Trump Undermines AIDS Programs

By SAM URETSKY

On June 16, 2017, six members of President Trump’s Presidential Advisory Council on HIV/AIDS (PACHA).resigned. Their public letter, which appeared as an op-ed article in Newsweek magazine, was headlined “Trump doesn’t care about HIV. We’re outta here.” PACHA was created in 1995 and provided advice, information, and recommendations to the Secretary of Health and Human Services concerning programs, policies, and research on subjects relating to AIDS/HIV. Members of the panel included clinicians, researchers, public health officials, faith healers, and people living with HIV. Participants on the panel were not paid.

In the letter of resignation, the writers noted “While Secretary Clinton and Senator Sanders both met with HIV advocates during the primaries, candidate Trump refused. Whatever the politics of that decision, Mr. Trump missed an opportunity to learn — from the experts — about the contours of today’s epidemic and the most pressing issues currently affecting people living with HIV.”

“In keeping with candidate Trump’s lack of regard for this community, President Trump took down the Office of National AIDS Policy website the day he took office.” President Trump has not appointed a Director of the Office of AIDS Policy, so that even if the panel meets and has a recommendation, there is no one to bring the recommendation to the Secretary of Health and Human Services.

This is important because, while HIV disease no longer makes the headlines as it did during the 1980s, it is being controlled only by a combination of expensive drugs and readily available medical care. One example of what happens when the services needed to control the spread of AIDS occurred in Scott County, Ind., when, after Mike Pence was elected governor, cutbacks in health spending forced the county’s only Planned Parenthood clinic to close. The Planned Parenthood office was the only source of HIV testing, and Scott County had a high rate of intravenous drug abuse. With neither a needle exchange program nor a means of testing for HIV, the county of 24,000 residents was reporting 20 new cases of HIV disease each week.

On August 30, 2017, even after the resignation of the six PACHA members, the remaining members of the panel sent a letter to Secretary Price warning of the potential impact of cutbacks in the availability of health insurance and public health programs. Included in the letter was a warning “… legislation that decreases healthcare coverage would undermine access to medical care for people living with HIV. Medical care provides antiretroviral therapy for people with HIV, which suppresses their HIV viral load to below detectable levels, and makes their risk of transmitting HIV to others negligible. Therefore, effective antiretroviral therapy is a powerful prevention tool. Currently, four in 10 people with HIV receive Medicaid. Over 90% of new hemagglutinin-neuraminidase (HN) infections come from people from living with HIV who are not in effective medical care. Reducing access to medical care for HN infection will compromise viral suppression among Americans living with HIV, and will result in increased new HIV infections.”

Over the years, the distribution of AIDS cases has changed. This is a disease first reported in New York and San Francisco in 1981 and these two cities still remain on the list of cities with the highest rates of new infections, but New York City is now 9th on the list and San Francisco is 21st. In contrast, Miami is first, followed by New Orleans and Baton Rouge, La. This is the legacy of former governor and presidential candidate Bobby Jindal who after calling on Republicans not to be “the stupid party” refused to expand Medicaid as part of the Affordable Care Act and cut other public health programs.

On Dec. 28, 2017, the Washington Blade, a local LGBT newspaper reported that President Trump had fired the remaining 16 members of the AIDS panel, by means of a form letter with no explanation. One former panel member simply suggested that the Trump administration simply wished to fill the panel with its own appointees instead of leaving Obama holdovers, but it’s also possible that the Trump administration is thinking in terms of the list of words which it reportedly banned from use in CDC (Centers for Disease Control and Prevention) documents.

The outlawed words are “diversity,” “entitlement,” “evidence based “fetus” “science-based,” “transgender” and “vulnerable.” One suggestion is that President Trump, and others from his administration, are simply moving away from his previous claims of support for LGBT people. On Dec. 1, World AIDS Day, President Trump focused on women and girls in African countries who suffer from HIV infections. He said nothing about the fact that 55% of Americans who have HIV Disease are gay men.

Very likely the simplest answer is the right one: Donald John Trump just doesn’t want to be bothered.

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

From The Progressive Populist, Febuary 2, 2018

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