World AIDS Delay or Why We Really Need, and May Even Get, A National U.S. AIDS Strategy

Julie Davids

The change we need for the country as a whole is the change we need to fight HIV/AIDS. Let's insist that economic stimulation and health care reform become components of a comprehensive strategy to fight HIV/AIDS, rather than being complicit with this stable epidemic that will infect another person every nine minutes on this World AIDS Day.

On November 20, over 1000 low-income people of color living with HIV came to the 100 Days to Fight AIDS rally to stand up for the ambitious HIV/AIDS platform under which Obama campaigned for president, including his pledge for a National AIDS Strategy.
100 Days to Fight AIDS Rally100 Days to Fight AIDS Rally

For a change, we approached the nation’s capitol in the lead-up to World AIDS Day with a spirit of hope. In the coming months, we must continue to push forward with an expectation of more – not just more resources for existing HIV/AIDS efforts, but for a more strategic and more coordinated, comprehensive response that will actually bring down the rate of infection, tackle the epidemic in communities of color and in gay men, and bring dignity and medical care to the lives of all those who are infected.

And change is what we need. Since we last commemorated World AIDS Day, it’s been confirmed that HIV/AIDS is worse in the United States than we ever knew.

In August, CDC finally revealed the data showing that incidence of HIV has always been higher than the 40,000-new-infections-a-year figure trotted out for over a decade – and that the epidemic has stubbornly wedged itself into our society at the rate of 56,300 new cases a year.

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CDC calls that a stable epidemic.

I call it a travesty.

And think those that are infected are able to get the care they need? Those flaming radicals at the Institute of Medicine have noted that over half of those who should be on AIDS treatment can’t get it consistently.

On this World AIDS Day, let’s set down the slogans for a second and take a long sober look at where we are at, and where we need to go.

There’s three things we need to do to overcome HIV in our nation:

1) Fund what we know works, like syringe exchange and the provision of HIV/AIDS antiretrovirals and basic health care to all who need it;

2) Stop funding things that don’t work, or that cause harm, whether it’s Federally-funded stigma promotion, a.k.a. abstinence-only programs; and

3) Figure out what the hell we need to do in the cases where we just don’t know.

Even though we know a lot of what we need to do to fight HIV/AIDS, anyone who tells you we know exactly what we need to do to solve the epidemic in this nation – or around the world, for that matter – is either naive or lying. 

For example, there’s a big disconnect in the fragmented HIV/AIDS service sector between prevention programs and the provision of HIV care. Yet HIV treatment itself is increasingly recognized as a contributor to HIV prevention – when people know their status, are in care, and receiving effective treatment, they are less likely to pass on the virus. But as spread thin as people are who work in either prevention or care, with little time for strategizing or collaboration, there’s also additional obstacles to working together based on funding streams, red tape, and a lack of overarching, systematic and measurable priorities in the domestic AIDS sector.

Sound like a complex problem and, well, kind of geeky and bureaucratic? It is.

And that’s just one example of why we need a National AIDS Strategy (NAS). A true NAS wouldn’t be a re-branding of current HIV/AIDS efforts in the US. It wouldn’t even be a label for a new initiative to scale-up our overloaded efforts to combat the epidemic in a nation.

The NAS needs to be a fundamental re-think of how we fight HIV in this country – the plan that moves past the patchwork of current programs and that figures out a better way and assigns responsibility for doing it.

The US global AIDS response (through PEPFAR) is not without its problems but emphasizes target setting, coordination, and accountability for outcomes.  These key principles are lacking in our domestic effort. Like PEPFAR, an effective domestic NAS needs to be owned by the government with strong Presidential leadership and present an operational plan.

So what now? Action on the NAS early in the new Administration would cost little but demonstrate decisive action on health issues.  The Coalition for a National AIDS Strategy is urging our next President, within his first 100 days, to:

  • speak publicly about the need to more effectively address our biggest public health challenges, including AIDS at home;
  • appoint a National AIDS Strategy Panel to develop the Strategy; and
  • create a White House-level AIDS office and appoint staff to lead on the Strategy.


We need the President to urge the Panel to be creative and courageous, and to stay focused on improving outcomes rather than placating constituencies.  We don’t need a laundry list to appease everyone, but rather a plan of action to increase our effectiveness.  The Panel should identify measures that can be taken quickly, as well as more fundamental changes needed over time.  For example, improving coordination of government agencies can be mandated quickly and at no cost.

