The Washington Blade - September 24, 1999
Rhonda Smith

"We are not excited or pleased with the $156 million," said Sandra McDonald, president of Outreach Atlanta, an AIDS service organization in Georgia. "It's a beginning."

The $156 million is the amount of additional federal funds the Clinton administration made available in fiscal year 1998 for programs that specifically address the AIDS-related health needs of African Americans and Latinos.

McDonald spoke Thursday, Sept. 16, during a forum on AIDS sponsored by the Congressional Black Caucus. She chairs a national committee of African American directors of AIDS service organizations, and said 100 more clients have sought help at Outreach in the past few months.

Donna Christian-Christensen (D-VI), who chairs the Congressional Black Caucus committee focused on health issues, submitted a letter to the chair of the House Labor, HHS, and Education Appropriations Subcommittee Thursday in which she requested additional AIDS funds for various communities of color.

"The Congressional Black Caucus is asking Congress to provide $349 million to fund an Emergency Public Health Initiative on HIV/AIDS targeting African Americans and other minorities, specifically Hispanics, Native Americans, and Asians/Pacific Islanders," she said. "If the HIV/AIDS crisis is [not addressed] in other minority communities, they will soon mirror the tragedy that has befallen African American communities nationwide."

Christian-Christensen did not mention the concerns among some black AIDS advocates that more attention be focused on redirecting how the $7.8 billion in HHS funds for HIV/AIDS programs throughout the U.S. is allocated.

President Clinton declared AIDS a "severe and ongoing health care crisis" in black and Hispanic communities nationwide last October. As part of the announcement, he unveiled a plan to invest $156 million in additional federal funds for various programs designed to address the epidemic in communities of color.

Dr. Eric Goosby, director of the Office of HIV/AIDS Policy for the U.S. Department of Health and Human Services, told the Blade Wednesday that some portion of existing federal AIDS funds currently aimed at institutions primarily serving Gay white men should be allocated to those serving black and Hispanic clients

Goosby said the $156 million is being used to fund ongoing HIV/AIDS programs in black and Hispanic communities that needed additional support. But this is not enough, he said.

"We tried to fund programs already up and running but that needed additional support, as opposed to starting new programs," he said, "because the money [the $156 million] was so small."

Goosby said more funds are needed for HIV/AIDS programs geared toward various communities, including white Gay males, Latinos, and African Americans. "The dilemma is that the epidemic is expanding disproportionately in minority communities," he said, "but the total number of individuals impacted by AIDS remains most heavily in white Gay male populations."

"What it boils down to," he added, "is that we need more funds for all these programs."

Among African American men ages 25 to 44, AIDS remains the leading killer, federal officials said. It is the second-leading killer of African American women in the same age range. While African Americans make up 13 percent of the U.S. population, they represent 49 percent of all AIDS cases, Congressional Black Caucus officials said.

Daniel Zingale, executive director of AIDS Action, said the $156 million that McDonald and others mentioned is inadequate to address the current AIDS-related needs in black communities.

"It should, and I believe will be, increased in the next round of appropriations," he said.

The HHS budget for federal AIDS funds amounts to about $7.8 billion. The president's budget asks for $171 million in additional federal funds to address AIDS among African Americans in fiscal year 2000, which runs from Oct. 1, 1999, to Sept. 30, 2000.

In comments that U.S. Rep. Jesse Jackson Jr. (D-Ill.) was scheduled to make Thursday, Sept. 23, to the Labor, HHS, and Education Appropriations Subcommittee about AIDS funding, he said: "àminority communities need more."

Jackson's written comments included statistics that said one in every 50 African American males and one in every 120 black females is infected with HIV. He also said 90 percent of all children and 80 percent of all women with full-blown AIDS are African American.

"I had hoped that [the federal budget negotiations] would have include more money to address this epidemic that is destroying communities of color," he said.

On Wednesday, Zingale at AIDS Action said, "The starkest example of where we're failing to address the HIV epidemic among African Americans is the fact that national HIV-prevention funding has been flat for four years, while the rate of infection has increased among communities of color."

"One can't help but be struck by the fact that increases have occurred for AIDS research, care, and housing," Zingale added.

AIDS Action has called for a 25 percent increase in overall spending for federal HIV-prevention initiatives. Federal funds aimed at HIV-prevention programs currently amount to $660 million, he said.

