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Advocates Want More Focus on Domestic AIDS Cases


We're going to talk more about the issue of HIV/AIDS on African-Americans. The Black AIDS Institute in Los Angeles recently released a report declaring that AIDS in America is a black disease. Close to 600,000 African-Americans are infected with HIV. The community is more devastated by the disease than seven African countries supported by the Bush administration's anti-AIDS program. The CEO and founder of the Black AIDS Institute, Phill Wilson, joins us now from the AIDS Conference in Mexico City. Welcome. Thank you for speaking with us.

Mr. PHILL WILSON (Founder and Executive Director, Black AIDS Institute): Well, thank you for having me, Michel. It's great to talk to you.

MARTIN: Your report is titled, "Left Behind: Black America, A Neglected Priority in the Global AIDS Epidemic." Why do you think that African-Americans are being left behind?

Mr. WILSON: Well, in many ways, you know, Dr. Fenton spoke to you and he listed reasons why African-Americans are disproportionately impacted, including poverty, city drug use and prisons. But he did not mention neglect by our federal government. You know, last week President Bush signed a reauthorization of the PEPFAR, now committing 48 billion dollars to fight AIDS in developing countries. And we applaud that effort, but yet, over the last eight years, at least, we've had flat funding of the domestic AIDS portfolio. In fact, now, our AIDS prevention efforts have failed Americans and it particularly failed black folks.

MARTIN: How so and why so, in your view?

Mr. WILSON: Well, you know, you asked the question earlier about whether or not new prevention efforts have been pulled back in some populations, and with all due respect to Dr. Fenton, I will answer that question differently. The answer is, yes. Now, we have basically dismantled effective prevention strategies in this country. We've had an obsession with abstinence only, to the exclusion of comprehensive prevention efforts that would work. Our federal government continues to have a ban on federal dollars to needle exchange programs that have been proven to reduce HIV infections in black communities and do not increase drug use.

And you know, Michel, we are going into 28 years into this epidemic and we still do not have a national AIDS strategy. Now when we give money to developing countries, we require for them to have a national AIDS plan, but we don't have a national AIDS strategy in this country. And as a result, now, all Americans are being failed by our policies and African Americans, in particular.

MARTIN: I think the administration would probably resist that interpretation. I think that they would say that they do have a national AIDS plan but it's within, sort of, the values parameters that they believe there is consensus around in this country. What do you say to that?

Mr. WILSON: Well, I will submit two things. One, I would reject the notion that they have a national AIDS strategy. They have a hodgepodge of programs. They do not have targeted goals and objectives that they measure against outcomes. There is not a coordinated plan. The CDC does not talk to HRSA, which does not talk to NIH, and nobody seems to create a plan that incorporates the community, and particularly traditional black institutions.

And secondly, what I would say to you is that they do - what they do is consistent with their policies. And unfortunately, we have allowed ideology to trump science, and politics to trump effective behavior strategies to prevent HIV and AIDS.

MARTIN: So you don't object to the U.S. government's initiatives overseas. What you're saying is that the level of leadership that the U.S. is demonstrating overseas is absent at home.

Mr. WILSON: Absolutely. You know, I applaud the efforts overseas but what I'm afraid of is - I travel around the globe - that our ineffectiveness to fight the domestic epidemic is undermining our leadership on the global stage, as well. When I go to Sub-Sahara Africa and I talk to African leaders, they say to me, how can the U.S. tell us how to fight our epidemic when they can't even figure out how to fight an epidemic among black people that they live next to, that they go to school with, that are right in their own community?

MARTIN: Just briefly, Phill, if you would, give me your view of what this comprehensive strategy would look like. We only have about a minute left. But give me what you think are some of the components of that kind of comprehensive, national, targeted strategy in the U.S.

Mr. WILSON: Well, first of all, it would have to have a coordinated program across all federal agencies and incorporating community-based organizations. It has to be a major increase in our commitment to prevention. We're calling for a 1.3-billion-dollar a year commitment to really develop a comprehensive prevention strategy. And obviously, we need to deal more effectively with access and utilization of treatment.

MARTIN: And what would that look like? Are you suggesting that - that just our current set of health care delivery system just is inadequate for African-Americans overall? Or is it the AIDS community overall?

Mr. WILSON: It's all Americans overall, but in particular, African-Americans and people who live with HIV, in particular. The fact there are so many Americans who do not have health care, that is a challenge. The fact that we have folks with HIV who are on waiting lists to get access to treatment or the fact that our state programs are not coordinated with our federal programs. The fact, quite frankly, that a quarter of HIV-positive Americans don't know their HIV status and the black community is even worse.

MARTIN: OK. We're going to have to leave it there. Phill Wilson is the CEO and founder of the Black AIDS Institute. He joined us from the International AIDS Conference being held in Mexico City. Phill Wilson, thank you so much for speaking with us.

Mr. WILSON: Thank you, Michel. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Corrected: August 4, 2008 at 2:53 PM EDT
We initially said: "One out of every two Black Americans is infected with HIV, according to a new report from the Black Aids Institute." In fact, as the story now says, "One in two persons newly infected with HIV in the U.S. is African-American ... "