Are You Ready?

Yesterday the House Appropriations Subcommittee for Labor, Health and Human Services, Education and Related Agencies recommended $462 million in new funding for domestic HIV programs. $291 million is set aside for the administration’s initiative to end the US HIV epidemic. While we are a long way from final approval, the bipartisan support was a very hopeful sign. This could be the largest annual increase in domestic HIV funding in over two decades.

If approved, the challenge will be to make sure the funding reaches the communities that are hardest hit by HIV. Far too often, funding gets stuck in the system and does not trickle down to the people and organizations in need.

When the Affordable Care Act was about to be approved, NMAC asked the question to our movement, “Are You Ready?” Agencies that heeded the call and became federally qualified health centers (FQHC) were able to grow and expand to be part of the historic gains in health insurance coverage. Budgets and services quickly expanded and many of these new FQHCs are now integral to the healthcare safety net in their community.

Plans to end the epidemic will focus on a biomedical HIV solution. Priority will be given to programs that retain people living with HIV in healthcare and adherent to meds.  There will also be a push to get 1.1 million Americans on PrEP. Is your agency ready to address either or both of these challenges? Remember, it is all about retention and adherence.

The last big increase in domestic HIV funding was for the Minority AIDS Initiative (MAI). NMAC was there fighting for this funding.  In FY 1999, Congress approved $166 million in new domestic HIV funding. We hoped this money would change the trajectory of new cases of HIV within communities of color. Unfortunately this did not happen. Why should we believe this FY 2020 money will be different?

History and experience are not on our side. Our movement needs to hold the government accountable to make sure this new funding does what the MAI could not. Communities of color must be prioritized. For that to happen, not only must we be at the table, we need to lead the discussions and new programming. It is not OK that 70% of the people on PrEP are white while the majority of new cases of HIV and the majority of people living with HIV are people of color.

Yours in the struggle,

Paul Kawata with Miguelina Maldonado who was the lead staff for NMAC’s work on the MAI.