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The following is a letter by Paul Kawata, executive director of the National Minority AIDS Council (NMAC), to his constituents upon his return from a well-deserved sabbatical after 20 years of service.
I want to thank National Minority AIDS Council's (NMAC) board and staff for the gift of my 20th Anniversary Sabbatical; hopefully you did not notice any difference with my absence. As I get ready to return, I want to update you on:
- My Health
- My Thoughts on the Movement
- The Future of NMAC
During my time off, I tried to uncover/understand my feelings of grief, loss and anger associated with this epidemic, particularly during those early years. Work can be a good way to ignore and/or avoid good mental health. For the first time since I started this job, I stopped to look back at the funerals, memorials and hospital visits I did over this period. I am part of a generation of gay men (between 45 and 65) who have lost more friends than they can remember.
Can anyone wrap his or her brain around this amount of loss? I use work and food as my mechanisms to cope. Recently there was a series of articles about the AIDS doctors from the early years in New York and San Francisco. So many of them have gotten lost in drugs, depression and even suicide. Like many of the survivors of this pandemic, good mental health seems just out of my reach.
In 1993, less than one month after my friend Paul passed, I had to return to work because NMAC had a big benefit at the Warner Theater. It was during the March on Washington and we sold over 1,400 tickets. Somehow I had to smile and thank all the guests. I remember pushing down so much anger and rage as I walked up on stage. The event was Divas Simply Singing with Sheryl Lee Ralph. As Sheryl held my hand, in front of 1,400 people, I sobbed. It was the first time since Paul had died that I cried; I mean really cried. There is nothing more attractive than a person crying so hard that snot is running out of his nose.
The next month, I had five funerals, over 30 hospital visits, and I spoke at two memorials. That was my life in the '80s and early ‘90s in the AIDS epidemic. My life was not unique; this was the reality for many folks fighting the epidemic in those early years. It is a lot to ask for one sabbatical to heal all that loss.
It's going to take time, maybe the rest of my life, to understand and put into perspective the enormity of the grief and loss so many of us experienced. This sabbatical was the first time I stopped to examine those horrible years and the friends I lost along the way.
My Thoughts on Our Movement
Being away gave me time to think about our movement, and to try and put the last 20 years into perspective. Our movement started because the larger society did not care that we were dying and we were dying in the thousands. We were a movement that had nothing to lose, so getting arrested at the White House was considered a badge of honor. We were a movement that created organizations, systems of care and HIV prevention programs out of nothing.
In 1987, I was arrested in front of the White House. The formal charge was civil disobedience. I was part of a group of national leaders who were chained to the gates of the White House to protest the lack of response from the Reagan administration to the HIV/AIDS epidemic. This is actually the second time I was arrested; the first time was to protest apartheid in South Africa.
In order for us to be arrested at the White House, we had to sit on the ground. Well I was wearing a brand new black cashmere jacket and I was not going to sit on the ground. So the Capitol Police got me a blanket so I could sit on the ground and they could arrest me.
It was all very orchestrated until we got handcuffed in buses and had to wait for hours to be processed. At that time, AZT had just been released and compliance to the treatment regimen was still very new. We were all so concerned about missing a dose, yet with your hands cuffed, how do you take your medication? So we worked in teams to split open AZT capsules, and folks had to lick their meds off the bus seat because we did not have water. Boy those were good times…
On top of this indifference, add homophobia, racism and sexism and it's no wonder there is so much dysfunction in our movement. I think we should embrace our dysfunction. For it is through this dysfunction that we created the organizations that continue to fight this epidemic.
We are not the American Red Cross, we are not Citibank—and I hope we never will be. It is our rage, anger and loss that gave us the strength to change the world. Now 28 years later, we should not become that which we rebelled against. Can our movement professionalize itself and still stay true to the rage, anger and loss? Yet without systems and structure, is anger or loss enough to sustain an organization?
We are in the middle of the Darwinization of AIDS service organizations. Survival of the fittest. As funding continues to be flat or reduced, federal, state and local government funders, corporations and foundations and a limited number of individual donors will be deciding the future of our movement. The new reality means that either you get the grant and stay open or you close your doors. There are very few new funding options. Small and rural cities will have at most one AIDS service organization. This organization will coordinate with its local health department and other nonprofits to provide HIV/AIDS care and services to their community.
Every year this community-based organization's budget will be slightly reduced as its local or state government reduces or flat funds its HIV commitments. For some communities, the services will move to the local health department as AIDS service organizations close their doors.
In larger urban settings, you will find more then one AIDS service organization. Even in these environments, you are seeing a culling of the field. As we look to this future, we have several difficult questions:
- Which community-based organizations should survive?
- What is NMAC's role/responsibility to these agencies?
- Strategically, what is best for the movement?
- Reauthorize the Ryan White Care Act
- Remove the ban on federal funding for needle exchange programs
- Remove funding for abstinence-only programs from the federal budget
- Remove the travel ban on HIV-positive individuals
- Appropriate new federal funding for HIV prevention programs
Unfortunately, we still have many challenges. Foremost from my perspective is the state HIV/AIDS budget cuts. California alone cut 87 million state dollars over a two-year period from its budget. International HIV activists are very concerned about the Obama administration's commitment to global funding. And gay men, particularly black gay men, continue to be disproportionately impacted by HIV/AIDS.
The Future of NMAC
I am not coming back to NMAC with an agenda to change everything. I have some new ideas; however, I also want to hear from staff. I am very curious to see how the agency functioned without me.
If I learned anything on this break, I learned how much I like to plan. During my break, I traveled across Asia (Thailand, China, Hong Kong and Singapore). My travels were planned at a level of detail that even surprised me. I am the person who reviews all the websites and travel blogs to make sure I make the most of my limited time. I am not the person who likes to arrive in a city without a hotel reservation. I am the person who likes to visit/stay/experience the newest, coolest most cutting-edge hotels, shopping and restaurants.
As I return to NMAC, I will continue my obsession with planning. I will also continue my commitment to new and cutting-edge ideas. For me, it is important that NMAC be in the front of the curve and not behind the trends. It also means that if other people are doing it better, we should support their work and stay out of their way.
I want NMAC to do what we do best, to not duplicate programs that are being done better by others, and to fill any gaps in services. In order to get this right, we need to go back to strategic planning. However, let me be very clear about what is and what is not on the table. I don't want to spend a lot of time looking at our mission. I don't want to spend a lot of time looking at the abstract. For strategic planning to work for me, it must do the following:
- Create an ongoing system of planning and evaluation
- Programs must be cutting-edge and new (not duplicative)
- Change will be the only constant at NMAC