Time to renew the fight

Published 2:35 pm Tuesday, August 5, 2008

By Staff
against HIV/AIDS
Most of the headlines about HIV/AIDS in recent years are about efforts to control the disease in Africa, but the deadly epidemic is still raging in the United States, particularly in black communities in the rural South, including many parts of North Carolina.
Two recent reports document the problem and the failure of federal policymakers to address it. The Southern AIDS Coalition says federal funding formulas have not changed to reflect the shift of HIV/AIDS to the South and finds that large urban areas of the country are receiving a disproportionate share of federal dollars to fight the disease.
North Carolina is among six Southern states the coalition says are struggling with rising infection rates and inadequate resources for treatment and prevention programs.
The Black AIDS Institute released a report recently that also criticized the federal government for its lack of efforts to fight the disease among blacks, pointing out that there are more Black Americans infected with HIV than in many of the countries targeted by the Bush Administration for anti-AIDS programs.
North Carolina has a mixed record. There have been big improvements in recent years in making lifesaving drugs available to people living with HIV, but lawmakers have yet to make the needed investments in education and prevention efforts and refuse to authorize a clean needle exchange program to reduce infections among IV drug users and their partners.
Just a few years ago, North Carolina had the lowest eligibility limit in the nation for the AIDS Drug Assistance Program, denying lifesaving medication that costs as much as $15,000 a year to anyone who earned more than 125 percent of the federal poverty level, currently set at $13,000.
A few years ago lawmakers raised the eligibility limits to 250 percent of poverty and this session it was increased to 300 percent, roughly the national average. Advocates have had a much tougher time on prevention strategies, though the state’s Get Real, Get Tested Campaign continues.
This year’s budget includes next to nothing for HIV/AIDS prevention. It does allocate a million dollars for local programs working on health issues in minority communities, but that’s not all for AIDS and it’s not nearly enough. Public-health advocates have also not yet convinced lawmakers to make comprehensive sex education available in school, so the abstinence only curriculum remains.
Last summer, the Senate budget briefly included a provision setting up a pilot program to allow three communities to set up clean needle exchange programs. Studies show the programs reduce HIV infections and increase the number of addicts who enter treatment because of the relationship they establish with the people who administer the program.
Senate leaders ultimately decided not to support the needle exchange proposal because of the perceived political risk and as a result infections that could have been prevented have occurred.
Statistics from the Division of Public Health show that 1,943 new cases of HIV infection were reported in North Carolina in 2007 and 62 percent of the people infected were black. Those numbers are probably low. Many people infected last year don’t yet know it.
It is not a coincidence that as HIV/AIDS has become more a disease of poor and rural blacks that it has faded from the headlines and moved down on the list of federal budget priorities. Maybe the recent reports will refocus attention on the deadly epidemic that is still taking lives and devastating families.
North Carolina lawmakers and public health officials deserve credit for improving the state’s shameful ADAP program and providing medication for more people living with HIV who can’t survive without it.
Now it’s time for the next step, to realize they must do more to prevent people from becoming infected in the first place, whether they think it is good politics or not.