Recently, I was interviewed by The Chicago Reporter on the challenges facing black HIV/AIDS organizations when it comes to funding, sustainability and effectiveness. I just read the published product, “Cocktail for Disaster” from the January/February 2009 issue, which was disappointing to me.
As an African American of Caribbean (Suriname) descent, I have had the privilege of working in numerous communities of color as a public health expert. The challenges described in the article do not adequately address the real issue, which is that black organizations, from the inception of the HIV/AIDS epidemic, have not had the social capital seen in the gay community in order to effectively provide services for their constituents.
Due to this lack of social capital, African-American HIV/AIDS organizations were left out of the picture with no place at the table when policies were implemented that mostly addressed gay communities. After the Reagan era, politicians began recognizing that African Americans were actually suffering and had been in greater amounts; we had missed the boat. When programs were installed during the early Clinton years, those programs were simply “adapted” from those designed for gay communities and therefore were not very effective in African-American communities considering that one shoe does not fit all.
African-American advocates had already begun to create programs, which did not receive the kind of funding needed to sustain them because of the ignorance of our government to recognize that we were sinking into a deep epidemic–”one that we will never [bring] ourselves out of. Due to the fact that many gay organizations have been at the table for years and continue to treat the epidemic as an entitlement for them to stay in control of any programs and policies, we have lacked to address the true causes of HIV in the African- American community: lack of social capital and social determinants that do not apply to gay communities.
[As Jesse Milan Jr. described in “Left Behind,” a 2008 report of the Black AIDS Institute, “The number of people living with HIV in Black America exceeds the HIV populations in seven of the 15 focus countries of the PEPFAR (U.S. President’s Emergency Plan for AIDS Relief) initiative.”] Yet the gay community has continued to control the funding and programs, leaving us out of the picture. Surely everyone uses data on African Americans to get funding; however, when it boils down to it, little of that money funnels to the places where it needs to go.
Adding to the problem is the lack of experienced, culturally competent and committed professionals available to run programs for our communities, due to lack of funding and bureaucracy. HIV funding has become an entitlement for gay organizations claiming to work hard on behalf of communities of color. When organizations serving African-American communities do get the funding, the disparity drives them to mismanagement and lack of accountability. The bureaucracy they face in actually receiving funds once they finally qualify for funding further drives mismanagement since they have little funds to sustain them in the meantime. Gay, predominantly white communities never had that problem. This is the point we failed to recognize in this article.
Surely [Lloyd] Kelly [of Let’s Talk, Let’s Test Foundation] was responsible for the funding allocation and the ultimate audit [of the African American HIV/AIDS Response Fund] but the real point of the problem was not about his organization locally, his appearance or sexual orientation, but the segregation created in funding HIV programs around this country.
It is my hope and prayer that in [this current] presidential administration we will be aware of the fact that funding and enabling organizations already scrambling for dollars is setting communities up for failure and death. Healthcare reform should include several components of HIV/AIDS care, which will allow us to move away from the stigma and bureaucracy in allocating adequate funds to one disease and promote quality of life to include knowing your status and preventing disease.
I am a policy associate for the division of government relations and public policy at the National Minority AIDS Council but want to make it clear that I am not the spokesperson and in no way are my words intended to reflect the opinions of NMAC.
Ludmilla F. Wikkeling-Scott