Fail to plan, and plan to fail

October 1, 2007

Democratic presidential hopeful John Edwards became the first candidate in either party to substantively address the Black AIDS epidemic on Sept. 24 by publishing a comprehensive HIV/AIDS platform. Black America must now demand that every candidate similarly explain how he or she will end this epidemic.

Edwards wisely makes the development of a "National HIV/AIDS Strategy" a priority in his platform. The U.S. government rightly insists that any country receiving foreign aid for HIV/AIDS first craft a national strategy, but 26 years into the epidemic the U.S. shockingly still doesn't have its own overarching plan. Edwards highlights the consequences of this failure in his AIDS platform.

"In 2001, the CDC set a national goal of reducing the annual number of new infections in half by 2005," the Edwards platform reads, "but the actual number of infections has barely budged. A 1998 presidential initiative set a goal of eliminating racial disparities in HIV/AIDS by 2010, but disparities are as bad today as they were then. Our disappointments can be explained in part by the failure to create a national strategy, backed by necessary funding and with clear and bold goals, specific action steps, real accountability and broad participation and buy-in from stakeholders both inside and outside of government."

Edwards' platform goes on to stress that "any serious effort to end the HIV/AIDS epidemic must begin in the African-American and Latino communities," including addressing the impact on Black gay and bisexual men and inside the nation's prisons.

Edwards vows to develop a national strategy with these goals in mind, which will coordinate inter-agency programs and make the secretary of Health and Human Services responsible for publishing an annual progress report.

In addition to his call for a national HIV/AIDS strategic plan, Edwards vows to support "fully funding" the Ryan White CARE Act, which is the federal government's primary vehicle for AIDS care programs, and to "put an end to waiting lines for HIV drugs." Every year, state-run AIDS Drug Assistance Programs face massive budget shortfalls, leading to service reductions and hundreds-deep waiting lists. In 2006, at least four people died in South Carolina awaiting AIDS drugs; the state announced this week that it had finally cleared its waiting list.

Edwards further stresses the need for science-based prevention policy. Specifically, he vows to lift the ban on federal funding for syringe exchange programs and to promote "comprehensive, age-appropriate sex education."

Edwards highlights his broader universal health insurance plan as the primary tool for securing adequate treatment for all, and he promises to support the Early Treatment for HIV Act, which would expand Medicaid to include those who are HIV positive but not yet diagnosed with AIDS. But his platform does not discuss how he'd resolve the ongoing crisis for Medicaid overall. The massively expensive program has forced every state in the nation to consider ways to reign in costs, including restricting services.

It may be that Edwards' larger health insurance plan relieves the pressure on Medicaid. But he must tell voters how he'll reform the program to make it both affordable and accessible to all of America's poorest, whether he achieves universal coverage or not.

The Institute continues to urge all candidates, in both parties, to publish an AIDS platform.
Black journalists have put candidates on notice by questioning them on their response to AIDS, and some have been able to answer with positions on individual AIDS policy questions. But without an overarching plan, those efforts are wasted.

Black America's message to any candidate seeking our votes in 2008 must be clear: First, show us the plan.

Click here to read the Edwards plan.