If we are to end the epidemic, we have to ask hard questions. We have to push our leaders to have a big vision. The International AIDS Conference gave us our marching orders: job number one is ending this epidemic. Scientists have given us a pathway. Now it’s up to the community. It’s up to people living with HIV/AIDS (PLWHA), health departments, community based organizations, community health centers, researchers, pharmacies, healthcare providers, health plans, pharmaceutical companies, activists, elected officials, donors and the federal government to work collaboratively to figure out the real-life application for the biomedical and behavioral interventions that will hopefully be the beginning of the end of this epidemic.
Are we the right leaders? Can we ask the difficult questions, even of our funders? Are we really doing everything we can with the resources available to us to end this epidemic?
The United States Conference on AIDS (http://www.2012USCA.org) is a critical opportunity to ask these questions and have these discussions. While our movement finds itself at a time of incredible promise, there are a number of challenges and unknowns that must be addressed. What effect will High Impact Prevention (HIP) have on our work? When I talk with health departments and community-based organizations, there always seems to be more questions than answers. How is HIP going to lead us to end the epidemic and is enough being done to ensure an effective transition from the federally mandated Diffusion of Effective Behavioral Interventions (DEBIs) to HIP activities? While the Supreme Court upheld the Patient Protection and Affordable Care Act, a number of questions about its implementation remain, especially the Medicaid expansion. What should post-ACA Ryan White (RWCA) programming look like? If the RWCA is suppose to be the payer of last resort, does that mean when we enroll PLWHA into ACA health cooperatives they are no longer eligible to receive services from RWCA funded programs.
These are not minor issues. Our entire HIV/AIDS infrastructure is changing. Communication is critical if we are to be successful. And in the absence of meetings like the HIV Prevention Leadership Summit and the Ryan White Clinical Conference this year, USCA 2012 is that much more important. Ending this epidemic is going to take more than rhetoric. There’s a lot of work ahead of us. We need a unified vision, an actionable plan and the guts to make the tough decisions. We need to be transparent and collaborative. Most of all, we need to believe that we really can end this epidemic.
When I came to Washington, DC in 1985, the only thing I wanted was to go home to a world without HIV. It’s still my dream and I’m going to fight like hell to make it happen. I hope you’ll join me at this year’s United States Conference on AIDS (USCA) so we can move forward together and make this epidemic a thing of the past!