Charles King

Three years ago, I ranted and raved about giving the newly minted Obama administration needless years to put together a National HIV/AIDS Strategy. In 2008, after nearly three decades of AIDS, we already knew that treatment, prevention, education, housing and other critical supportive services would end the epidemic, right? What was there left to figure out? I was unanimously shouted down in person and online by fellow AIDS advocates. (That's okay, I'm used to it.)

We didn't get the NHAS until July 2010, at which point, I ranted and raved about its inadequacy. The NHAS set shamefully low targets and did zero to end the ADAP crisis. Much as it pained me, I played the role of skunk at the party and interrupted the president during the historic unveiling of the strategy. I was tarred and feathered for that one. (I'm fine, really.)

Now, here we are a year into the plan. Its accomplishments are all intangibles. Yes, we have access to the White House and Health and Human Services. Yes, some departments, like the Department of Justice and Housing and Urban Development, have taken stock of their role in the strategy. Yes, some progressive states are heeding the call for state AIDS blueprints. These glimmers of hope are laughable when compared to the goal of the National HIV/AIDS Strategy: a nation where "HIV infections are rare."

Since the president unveiled his visionary strategy, 6,330 people have been added to the ADAP waiting list. That list is almost four times longer than it was last July. Medicaid, on which tens of thousands of people living with HIV/AIDS depend for their medical care, is on the chopping block--and President Obama has his own knife poised and ready. Don't worry about your "enemies," the Republicans. Obama's proposed cuts are sufficient to sabotage the NHAS.

As for the NHAS itself, we still wait for recommendations for improvements to governmental systems and streamlining lines of federal funding (both of which are called for by the NHAS). In terms of housing, HUD is still working on a definition of homelessness, and we don't have a draft of potential changes to the HOPWA formula. Women and children remain invisible in the NHAS. The 12 Cities project has taken an inordinate amount of space. The Obama administration chose to build upon the CDC project, and when it became apparent that it wouldn't translate to the entire country, only negligible adjustments were made.

How do we expect to implement the NHAS, which is dependent on health care reform? Can we really operate as though HCR is the law of the land and the federal budget crisis will have no impact on its implementation?

You may be curling up your nose at the unpleasant words you've just read. My apologies for that skunk smell again. But I only stink up the joint because I believe that advocacy and activism still work. Lately we have been reminded of this truth not by the AIDS community, but by the Tea Party. Its relentless drumbeat has paralyzed the Obama administration and Congress' ability to govern. The result could be catastrophic should they win and "solve" the budget crisis on the backs of poor and disabled, including those living with HIV/AIDS. Going forward, let's cancel the free pass for Obama. The NHAS is not enough, and it will never be enough without a vocal, relentless drumbeat of our own.

(This entry originally appeared on the Housing Works AIDS Issues Update Blog.)

I greatly admire the work done at POZ, and in particular the high-profile efforts of my friend Regan Hofmann in the fight against AIDS. When I read her recent blog harshly criticizing activists (myself included), who protest at supposedly inopportune political times, I felt obligated to respond. Regan, you asked your readers what they think...here it is:

With all due respect, I disagree with you on three fronts.

First, I disagree that the Democrats are our allies, and that the Republicans are the enemy. Over the years, both parties, at all levels of government have been lackluster in their response to the AIDS epidemic, and both parties have had folk who have risen to the occasion in one way or another to advance prevention and treatment. The Ryan White Care Act would not have passed without Senator Orrin Hatch. And PEPFAR was initiated by a Republican named Bush. Meanwhile, both Bill Clinton and Barack Obama have in turn paid lip services to the things we care about (needle exchange; a robust National AIDS Strategy; global AIDS funding) -- and then failed to follow through.

Second, I disagree with the idea that we need to tackle the recession before we can save the lives of millions of people with AIDS and HIV. The real question is the value of a life and whether we believe that saving lives of people with AIDS is just as important as saving banks, saving GM, or waging war in Iraq and Afghanistan. It is not the Republicans that have been making those choices over the last two years, and as people living with AIDS and HIV, we shouldn't buy into the false dichotomy of people with AIDS versus the economy. I would be crying tears for the Democrats if they were going down for saving peoples lives. But they are going down for saving Wall Street!

Third, I disagree that there is something wrong with disrupting the President, whether at the White House or at a pep rally. Regan, it's naive and just plain wrong to suggest that I should have spoken to one of the members of the President's toothless AIDS Advisory Council (not that I don't interact with many of them on a regular basis). I had a chance to speak directly to the President, and I did. That's democracy. Sorry it soured folks' beautiful moment at the White House, but should we really be giddy that someone was paying attention to us when there are 4,000 people on waitlists for drugs, and the president is doing nothing about it? The same for the students. Presidential rallies are one of the few occasions college students have an opportunity to speak directly to their President. Why shouldn't they take advantage of that opportunity to voice their dissent?

Regan, you often pay homage to the activists who have launched controversial protests during the last 25 years. So I have to ask you: Would you have stood beside us when we disrupted mass in St. Patrick's Cathedral, or carried a coffin with a dead person to the White House? Would it have been too impolitic for you when we shouted Secretary Sullivan down at the International AIDS Conference in San Francisco in 1990? POZ's own blogger Eric Sawyer shouted down Vice President Al Gore during his campaign for president that led the U.S. to support generics in developing countries.

The truth is that the activism that has saved millions of lives around the globe has always been unpopular and controversial. But it has laid the issues squarely on the table and forced elected officials to respond. As long as there are pretty receptions and happy pep rallies, some of us are going to keep on being the skunk at the party.

Charles King is the President and CEO of Housing Works, Inc., the largest community-based AIDS service organization in the U.S.

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To read the blog entry by Regan Hofmann, POZ editor-in-chief, that prompted this response, click here.

To read Gregg Gonsalves' blog entry on the same subject, click here.