May 24, 2006

Trouble at Home? U.S. Called to Task as UN AIDS Session Approaches

With a major United Nations AIDS meeting just a week away, Indians are raging on the radio about the price of meds, Israelis are discussing the future of HIV with their parliamentarians—and a prominent array of Americans are wrestling the spotlight from the Bush administration’s programs overseas to shine it instead on failures at home.

“People mistake being better than developing countries with being good,” says Phill Wilson, who heads the Black AIDS Institute and is part of a coalition of U.S. AIDS leaders behind a report just released by the Open Society Institute. “We need to acknowledge that the U.S. is still part of the globe and that over the past 25 years the burden of HIV in America has fallen more and more on people of color.”

This week (May 20-26) is the Global AIDS Week of Action, a worldwide effort to hold governments accountable where they have generally fallen behind in the five years since the U.N. set concrete goals in a 2001 Declaration of Commitment signed by 189 nations. In candlelight vigils, street marches and hundreds of meetings producing hundreds of wish lists, participants also hope to send their national delegations off to New York with a firm sense of direction.

The Open Society Institute report looks at Washington’s shortcomings in the areas of prevention, treatment and discrimination. In 2001, the U.S. Centers for Disease Control set out to cut domestic HIV infection rates in half by 2005 (a target achieved against great odds in Kenya), but U.S. infections have continued to rage steadily at about 40,000 a year. “The United States is failing its own citizens,” says report author Chris Collins.

Judy Auerbach of the American Foundation for AIDS Research (AmFAR) contends that the U.S. numbers might well have been halved if the Centers for Disease Control had put its $460 million annual prevention budget into needle exchange, condoms, mass media campaigns and community mobilization in high-risk areas—instead of policies with an “abstinence-only cornerstone” that she says have shown little effect.

Fifty percent of positive Americans are not getting the health care they need, according to the report, and the rate of people with HIV progressing to AIDS is rising in almost every region of the country. “There are consequences to the government not living up to its obligations, and they are manifesting themselves in a growing AIDS epidemic,” says Wilson. He urges Washington to target communities of color, where the disease is rampant, not just by adjusting existing programs but by consulting them directly and strategizing together.

Adds Collins, “America needs a true national HIV strategy. And then maybe next time the U.S. reports to the U.N., they will have better news.”

The Global AIDS Week of Action ends the day after tomorrow, but activists from dozens of countries will follow their leaders up to the door of the United Nations General Assembly for this second Special Session on HIV/AIDS. A massive demonstration is scheduled right outside for May 31, just as the international dignitaries file in.