Dollars and Sense in the Era of Tooth and Claw


Chad S. Johnson and Chris Romano

The emergence of another fiscal cliff bogyman has been deterred for a few weeks, as the House, allowing a welcome reprieve from countdown clocks and diatribes about the end of western civilization as we know it, prepares for summer recess. We were all thoroughly distracted by the ache and convolutions of our elected officials bemoaning one another’s consistent failure to produce solutions that don’t devalue the gratuity of their corporate benefactors. People living with HIV/AIDS around the country, and around the world – and their family and friends – sat before the late night glare of 24/7 media outlets, wondering if the rational, genuine commitment to saving the essential benefits of millions of people is even a slight priority for the Trump Administration and its congressional allies.

The HIV community is politically savvy. Advocates have spent copious amounts of time on Capitol Hill, in the offices of legislators, both supportive and not, and know well what to expect when the political climate turns hyperpartisan as we’ve witnessed these months since the election. Sure, there’s always a deep crevice of some nature between Republicans and Democrats, with extremists emerging on both sides of the aisle. However, it’s apparent that this time around, the budget process is following an unprecedentedly calamitous path. The Administration plans draconian funding cuts for the NIH and elimination of essential coverage for tens of millions, both domestic and abroad, who are dependent on public heath funding through Medicaid, The VA, PEPFAR and contributions to the Global Fund. The tragic and inevitable result is so extreme that it frankly defies concrete anticipation and visualization.

So many hard-won victories in the context of ‘the plague of decades’ look to be put to the fiscal knife in previously unimaginable, unforgivable ways. While redress is called for by those who are positively sick, as much from enduring this odious policy process as they are from the virus, Capitol Hill continues its spurt-and-paralysis mode in the face of outrages of an Administration defying all norms.

After IAS 2016 in Durban and before the convergence on the 9th IAS HIV Science Conference in Paris later this month, our ability to solicit change and voracious in our contempt for policymakers who use their bully pulpits to perpetuate a plague, we should become equally unforgiving in our opposition to see the return to public service en mass those representatives who determined that the lives of people living with HIV/AIDS are of lesser value than cherished tax breaks.

So, it is time for the HIV community to consider organizing more creatively, with whatever various means and abilities are at its disposal. With the upcoming 2018 congressional midterm elections, large numbers of legislators are facing a level of surmounting pressure that the political pundits at Washington Weekly, The Hill and Politico are compelled to take notice of. Potential opponents challenging incumbents are already emerging. The leadership of the HIV community should be propounding the assembly of a teeming number of political machines that facilitate volunteers and campaign contributions from across the country to concentrate efforts on elections where the outcomes may determine the lives of friends and family members. At this precarious time in our struggle to find a cure, the community should be organizing like rabid tigers to ensure that those who so cavalierly threatened our survival during this latest chapter of our nation’s fiscal malfeasance are thoroughly routed from the political spectrum of public service.

Once and for all, the HIV community should be tired of living in a state of fear of those sent to Washington to provide the people of this county with viable leadership. Those who who allow, or even encourage, the backroom deals and the conspiratorial gamesmanship that defined a political process where the poorest of our citizens are exposed to the evisceration of entitlements, access to care and support that would have resulted in increased morbidity, further deaths and more suffering. Even before the advent of the Trump movement, too many people living with HIV/AIDS were relegated to a marginal kind of an existence where some of 1.1 million people and their families living with HIV are subject to homelessness, denied essential medicines, and left hungry because a handful of aged gluttons and anemic, dull-witted ingrates lacking testicular fortitude enjoy their sad existence while their most vulnerable constituents are offered up in wholesale sacrifice.

Bullies know they can only continue their acts of tyranny so long as the victims of their cruelty allow themselves to be powerless.

These lessons are paid for by the gun lobby, the aerospace lobby, the banking industry, the millionaires and billionaires of our country and of other countries, who afford a consistent presence on the Hill to ensure disproportionate levels of attention to their interests. People living with HIV/AIDS have AIDSWatch and a dozen AIDS Awareness days that receive an hour of attention. The community can do better – and it must to survive the conditions of the fourth decade of the AIDS crisis.

Those of us who care or are directly impacted by this plague need a post-Citizens United “AIDS PAC”. We need both defensive and offensive strategies. We must protect previously untouchable legislation like The Ryan White CARE Act, and we need to push initiatives like Danny Davis’s H. Res 1179 and Barbra Lee’s AIDS Cure Act, to facilitate more clinical options and fewer funerals. We can make a mechanism for the drug companies who have made billions from our friends and families to contribute to keeping a safety net.

Starting a PAC is easy, economical and, in the short term, perhaps the best chance to ensure that we aren’t spending our precious time meeting with the dregs of the legislative offices. The internet is choked with information on the mechanisms of getting a so-called super Political Action Committee up and running.
Try to endear a Member who knows you can contribute to the challenger to a particular seat. They’ll pour you a cup of coffee and personally follow up with you.
While there are times that being on bended knees, however compromising may be an advantageous position, such is not the case in the majority of the offices in the Rayburn building following the last election. For the vast majority of advocacy that afford such miscellaneous items as cancer research, environmental protection and the insurance of basic substance for the poorest of us, the advancement of human rights and the opportunities that we have to ensure quality education for the next generation, there are other more invasive anatomical positions being prescribed.

AIDS PACs that advance our agenda as a community-increased research, better service delivery, robust prevention programs, via the Ryan White CARE Act and HOPWA, the continued support of contributions to the Global Fund and PEPFAR at sustainable levels, the list goes on and on, this pittance that saves incalculable lives compared to a few of our most recent military adventures.

If we cost our opposition a handful of seats in the next election cycle, make it much more expensive for the visceral kind of marginalization upon which they appear to thrive, like any insulting pathogen exposed to an effective treatment, their burden will subside, and the symptoms of their political infection will subdue.

Creating a level political playing field for people with HIV starts with a wholehearted shedding of our immaturity about influencing Washington. We have the best government money can buy. The elements we are in sorest need of as a community-integrity, compassion and enduring commitments is the influence that preserves our community in this heinous environment.

 

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