To understand how every dollar counts in the fight against AIDS, one only has to look at the battle over funding that took place during last month’s City Council budget meetings.
Supported by figures showing that African-American and Hispanic communities are being ravaged by the virus, activists and some aldermen put on a spirited and public plea for more funds. Eventually, an extra $500,000 was squeezed into the 2004 city budget, which lifted the total to $4.2 million for AIDS prevention.
Chicago aldermen, led by Ed Smith (28th), backed an amendment to increase the funding. “Our position is that we should get it because we need it in our community,” Smith said before the money was approved.
Although proponents cheered the extra funding, it might end up being a hollow victory. The majority of local AIDS funding, around $43 million, comes from federal sources, including the Centers for Disease Control and Prevention, which in April announced a radical shift in policy that activists warn could cost Chicago’s agencies millions.
Some activists believe the Bush administration has influenced the new CDC policy because it focuses more on abstinence than education. Some fear social policy is being driven more by politics than public health.
“The CDC just kind of rolled this out,” said Sean Smith, director of government affairs at the Howard Brown Health Center. “They never really talked to anybody about it beforehand. It just kind of came from on high. There’s clearly been a shift in focus in HIV prevention since 2001.”
The new CDC strategy, “Advancing HIV Prevention: New Strategies for a Changing Epidemic,” is intended to halt the spread of HIV by putting more money toward testing so infected people will be aware of their status and, presumably, then take the necessary precautions to not spread the disease.
“I’m not so sure everybody thinks that is the best strategy, but that’s what they are doing,” said Chris Brown, assistant commissioner for the Chicago Department of Public Health. He said the effects on Chicago won’t be known until the spring when the funding is announced.
Attempts to get CDC officials to comment for this report were unsuccessful.
Many agencies believe that educating people before they are infected, through traditional outreach programs, is the best method to halt the spread of the disease. Victor Pond, director of the South Side Help Center’s MOCHA Coalition, says many groups will have to either adopt a strategy they don’t believe in or face losing their funding.
“They have to make some compromise between their personal politics and the federal perspective on public health. So it becomes a decision on where do we draw the line and how far do we want to compromise to stay afloat.”
David Munar, associate director for the AIDS Foundation of Chicago, says there is a need to expand testing and identify the HIV-positive population, but he has concerns that the CDC’s new methods could be disastrous.
“We fear that this strategy kind of abandons young people who are high risks for HIV and kind of puts an emphasis on just identifying those who are already living with the infection and then working with them,” Munar said. “We believe it’s writing off large populations that really should be given a chance to stay HIV-negative.”
One of the largest agencies serving the African-American community is the South Side Help Center, which last year had a budget of just more than $3.1 million. A little more than $1.5 million of their funding in 2003 came from the CDC.
“We may have to change the way we do HIV prevention,” said Betty Smith, executive director of the South Side Help Center. “Certainly, CDC thinks the most important thing here is testing and getting people into prevention case management.”
