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New Congress must consider new policy approaches for world AIDS fight

With Ebola in the United States, World AIDS Day 2014, December 1, is a stark reminder of the continued U.S. and global challenge AIDS represents. The new Congress should also consider the critical funding needs of working to end the disease globally.   

Though the U.S. was slow to respond to the epidemic, the world now looks to the U.S. for leadership in fighting the advance of the disease, now considered a chronic illness in the U.S. due to a new generation of drugs. Responsive and informed economic, health and political policies will determine whether the U.S. will be the global leader in ending the world health crisis AIDS continues to be.

{mosads}Ironically, the federal government’s website,, links success in the fight against AIDS with 2010’s Affordable Care Act, whose architect, MIT economist Jonathan Gruber, said became law due to the stupidity of the American people. The inclusion of this crass ACA “commercial” on the government website is a cruel reminder to people living with AIDS that the U.S. government is, once again, playing politics with their health and lives. The “commercial” should never have been a part of the administration’s website.  

In President Obama’s World Aids Day Proclamation he noted the “extraordinary progress” made in the fight against AIDS, but stressed the fight is not over. Increased infections among young gay and bisexual men in the Deep South are alarming.

HIV infection rates in the South have been a policy concern for many years for the region’s lawmakers. They have succeeded in directing more funding to the region in spite of political opposition from lawmakers from the early hard hit metropolitan regions. Still, more funding is needed in the South due to the increased infection rates.

“Extraordinary progress” and extraordinary work by Congress are needed in the South in the form of more safe sex education, improved public health services, availability of drug assistance programs, community awareness programs, political leadership, emphasis on testing and a more supportive culture. Needs are great in this area and significantly more resources are needed.

Congress should work on a more effective public health approach in the South as President Obama, the ACA, and the Democratic Party are, to put it politely, not popular and not wanted there by the majority of elected state officials. Congressional leaders would be wise to consider a nonpolitical approach based on the region’s culture.  

As Congress considers more AIDS funding resources to the South, it is time to rethink how nationwide services are provided. Models developed in the early years of the epidemic have abandoned needed services, like warm meals, food pantries and nutritional education, and morphed into providing unhealthy services, such as “educating” AIDS clients on how to use illegal and dangerous drugs to prolong and enhance sexual experiences. Such wrongheaded services have alienated donors and clients and should be cause of concern for lawmakers who determine the level and distribution of AIDS funding.

Congress should examine the AIDS services provided by recipients of federal funding to determine if the agencies are providing “education” on illegal drug use as a sexual “therapy” for people with AIDS. This is a doubtful health service and Congress should determine if funding such a practice is a wise use of federal funds.

As people with AIDS in the U.S. are living healthier and longer due to better drug therapies, service agencies must adapt. Many individuals who retired from work in the 1990s with Social Security and Medicare coverage due to a diagnosis of a terminal illness, are now capable of returning to work. Congress should consider a program of reemployment training for such individuals so scare federal AIDS funds can be redirected to more effective uses.

More “extraordinary progress” is needed in the fight against AIDS. Congress must make effective use of funding and delivery of AIDS services in traditionally underserved areas like the South. Better and more accountable governance of the AIDS service infrastructure should be on the agenda of the new Congress.

The fight against AIDS is winnable. An AIDS-free generation is achievable sooner than most think possible. To get there will require new policy approaches by a new Congress in the New Year.

Patterson, a former diplomat, is a San Francisco-based writer and speaker. He blogs at


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