Even as we push forward towards the NAS, however, we do know much of what we need to embark upon to start to bring the epidemic under control. And it sounds a lot like what we need to do for this whole country to get back on its feet:

  • Provide health care for all
  • Ensure housing for those in need (which is what DC Fights Back and allies will be marching for in Washington DC on this World AIDS Day).
  • Confront the poverty that leads to a whole range of health challenges, including HIV, and that is getting worse by the day as our economy is in free-fall triggered by a generation of greed and inequity.
  • Invest in American ingenuity, as they say, by supporting a robust platform of uncensored research at and beyond the NIH, rather than turning away a new generation of researchers seeing funding fall way below the rate of biomedical inflation.
  • Make the inclusion of gays and lesbians in Obama’s victory speech a real thing by including LBGT people and our needs in public health and social programs, and by waging a mass public education effort to confront anti-gay and anti-trans bias so no one can be hoodwinked again by Prop 8 campaign style lies.

 

The change we need for the country is the change we need to fight HIV/AIDS. Let’s insist that economic stimulation and health care reform become components of a comprehensive strategy to fight HIV/AIDS, rather than being complicit with this "stable" epidemic that will infect another person every nine minutes on this World AIDS Day.

News Politics

Ohio Legislator: ‘Aggressive Attacks’ May Block Voters From the Polls

Ally Boguhn

Efforts to remove voters from state rolls and curb access to the polls could have an outsized impact in Ohio, which has seen a surge of anti-choice legislation under the state’s Republican leadership.

Ohio Rep. Kathleen Clyde (D-Kent) said she is worried about the impact of what she called “aggressive attacks” on voting rights in her state.

Ohio voters who have not engaged in voter activity in a fixed period of time, generally two years, are considered by the state to have moved, which then begins the process of removing them from their rolls through something called the “Supplemental Process.” If a voter fails to respond to a postcard mailed to them to confirm their address, they become “inactive voters.” If an inactive voter does not engage in voter activity for four years, they’re automatically unregistered to vote and must re-register to cast a ballot. 

Though other states routinely clean voting rolls, most don’t use failure to vote as a reason to remove someone.

“We have two million voters purged from the rolls in the last five years, many in the last four years since the last presidential election,” Clyde said during an interview with Rewire

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Ohio Secretary of State Jon Husted (R) dismissed concerns of the voter purges’ impact during an interview with Reuters. “If this is really important thing to you in your life, voting, you probably would have done so within a six-year period,” he said.

Ohio’s removal of voters through this process “is particularly problematic in the lead-up to the November 2016 federal election because voters who voted in the high-turnout 2008 federal election (but who did not vote in any subsequent elections) were removed from voter rolls in 2015,” according to an amicus curiae brief filed by the U.S. Department of Justice’s (DOJ) Civil Rights division in support of those who filed suit against Ohio’s law. 

The DOJ has urged the 6th U.S. Circuit Court of Appeals to reverse a lower court’s ruling in favor of the state, writing that Ohio’s voter purge violates the National Voter Registration Act of 1993 and the Help America Vote Act of 2002.

Since 2012, at least 144,000 voters have been removed from Ohio’s voter rolls in its three biggest counties, Reuters reported. The secretary of state’s office said 2 million registered voters had been taken off the rolls in the past five years, though many had been removed because they were deceased.

Husted contends that he is just enforcing the law. “Ohio manages its voter rolls in direct compliance of both federal and state laws, and is consistent with an agreement in this same federal court just four years ago,” Husted said in an April statement after the ACLU of Ohio and Demos, a voting rights organization, filed a lawsuit in the matter.

In predominantly Black neighborhoods near downtown Cincinnati, “more than 10 percent of registered voters have been removed due to inactivity since 2012,” reported Reuters. The outlet found that several places where more voters had cast ballots for President Obama in 2012 were the same locations experiencing higher percentages of purged voters.

“Some of the data is showing that African Americans voters and Democratic voters were much more likely affected,” Clyde said when discussing the state’s purge of registered voters. 

Clyde has requested data on those purged from the rolls, but has been turned down twice. “They’ve said no in two different ways and are referring me to the boards of elections, but there are 88 boards of election,” she told RewireWith limited staff resources to devote to data collection, Clyde is still searching for a way to get answers.

In the meantime, many otherwise eligible voters may have their votes thrown away and never know it.

