With all the excitement, hope and opportunities presented by the upcoming installation of President-elect Barack Obama as the 44th President of the United States, every progressive constituency group is hawking their first 100 days list. That includes our nation's efforts to combat HIV/AIDS which has spent the past 8 years in the Beltway wilderness.
During the campaign and since his election, the President and Vice-President elect have promised to prioritize the fight against HIV/AIDS. If the incoming administration follows the plan being proposed by numerous AIDS advocates, we could have a national strategy for combating AIDS by 2010. In my view that seems like too long. After all, this is a matter of life and death, not to mention untold suffering for hundreds of thousands of Americans.
Tragically, on September 11, 2001, three-thousand lives were lost. We responded immediately with far-reaching legislation and military force. Three-thousand Americans die every month from AIDS.
I find it unconscionable that 27 years into an epidemic that has ravaged the gay community, our country has never had a coordinated policy in place to combat AIDS. Over two decades into the epidemic and 50 percent of HIV-positive people are not yet in care and 20 percent of the people infected do not know their status. Since Ronald Regan left office, more Americans have died from AIDS than all the soldiers that have fought under our flag since World War I.
President Obama must revive the White House Office on National AIDS Policy (ONAP) and appoint a new director to oversee the office with new vigor and urgency. ONAP was created in 1993 by President Bill Clinton as a branch of the Executive Office of the President.
At the time it seemed like a breakthrough. However, by 2002, when President Bush appointed openly gay Dr. Joseph O'Neill, he was the sixth individual to lead that office in less than ten years. O'Neill followed Kristine Gebbie, Patricia Fleming, Dr. Eric Goosby, Sandra Thurman and Scott Evertz. Most of them promised aggressive HIV prevention and education for America. Several quit after complaining of conflicting agendas and lack of support. They all headed an organization that was, for the most part, a public relations flack functioning primarily to create the illusion of a comprehensive vision for ending AIDS and caring for the millions of citizens already infected due to the massive prevention failures.
In reality, decisions that affected HIV and AIDS policies were being made without coordination by the Congress, the National Institutes for Health, and the Centers for Disease Control, the Food and Drug Administration, state legislatures, and the Department of Health and Human Services.
Candidate Obama often spoke of the world as it is and as we would want it to be. To meaningfully combat AIDS we must have a course correction and it should start in the White House.
The Obama administration must quickly implement a number of changes. The ONAP director must be given budgetary authority over the more than $23 billion in federal money spent on HIV prevention and care for people living with HIV and AIDS. We must lift the ban on federal funding of syringe exchange programs; defund failing abstinence-only education programs; and fully fund comprehensive prevention and treatment programs.
The last person to oversee the office, Carol Thompson, stepped down in February, 2006, and it has been vacant ever since. With the prospects of a national public works and economic stimulus package, health care reform and the development of a national HIV/AIDS plan on the table the appointment of a director for ONAP should be prioritized. The President and Vice President elect flanked by former Senate Majority leader and Secretary of Health and Human Services-designee Tom Daschle should announce the new director with all the fanfare and great urgency afforded our nation's top priorities. The director should then immediately get to work assembling the brain trust and action team. The resources for this office are already in place.
At least two names are being floated as a potential AIDS czar: Dr. Helene Gayle, who served as director of the Centers for Disease Control and Prevention's National Center for HIV, STD, and TB Prevention between 1995 and 2001; and Jesse Milan Jr., chairman of the Los Angeles-based Black AIDS Institute. I know and admire both of these individuals. As African Americans they would bring an important perspective to this role. As a person living with HIV Jesse's appointment would bring some much needed visibility for people living with HIV/AIDS.
In choosing a director the President elect and his transition team should ensure that the appointee has the kind of national profile and Washington intergovernmental connections that are required for a leadership position.
For day one the vision for change and an end to the devastation and pain of AIDS must come from the President.
The author was a member of the Presidential Advisory Council on HIV/AIDS in the first term of the Clinton administration where he chaired the Prevention Subcommittee.