the Clinton administration's most glaring
failure has been its refusal to come up with a comprehensive plan to
cover the 79 million Americans who currently have no health insurance
and to lower costs for those who do. The failed 1994 reform cooked up
under Hillary Rodham Clinton would have put America's health into the
hands of the scandal-plagued HMO industry, which has been rife with
abuses of PWAs. On this issue, Gore, so far, is not doing much better.
As Harvard University public health expert David Himmelstein, MD, puts
it, "There's virtually no difference between the Bush and Gore health
plans for people with AIDS." He adds: "Gore's plan would give only modest
additional subsidies for women and children through private insurance.
Bush would give slightly more to the insurance companies and provide
less to those not now covered. Neither would cover a substantial number
of the uninsured, and both would enrich the insurance industry."
Most of the activists POZ spoke to agree
with Mike Gifford, deputy executive director of the AIDS Resource Center
of Wisconsin, that the lack of universal health insurance has meant
"a lack of specialty care for PWAs." Gifford says, "Here in Wisconsin,
up to 20 percent of people with HIV are not able to access life-prolonging
meds on a regular basis. We need to go beyond the patchwork approach
of Medicaid waivers, which is not doing the whole job." Or as Jim Jones,
the policy director for Sen. John Kerry (D-MA) and one of the Hill's
most effective staffers on AIDS, insists: "The AIDS community needs
to think in a bigger context in making its demands -- universal health
care, insurance reform, affordable housing in general -- so our advocates
are not constantly playing catch-up."
What's needed in this election year to make AIDS
a part of the political discourse is a systematic approach to the epidemic
embodied in a comprehensive platform that can be used to hold all
candidates' feet to the fire. National Organizations Responding to AIDS,
the coalition convened by AIDS Action, earlier this year put together
a legislative platform for 2001 that has been endorsed by 59 AIDS groups.
While this detailed document is useful, it is rather lacking in what
Bush père used to call "the vision thing," and mainly proposes
tinkering with existing programs and providing an incremental increase
in their budgets. In politics, one should always demand a lot more than
one expects to get -- that's how change is made. Most POZ interviewees
who say they're voting for Gore agree that more pressure is needed on
a broader, more far-reaching set of demands. For instance, neither Gore
nor Bush has said anything about HIV criminalization, housing for people
with AIDS, or maintaining AIDS Drug Assistance Programs.
Among the more interesting responses is that
of author and sex educator Daniel Wolfe, formerly of New York City's
Gay Men's Health Crisis, who emphasizes the need for "an honest and
complete federal study of sexuality and sex practices" shorn of pandering
to the religion-driven moralizing that characterizes the inadequate
surveys that motor public policy now. "We're 20 years into the epidemic
and we're all still operating out of ignorance," says Wolfe. He also
proposes that "pharmaceutical companies and all health care providers
should be forced to open their books to allow public discussion and
scrutiny of their profit ratios. When drug companies can cut drug prices
by 95 percent in Africa and still make money, it raises the question
of why we here are still having to pay such exorbitant amounts."
Since the federal government currently has AIDS
programs scattered throughout dozens of different departments, agencies
and institutes, Mario Cooper, founder of the African-American and Latino
group Leading for Life, concludes that there's a need for a single interdepartmental
authority that could coordinate and evaluate these programs and hold
those who run them accountable -- and that this "should include not
just AIDS but all sexually transmitted diseases." And virtually everyone
POZ interviewed volunteered that, as Wisconsin's Gifford put
it, "at long last the federal government should put science before politics
and fund needle exchange and clean needles on demand -- this would be
an investment in the science of saving lives."
On the international front, the Treatment Action
Group this summer issued a meticulous report, "Exploring the American
Response to the Global AIDS Pandemic" (see http://www.aidsinfonyc.org/),
which pointed out the confusion in U.S. international efforts on HIV:
The U.S. government makes no straightforward contributions to foreign
governments but divides the dollars, "among direct overseas programs
of 12 divisions of the U.S. government, contracts and grants to 48 universities
or NGOs, all but three of which are located in the U.S., and . . .
support for the United Nations." The report also calls America "the
meanest donor of all," since "many rich countries give substantially
more in terms of their own population and GNP than does the U.S."
For American Foundation for AIDS Research Chair
Mathilde Krim, PhD, the single most important international step to
fight AIDS would be "to forgive the debts of poor countries -- around
$100 billion -- in nearly all of which AIDS is a terrible problem. And
the U.S. should promptly put together the $3 billion that UNAIDS has
estimated is the minimum needed to fight AIDS in sub-Saharan Africa."
Although the Clinton administration announced this summer that the Export-Import
Bank will loan $1 billion to these AIDS-afflicted nations, Krim says:
"This merely adds a new layer of debt. Instead, it should be a gift."
(South Africa, Namibia and other countries have refused the loan.) AIDS
Action Committee's Kessler points out that "there's never been an international
summit of heads of state on the AIDS crisis. The president is the only
one who can get the world to sit down with him at a table. The U.S.
should convene a summit with an AIDS-only agenda." Although President
Clinton put sexually transmitted diseases on the agenda of the July
G8 summit in Tokyo at the last minute, the meeting took no concrete
action on either AIDS or debt relief and was little more than a PR photo
op for domestic political consumption by the leaders' constituents.
(This pointless show cost $70 million to put on -- enough to cancel
the debt of eight African nations.) An AIDS-only summit would leave
participants no wiggle room.
This list of suggestions is hardly exhaustive,
but unless far-seeing demands on this scale are made on our governing
elites now, you can bet there won't be much action -- no matter who
wins in November. And whether you're voting for Ambiguous Al or Righteous
Ralph -- the only real choices this fall for anyone who cares about
AIDS -- Election Day should mark not the end of your fight, but another