“[P]eople that had been purged often don’t know that they’ve been purged, so they may show up to vote and find their name isn’t on the roll,” Clyde said. “Then, typically that voter is given a provisional ballot and … told that the board of elections will figure out the problem with their voter registration. And then they don’t really receive notice that that provisional ballot doesn’t eventually count.” 

Though the state’s voter purges could continue to disenfranchise voters across the state, it is hardly the only effort that may impact voting rights there.

“There have been a number of efforts undertaken by the GOP in Ohio to make voting more difficult,” Clyde said. “That includes fighting to shorten the number of early voting days available, that includes fighting to throw out people’s votes that have been cast—whether it be a provisional ballot or absentee ballot—and that includes purging more voters than any other state.” 

This could make a big difference for voters in the state, which has seen a surge of anti-choice legislation under the state’s Republican leadership—including failed Republican presidential candidate Gov. John Kasich.

“So aside from the terrible effect that has on the fundamental right to vote in Ohio, progressives who maybe are infrequent voters or are seeing what’s happening around [reproductive rights and health] issues and want to express that through their vote may experience problems in Ohio because of these aggressive attacks on voting rights,” Clyde said. 

“From our presidential candidates on down to our candidates for the state legislature, there is a lot at stake when it comes to reproductive health care and reproductive rights in this election,” Clyde added. “So I think that, if that is an issue that is important to any Ohioan, they need to have their voice heard in this election.” 

News Human Rights

Mothers in Family Detention Launch Hunger Strike: ‘We Will Get Out Alive or Dead’

Tina Vasquez

The hunger strikers at the Berks County Residential Center in Pennsylvania are responding to recent comments made by Department of Homeland Security Secretary Jeh Johnson in which he said the average length of stay in family detention is 20 days. The women say they've been in detention with their children between 270 and 365 days.

On Monday, 22 mothers detained inside Pennsylvania’s Berks County Residential Center, one of the two remaining family detention centers in the country, launched a hunger strike in response to recent comments made by Department of Homeland Security (DHS) secretary Jeh Johnson in which he said the average length of stay in family detention is 20 days.

The average length of stay for the 22 hunger strikers has been between 270 and 365 days, they say.

Erika Almiron, director of the immigrant rights organization Juntos and a core member of the Shut Down Berks Coalition, informed the women detained inside Berks of Johnson’s recent comment via email, hoping they would want to release a statement that her organization could help amplify. Instead, the women decided to launch a hunger strike, with recent reports indicating the number of participants has risen to 26.

“When Johnson said [ICE] only detain[s] people for 20 days, he said that thinking that no one would care,” Almiron told Rewire. “Our goal has always been to make people aware of the inhumane nature of detention in general, but also that children are being locked up and moms are being held indefinitely.”

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By definition, “family detention” means the women in Berks are detained alongside their children, who range in age from 2 to 16 years old. In an open letter addressed to Johnson, the women share that their children have routinely expressed suicidal thoughts as a direct result of being imprisoned. The women allege that they are being threatened by psychologists and doctors in the detention center for making this information public, but are choosing to move forward with the hunger strike.

In part, the letter reads:

The teenagers say being here, life makes no sense, that they would like to break the window to jump out and end this nightmare, and on many occasions they ask us if we have the courage to escape. Other kids grab their IDs and tighten them around their necks and say that they are going to kill themselves if they don’t get out of here. The youngest kids (2 years old) cry at night for not being able to express what they feel … We are desperate and we have decided that: we will get out alive or dead. If it is necessary to sacrifice our lives so that our children can have freedom: We will do it!

An August 2015 report about the Berks center by Human Rights First, a human rights advocacy organization, seemed to confirm what women and children detained inside of the facility have been saying since the detention center’s inception in 2001: Detention is no place for families and being imprisoned is detrimental to the health and well-being of children.

According to the Human Rights First report, detained parents in Berks experience depression, which only exacerbates the trauma they experienced in their countries of origin, and their children exhibit symptoms of depression, anxiety, and increased aggression. Frequent room checks that take place at 15-minute intervals each night also result in children experiencing insomnia, fear, and anxiety, the report says.

Families detained inside of Berks have no real means to alleviate these symptoms because the facility does not provide adequate mental health care, according to the report. Human Rights First notes that Berks does not have Spanish-speaking mental health providers, “though the majority of families sent to family detention in the United States are Spanish-speaking and many have suffered high rates of trauma, physical and sexual violence, and exploitation.”

The organization also explains that only 23 of the total staff at Berks (or less than 40 percent) reportedly speak some conversational Spanish, “making it difficult for many staff members to effectively communicate with children and their parents.”

