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Posted Monday, August 25, 2008 9:34 PM

The Decline of AIDS Internationalism

Adam B. Kushner

DENVER, Colo. -- The constellation of lobby groups at the Democratic Convention in Denver to influence the influencers doesn’t just include AT&T, the Distilled Spirits Council, and the National Education Association. Public interest groups are also well-represented. The Global AIDS Alliance Fund gave a luncheon today to honor members of Congress who have battled the disease’s spread. AIDS activists, it turns out, are in an awkward position.

For one thing, they don’t want to alienate a potential Republican president by speaking too forcefully for Barack Obama. But the overwhelming opinion among attendees was that Obama would do more to fight AIDS than McCain. “We’re a bipartisan group, but we have to admit that the force for change comes within the Democratic Party,” says Paul Zeitz, the Fund’s executive director. “We sent out AIDS questionnaires to all nine of the Democratic primary candidates and all of the Republican ones.  We heard back from every single Democrat and not a single Republican.”

At the same time, there is a grudging respect for the work done by the Bush administration, which has devoted more than $30 billion—a greater sum than any government in history--to battling AIDS. AIDS fighters at the Democratic convention like the idea, but not the execution: They resent that about one-third of AIDS grants go to abstinence-only education, especially considering the peer-reviewed studies they cite showing it doesn’t work; they think the global gag rule—which bars money from health clinics that so much as mention abortion as a possibility, let alone perform it—deprives hundreds of thousands of people of healthcare; and, as always, they think more should be done (one study says that only 20 percent of people infected with AIDS receive treatment when they need it). But overall they appreciate the ramp-up of funds. (Amy Coen, the president of Population Action International, told me last month that U.S. AIDS grants had so flooded the aid community that European governments, feeling they could make little difference, are stepping down their grants.)

Yet the complaints go beyond mere gripes: if it follows the activists in Denver, the next administration could mark a huge shift in AIDS policy. Contented somewhat by the funds dispersed abroad, advocates are turning their attention inward to the United States. Actor Danny Glover was only one among several speakers to cite a recent CDC study showing domestic AIDS infections could be under-counted by 40 percent. The disease has hit African Americans especially hard; they represent half of all AIDS deaths in the United States. If black America were its own country, it would have the sixteenth highest rate of HIV infection worldwide. And, according to Marjorie Hill, the CEO of Gay Men’s Health Crisis, even in the United States AIDS remains badly stigmatized, socially and professionally—particularly among gay men, poor women, and drug users. Advocates here feel that, while America has looked outward to stop AIDS abroad, perhaps from a sense of noblesse oblige, the disease is on the rise at home.

Meanwhile, here was the scene earlier today outside the conference:



photos: Adam Kushner
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Posted By: david_bryden (September 2, 2008 at 11:19 AM)

McCain has said he supports the US program on global AIDS, but he gives no specifics in terms of the funding level or whether he will back programs that give young people all the information they need.  He has backed funding for abstinence-only programs in the US, even though these programs do not work.  IN CONTRAST, Obama has signed the Global AIDS Alliance Fund's pledge for leadership on AIDS (see the GAAF website for info).  And, he has issued his own very detailed proposals for action on AIDS both at home and abroad.  That shows Obama is taking this issue seriously, which is what we need in the next President of the United States.

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Posted By: joel.schectman (August 26, 2008 at 4:27 PM)

I don't know if I agree that a renewed focus on domestic HIV  really signifies a "decline" for internationalism.

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