Wednesday, July 29, 2009

Dear Friends,

I know that we all share a deep commitment to fighting HIV/AIDS and to ensuring quality care and services for those impacted by this pandemic, so I wanted to let you know personally about the devastating State funding cuts to HIV/AIDS programs and services.

Yesterday, Governor Schwarzenegger line-item vetoed close to $52 million in funding to the State Office of AIDS. These funds support HIV/AIDS education and prevention, therapeutic monitoring/viral load testing, HIV testing, early intervention services, home and community-based care and housing.

Although Californians living with HIV/AIDS will still have access to lifesaving medications under the AIDS Drug Assistance Program (ADAP), these cuts will make it extraordinarily difficult to determine whether the medications are working (viral load testing), or even if someone is positive and might need to begin medications (HIV testing). The cuts also devastate one of the most promising intervention systems -- early intervention services for those newly diagnosed -- and eliminate all of the few remaining prevention opportunities.

While we all know the state budget is more than a mess, and we knew some HIV/AIDS funding cuts were likely, the depth and scope of the Governor’s cuts are unfathomable.

Throughout our state, we are still sorting out exactly what these numbers will mean following the Governor’s unexpected decimation of so many systems of care, including those for people living with HIV/AIDS and for children from low-income families. Options are unclear but are frantically being researched.

It’s taken more than 25 years to build up the programs and services for people living with HIV/AIDS in our state. No victory came easy, and many spent their last days and breaths advocating for compassion, for care and for adequate funding. With all of our efforts, it is still true that every 9 ½ minutes someone in the United States is infected with HIV and 1 out of 5 of those people who are infected DO NOT KNOW they are infected.

Governor Schwarzenegger’s blue-pen frenzy dismantles a system of care that had become a model, not only for other states, but internationally. A model that has helped keep people alive and provided a quality of life that people with HIV/AIDS didn’t have just a few years ago. We’re not just taking apart a safety net, we’re destroying the system of care itself, and ensuring that the most vulnerable won’t have access to the care and treatment they need.

While we are still figuring out the exact financial implications of these cuts to services in our region, it is clear that losing this funding will be devastating. Please know that we will keep you informed the moment we have more specific details.

Given our mutual and profound commitment to helping those impacted by HIV/AIDS, many of you are asking what you do to help. We will likely have many calls to action in the next few weeks as the reality of these cuts begins to directly affect San Diego area programs and services.

But today, I hope you will do one thing -- please sign up for AIDS Walk San Diego and send a note to your friends asking them to contribute to your efforts in the wake of this tremendous loss of resources. Right now, in the face of this blow, I believe it so important to show people living with HIV/AIDS that we care deeply and that will continue to fight for them. We will continue to stand up for them -- and we will walk, always by their sides, as we face the challenges of this ongoing pandemic together.

AIDS Walk San Diego is a program of The Center.

Monday, July 27, 2009

We Can Do Better Than This

There are moments when the chaotic noise of political rhetoric about equality and healthcare reform is forced into the background by the reality of the human suffering. The kind of suffering that pierces the hype and spin and speaks directly to my heart. Unfortunately, in HIV/AIDS work, it happens around this time every year as we deal with fears and concerns about governmental funding cuts. This year is different – the stakes are much higher and the fears of those without health care resources are well founded.

Public health, like basic human rights, has been a huge part of my professional life. Three public health issues powerfully shaped my adult life, my work and my focus for the last 20 years -- HIV/AIDS, mental health issues and cancer, particularly breast cancer.

I completed graduate school and entered professional life a couple years before the 1996 medication breakthroughs for HIV. I came of age professionally after losing scores of my closest male friends and mentors and began my career by serving the hundreds who were suffering from and dying of HIV. After 1996, with better health care, better policy and new medications I was able to serve clients who were living with HIV/AIDS. As they began to live longer, I could spend time helping to build an inclusive network of care that could provide access to those who were uninsured or had fewer resources.

Every year in the summer months, the HIV Planning Council of the County Board of Supervisors (a remarkable coalition of more than 50 dedicated consumers, providers and community members) take up an annual review of local San Diego data and the needs of those living with HIV/AIDS in order to make budget recommendations for the coming year.

The committee charged with making those recommendations to the County Board of Supervisors is the Priority Setting Committee of the Planning Council. I have served as chair that committee for five of the eight years I have served on the Council.

This year’s budget process is almost too excruciating for words.

This year I could feel the sting behind my eyes as I listened to a mother of three children who has been infected for three years beg for us to find some money to help case management services stay open so she and her children can survive. I listened to a young man of 18 who haltingly and politely thanked everyone for their work and asked us to try to find prevention dollars to help educate his friends so they don’t have to suffer this disease. I listened, heart breaking, to the gay man of 45 who sero-converted right after the end of his long-term relationship; a man who apologizes for needing services, but he’s lost his job, and thus his health insurance, because he’s been sick.

Every 9½ minutes someone is infected with HIV. Every day in San Diego someone new is diagnosed with AIDS. Yet once again the State of California’s budget is uncertain. Well, I guess we should say cuts are certain to happen, it’s how deep and painful they will be that remains unknown. The Ryan White Treatment Modernization Act hasn’t been renewed or reauthorized by Congress and the costs of providing basic care are spiraling. And the nation continues to debate the necessity of health care reform.

But those are just the facts. As I sit in committee meetings, the facts fade away and it is the people who come into bold relief. The members of the public and consumers who come to this committee to try to participate in their own healthcare, to provide testimony and to try to find hope for themselves and others. These are real people, in real pain, terrified about their future and the futures of their families and all those impacted by HIV/AIDS. People who can’t get health insurance, people who can no longer work, people who need access to health care to continue to live. Each year, while the number of those living with HIV (and their medical needs) grow, the funding doesn’t. And each year, consumers come to testify and beg for health care - beg for hope.

Every year I listen and think, “Is this really the best we can do in America? Really?”

We’re one of the richest countries in the world, where pharmaceutical companies spent $44 billion dollars last quarter on lobbying and our banks awards multiple billions in bonuses to a few individuals? In this country with our new cars, homes and daily doses of Starbucks; the best we can do is to beat the drum of “no new taxes” and then make those who suffer come to beg for life-saving services for themselves and their families?

We can do better than this.
We have to do better than this.
This is not the world I want my children to inherit.