The Congressional Black Caucus request for $349 million is an effort to gain additional federal funds for HIV/AIDS initiatives geared toward people of color, in addition to other federal funds in the Labor, HHS spending bill. Some of the $156 million appropriated in fiscal year 1999 included funds for HIV-prevention initiatives.

Miguelina Maldonado, director of government relations and policy at the National Minority AIDS Council, said: "We need to look beyond [the $156 million] to the total amount being spent on HIV and AIDS in the U.S. and how it is being used to address the epidemic in African American, Latino, Native American, and Asian/Pacific Islander communities.

"The issue is, if there's such a high percentage of African American and Latinos already getting services from all these different HIV/AIDS programs," she said, "why do we have these huge disparities in health outcomes?"

The HHS department is using the Congressional Black Caucus initiative, related to the $156 million, as a vehicle to prod state health departments and local AIDS planning councils to do more joint planning related to allocating federal funds to AIDS organizations in communities of color, Maldonado said.

In some localities, state health departments have been working on such issues for a few years. "But that doesn't necessarily happen across the board," she added.

Goosby, director of the federal health department's Office of HIV/AIDS Policy, said federal officials are putting pressure on state and local officials who receive federal grants for AIDS work. They are being told to develop strategies that allocate federal funds that traditionally have gone to community-based organizations operated by white Gay men to similar organizations operated by African Americans and Latinos.

"Because the need present in the Gay white community is still largely unmet," he said, "you're positioning one real need against another real need." Zingale at AIDS Action predicted that African Americans would continue to be disproportionately harmed by HIV/AIDS until changes are made to the federal Medicaid policy. Medicaid beneficiaries who have HIV are not eligible for drugs that could prevent the onset of AIDS until they are diagnosed with full-blown AIDS.

"Medicaid still refuses to provide care to people until the late stages of HIV disease," Zingale said, "even though we know early intervention would be beneficial, in terms of human suffering and saved lives."

Debra Fraser-Howze, president and chief operating officer of the New York City-based National Black Leadership Commission on AIDS Inc., echoed concerns expressed by McDonald and others.

"The federal AIDS budget needs to be directed more toward black and brown folks," she said.

"We have not focused on the $7 billion," the approximate amount the federal government currently allocates for federal HIV/AIDS programs, she said. "We have got to begin to broaden our dialogue beyond the $156 million."

The $156 million initiative resulted from a push in May 1998 by the Congressional Black Caucus to have HHS Secretary Donna Shalala declare HIV/AIDS among African Americans a "public health emergency." Doing this would have set in motion a series of steps to release more federal funds for programs that address the problem.

Clinton administration officials stopped short of declaring AIDS among African Americans a public health emergency, however. At the time, Sandra Thurman, director of the White House Office of National AIDS Policy, said they decided to declare AIDS among racial and ethnic minorities a severe and ongoing health care crisis to reflect a long-term response to the problem.

"A 'state of emergency' indicates a short-term response, and what we understand is that we're at the beginning of this epidemic [as it relates to communities of color] and not at the end," she said. "So we need to make sure that we're looking at creating a long-term, ongoing response."

Dr. Beny Primm, executive director of the Addiction Research and Treatment Corp. in New York, has been another driving force behind the push to get federal officials to address AIDS among African Americans.

"I'm very disappointed we did not get the state of emergency," Primm said last week. "We had to compromise and go for a national health crisis in 'communities of color.' That diluted the impact of what we wanted to have."

During her opening remarks at the AIDS forum last week, Shalala said the Health and Human Services department has been offering AIDS outreach to African American and Latino organizations that have never received federal assistance. In addition, federal health officials are deploying "crisis response teams" to cities that request them for technical assistance on AIDS-related matters, she said. They also have plans to award $4 million in planning grants for AIDS-related programs affecting African Americans in rural and underserved areas.

990924
WB990906

The Washigton Blade, Inc., 1408 U St., N.W., 2nd Floor, Washington, D.C. 20009-3916

Copyright © 1999 - The Washinton Blade. All rights reserved. Republication or redistribution of The Washington Blade content is expressly prohibited without the prior written consent of the Blade. The Washington Blade shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.  The Washington Blade