AIDS Advisors Quit Trump Administration

By SAM URETSKY

Republican presidents don’t seem to have much interest in HIV/AIDS. In some ways Ronald Reagan was the worst, since he was president at the time the disease was first reported and was causing the greatest panic. The disease was first seen in the United States in 1980 but President Reagan did not discuss it publicly until May 1987. By the time he spoke 36,058 Americans had been diagnosed with AIDS, 20,849 had died, and AIDSphobia led to stigmatization and at times to violence.

Two Republicans may deserve favorable note. When Mary Fisher gave her memorable speech at the Republican National Convention in 1992, she spoke well of President George HW Bush and in one of the most moving passages said, “Elizabeth Glaser spoke into a sea of red ribbons,” Ms. Fisher said. “I looked out and I could see only one couple, President Ford and Betty Ford. Betty Ford was wearing a red ribbon and I love her for that. I just love her.”

But if Mary Fischer spoke well of President Bush (41), others were less generous on the subject, and Magic Johnson resigned from the President’s National Commission on AIDS, saying that the Administration had ignored the Commission’s recommendations and “dropped the ball” on AIDS. The Black AIDS Institute credited President Bush (41) with signing the Ryan White CARE Act and Americans with Disabilities Act, and meeting with the National Commission on AIDS. On the other hand, he failed to get adequate funding for the Ryan White Act and ignored the recommendations of the AIDS Commission. The BAI gave him a grade of C.

President Clinton got a more favorable report: “Supported robust funding increases for AIDS treatment and Ryan White services. Rallied public support for the fight against AIDS. Supported creation of the Minority AIDS Initiative as part of the Ryan White programs. Approved notable funding increases for global AIDS at the end of his second term.” The BAI are hard graders and President Clinton was downgraded to a B because he failed to get an expansion of health care financing (Hillarycare?) through congress.

President Bush (43) had a divided record. Internationally he helped provide vital drugs to millions of people, but in the United States he yielded to political forces and so sex education programs focused on abstinence.

President Obama achieved great things, but the challenge is whether they will survive the Trump administration. The Affordable Care Act was one of the most important social programs in recent years, and the benefits included eligibility for health insurance regardless of pre-existing conditions and the elimination of the lifetime cap on payments. Tragically, the Republicans have opposed the Affordable Care Act since it was originally enacted, but they have no satisfactory substitute and the bills that they have presented would deprive millions of people of health insurance. According to a C-SPAN poll of presidential historians, President Obama was the 12th best president ever, uniquely high rating for any president so soon after leaving office. Positions on the list have been known to change over time, although Lincoln and Washington have held the number one and number two slots respectively for many years.

Inevitably there is Donald John Trump. With all that has been written about this least qualified of presidents, no one has been as eloquent as the New York Times’ Charles Blow: “There is something insidious and corrosive about trying to evaluate the severity of every offense, trying to give each an individual grade on the scale of absurdity. Trump himself is the offense. Everything that springs from him, every person who supports him, every staffer who shields him, every legislator who defends him, is an offense. ...” The June 16, 2017, issue of Newsweek carried an op-ed column by Scott Schoettes headlined “Trump Doesn’t Care about HIV. We’re Outta Here.” The op-ed begins, “Five of my colleagues and I resigned this week from the Presidential Advisory Council on HIV/AIDS (PACHA). As advocates for people living with HIV, we have dedicated our lives to combating this disease and no longer feel we can do so effectively within the confines of an advisory body to a president who simply does not care.”

According to the CDC, the rates of HIV and AIDS diagnoses are highest in the south, while the south generally is behind other regions in some key HIV prevention and care indicators. While AIDS is generally thought of as a New York and California epidemic, Georgia, Florida and Louisiana, all Trump states, have a higher rate of HIV infection than either California or New York.

According to the Kaiser Family Foundation, “In 2011, the most recent year for which national data are available, there were approximately 242,000 Medicaid beneficiaries with HIV, a number which has grown over time.” If all states expanded their Medicaid coverage under the Affordable Care Act, another 47,000 HIV+ patients could be covered.

The members of the Presidential Advisory Council on HIV/AIDS who resigned wrote: “Because we do not believe the Trump Administration is listening to — or cares—about the communities we serve as members of PACHA, we have decided it is time to step down. … We hope the members of Congress who have the power to affect healthcare reform will engage with us and other advocates in a way that the Trump Administration apparently will not.” We can hope.

Sam Uretsky is a writer and pharmacist living in New York. Email sdu01@outlook.com.

From The Progressive Populist, August 15, 2017

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