Berks has a history of human rights abuses. A 41-year-old former counselor at Berks was recently sentenced to between six and 23 months of jail time for the repeated sexual assault of a 19-year-old asylum-seeking mother. The young woman, along with her 3-year-old son, fled sexual domestic violence in her native Honduras. The assaults on the young mother at the detention center were witnessed by at least one of the children detained with her.

There have also been health-care issues at Berks, including the failure by the detention center to provide adequate services, according to Human Rights First.

The organization was able to collect some of the letters women detained at Berks wrote to Immigration and Customs Enforcement (ICE), along with ICE’s response to their concerns. One woman, detained at Berks for four months, told ICE that her 5-year-old daughter had diarrhea for three weeks and that the detention center’s doctor failed to provide her child with any medication or other care. The woman asked for “adequate medication” for her daughter and for the opportunity to have her asylum case handled outside of detention. ICE’s response: “Thank you! You may disolve [sic] your case at any time and return to your country. Please use the medical department [at Berks] in reference to health related issues.”

Using family detention as a way to handle migrants, especially those fleeing violence in Central America, has been called inhumane by many, including activists, advocates, mental health specialists, and religious leaders. But the prolonged detainment of women and children at Berks is in violation of ICE’s own standards.

In June of 2015, Johnson announced a series of reforms, including measures aimed at reducing the length of family detention stays for families who had passed a protection screening. But then earlier this month, Johnson defended family detention, saying, “The department has added flexibility consistent with the terms of the [Flores] settlement agreement in times of influx. And we’ve been, by the standard of 1997, at an influx for some time now. And so what we’ve been doing is ensuring the average length of stay at these facilities is 20 days or less. And we’re meeting that standard.”

But all of the 22 mothers on hunger strike at Berks have been in detention for months, according to the letter they sent Johnson.

There’s also the issue that in July, a federal appeals court ordered DHS to end family detention because it violates Flores v. Johnson, which determined that children arriving to the United States with their mothers should not be held in unlicensed detention centers. Soon after, family detention centers scrambled to get licensed as child-care facilities (a battle they’re losing in Texas), but the Pennsylvania Department of Human Services (PA DHS) licensed Berks to operate as a children’s delinquency center. In October 2015, PA DHS decided not to renew the license, which would have expired February 21, 2016, because the facility holds asylum-seeking families as opposed to only children, as the license permitted. Berks appealed the decision to not renew its license, and continues to operate until it receives a ruling on that appeal.

“Our argument from the start has been that we don’t think any of this is legal,” Almiron told Rewire in a phone interview Friday afternoon. “What is happening inside of Berks is illegal. I have no idea how they continue to operate. Right now, Berks does not have a license. It was revoked because the license they did have didn’t fit what they were doing. They also have prolonged detention. Women who are hunger striking have been there 360-something days, but then Jeh Johnson says it’s only 20 days. There is no accountability with DHS or ICE. There are numerous ways [DHS and ICE are] not accountable, but Berks is a prime example. There is no transparency and they can to change the law whenever they like.”

Neither DHS nor Berks responded to requests for comment from Rewire.

Advocates have expressed concerns that the women in Berks will be retaliated against by ICE and detention center employees because of their participation in the hunger strike. As Rewire reported, when women at Texas’ T. Don Hutto Residential Center, a former family detention center, launched a hunger strike in November 2015, participants alleged that ICE used solitary confinement and transferred hunger strikers to different facilities, moving them further from their family in the area and their legal counsel. ICE denied a hunger strike was even taking place.

In December 2015, men detained at the Etowah County Detention Center in Gadsden, Alabama, ended a 14-day hunger strike after a local judge authorized officials to force-feed one of the hunger strikers because of his “deteriorating health” due to dehydration. Advocates told Rewire force-feeding was being used as a form of retaliation.

Almiron said the hunger strikers at Berks have already been threatened by guards, who told the women that if they continue to hunger strike and they get too weak, their children will be taken away from them. The organizer said the letter the women wrote to Johnson shows their bravery, and their understanding that they are willing to take whatever risk necessary to help their children.

“Honestly, I think they’ve been retaliated against the moment they came to this country. The fact that they’re in detention is retaliation against their human survival,” Almiron said. “Retaliation happens in detention centers all the time, women are threatened with deportation for asking for medical care for their children. These women are incredibly strong. In my eyes, they’re heroes and they’re committed to this fight to end family detention, and so are we.”

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