Why Don’t the Candidates Speak Out on HIV?

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Why Don’t the Candidates Speak Out on HIV?

Pamela Merritt

News that African-Americans are just 12 percent of the population but 46 percent of new HIV infections should get the presidential candidates talking about HIV/AIDS. They're not -- so we went looking for their positions.

When news hit
that another Wall Street financial institution was on the verge of collapse,
the response from rivals Sen. John McCain and Sen. Barack Obama was swift.  Both candidates issued statements touting their
respective economic plans.  What kind of
impact could our presidential candidates make if they responded as quickly to
the domestic and global HIV/AIDS crisis?

News that
blacks, who make up just 12 percent of the total population, account for 46
percent of new HIV incidences was certainly cause for alarm in my world.  It’s clear that we should add HIV/AIDS policy
to the list of things in need of change. 
So as the presidential campaign moves into the final stretch, I decided
to take a look at the two major political parties and what their nominees offer
to address the global and domestic HIV/AIDS crisis.

Sen. McCain
has not issued a formal HIV/AIDS plan or a strategy to address HIV/AIDS
domestically or globally. Sen. McCain does have a domestic health reform plan to
expand access to healthcare coverage – a plan that would use tax rebates to shift
Americans from employer-based coverage into the individual insurance market –
but he does not support policies that would prohibit insurers from denying
coverage based on pre-existing conditions, so HIV positive people seeking
insurance on the private market may not be able to secure coverage.  On the issue of global HIV/AIDS, Sen.
McCain supports the President’s Emergency Plan for AIDS Relief (PEPFAR), with ideologically-based
restrictions intact.  McCain has
suggested that contraception has no part in an HIV prevention program and supports
abstinence-only programming. If elected, McCain says he would call for the
creation of a new international organization to link democratic nations
together to address challenges including HIV/AIDS and the eradication of malaria
in Africa.

Domestic and
global policy development to address HIV/AIDS
was largely ignored during the Republican National Convention
.  There was no mention made of the domestic HIV/AIDS
crisis and only passing references made to the global epidemic. Neither Republican
Presidential nominee Senator John McCain nor Vice Presidential nominee Governor
Sarah Palin mentioned HIV/AIDS in their speeches before delegates at the
Republican National Convention.  When First
Lady Laura Bush spoke of AIDS in her address she noted the number of Africans
receiving AIDS treatment through PEPFAR, a program spearheaded by her husband President
George Bush. Yet no speakers at the Republican National Convention addressed
the HIV/AIDS epidemic in the United
States and the 2008 Republican platform
offers no direct plan to address it.

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In contrast,
Democratic Presidential nominee Sen. Barack Obama introduced a plan to address
in 2007.  That plan supports
the creation of a National HIV/AIDS
, a coordinated plan to address HIV domestically, set targets for
decreases in infection rates and respond to health disparities. He supports
expanding Medicaid coverage to all low-income people living with HIV/AIDS and he
supports the Ryan White CARE Act, the US’s largest
federally-funded program for people living with HIV and AIDS. Obama’s plan would
focus on eliminating disparate impact of HIV/AIDS, particularly in minority
communities. On the issue of prevention, Obama supports age appropriate
comprehensive sex education and federal funding for needle-exchange
programs.  Obama’s broader healthcare
proposal would promote universal healthcare coverage by building on the
existing public and employer-based system and by creating new coverage options
for the uninsured.  Insurers would be
prohibited from denying coverage based on individuals pre-existing health conditions
or from charging higher premiums based on health status. Low and
moderate-income individuals would be provided premium subsidies to ensure that
coverage is both available and affordable for people living with health
conditions such as HIV/AIDS.

To address the
global issue of HIV/AIDS, Obama proposes providing $50 billion by 2013 to go
towards the United States’
global AIDS efforts through PEPFAR.  That
proposal includes an increase in our commitment to the Global Fund to Fight
AIDS, Tuberculosis and Malaria. Obama would double foreign assistance to $50
billion by 2012 through his global development plan and coordinate the
consolidation of foreign assistance initiatives into a restructured aid program.
Obama supports increasing our national investment in the healthcare
infrastructures of developing countries so those countries can better address
public health challenges and he supports the cancellation of debt for those

The domestic
and global challenge of HIV/AIDS was addressed at the 2008 Democratic National
Convention where the 2008 Platform specifically calls for a National AIDS
Strategy.  When speaking at the DNC, former
President Bill Clinton
praised Senator Obama saying, "He will continue
and enhance our nation’s commendable global leadership in an area in which I am
deeply involved: the fight against AIDS, tuberculosis, and malaria, including
— and this is very important — a renewal of the battle against HIV and AIDS
here at home."   In addition to President Clinton’s call for
a renewed focus, Representative Barbara Lee and Representative Maxine Waters
also called for a National AIDS Strategy.

The Centers
for Disease Control and Prevention (CDC) recently
released an analysis
of their 2006 HIV/AIDS data.  The analysis looks at the number of new HIV
infections in 2006 and who is represented in that number.  The CDC found that 53 percent of the
estimated 56,000 cases of new HIV infections in 2006 were among gay and bisexual
men.  Forty-six percent of the infections
occurred among blacks. Within the gay and bisexual group, young black men
between the ages of 13 and 29 years old were roughly twice as likely to get
infected as young white and young Hispanic men within that same group. Among
women, black women were almost 15 times more likely to get HIV than white women
and are almost four times more likely than Hispanic women.

The revised
CDC HIV/AIDS figures and the analysis of those figures further highlight the
urgency of the HIV/AIDS crisis in the United States.  Yet, although the United States requires that
PEPFAR-funded countries have national coordinating strategies on HIV, we
continue to try to operate without one.  Voters
must add a candidate’s HIV/AIDS policy to our evaluation of a candidate,
because trying to address the global and domestic challenge of HIV/AIDS without
a National AIDS Strategy makes about as much sense as trying to govern without
a budget.