Commentary Sexual Health

World AIDS Day 2012: AIDS Funding Remains as Critical—and as Endangered—as Ever

Alison Yager

December 1st is World AIDS Day, a time to recognize those who live with HIV, to honor those who’ve died, and to come together in the fight against HIV/AIDS. In recent years HIV science and medicine have taken monumental leaps forward, but Hillary Clinton’s now oft-repeated goal of an AIDS-free generation will remain unattainable without on-going fiscal support for critical HIV/AIDS programs.

December 1st is World AIDS Day, a time to recognize those who live with HIV, to honor those who’ve died, and to come together in the fight against HIV/AIDS. This year’s theme is “Getting to Zero: Zero New HIV Infections. Zero Discrimination and Zero AIDS Related Deaths.”

This past Tuesday, as a prelude to this internationally-recognized day, seven naked AIDS activists emblazoned with such logos as “AIDS Cuts Kill” stood their ground in the Capital office of Speaker John Boehner, chanting: “End AIDS with the Robin Hood tax, no more budget cuts on our back.” And: “Budget cuts are really rude, that’s why we have to be so lewd.”

Their action and the response it generated highlighted a few essential truths in the fight against AIDS. First, services for people living with and at-risk of HIV/AIDS remain critical to individual health, and to the control of the disease. Second, AIDS programming is as vulnerable now as it ever was to the prospect of funding losses. And third, deep-seated homophobia, sexism, and ignorance, as revealed in much of the online reaction to the activism, perpetuate HIV stigma and continue to hamper this fight.

Funding for people living with HIVand AIDS remains critical. The HIV epidemic doesn’t generate much mainstream media attention these days (except when nudity is involved), and it’s not uncommon for even well-read Americans to think that HIV is a problem principally affecting those in the Southern Hemisphere. When people stopped dying in droves from HIV, our national attention was diverted from the on-going challenges of the disease. But while the nation’s eye is trained elsewhere, HIV in this country shows no sign of relenting. The HIV infection rate for heterosexual African American women in Washington D.C.’s poorest neighborhoods nearly doubled between 2008 and 2010, from an already alarming 6.3 percent to an unfathomable 12.1 percent. And just this week the CDC announced that in 2010 there were 47,500 new HIV infections, of which 12,200 (25.7 percent) were among young people. Perhaps more startling, nearly 60 percent of these HIV-positive youth are unaware of their status. Our most vulnerable communities remain in HIV’s stranglehold, and prevention programming and support services, as well as specialized medical care and treatment programs remain essential to our ability to out-maneuver the epidemic.

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AIDS programming is vulnerable. The so-called fiscal cliff is looming large for constituents of every stripe as all non-discretionary funding is on the chopping block. And people living with HIV and their advocates are looking nervously at the spectrum of services and programming that could be lost at the bargaining table. Medication. Housing. Food. Case management. Prevention. These and more hang in the balance, and as a result so do the lives of so many individuals and families affected by HIV.

Stigma still stands in the way. HIV stigma has always been intimately connected with other forms of discrimination: homophobia, transphobia, misogyny, and racism.  And each of these, whether they manifest as vitriol or apathy, remain as stumbling blocks on the road to Zero. Online comments to the various articles reporting on the nude demonstration in Boehner’s office demonstrated a toxic dose of fraternity-style appraisals of the naked female body alongside plenty of hateful anti-gay rhetoric.

But the right’s ongoing zeal to demonize AIDS activists shouldn’t bury the larger point: ACT-UP style activism is still required to get mainstream media to pay attention to the on-going fight against HIV in this country. As Jennifer Flynn, one of those arrested noted, the “naked truth” is that budget cuts are devastating to people living with HIV/AIDS. In recent years HIV science and medicine have taken monumental leaps forward, but Hillary Clinton’s now oft-repeated goal of an AIDS-free generation will remain unattainable without on-going fiscal support for critical HIV/AIDS programs. Now is not the time to abandon the struggle.

Commentary Contraception

Zika Threat Shows Urgent Need for Better Contraceptive Access

Julie Rabinovitz

As summer approaches and global officials continue to issue warnings about Zika, U.S. federal and state officials can allocate funds and expand insurance coverage to ensure contraceptive access.

Pressure is mounting on Congress to send President Obama a sufficient spending bill to combat the Zika virus’ spread.

The House and Senate recently passed their own measures, both proposing less than the $1.9 billion the president requested. But now they must work out their differences for the sake of our public health. Currently, none of these proposals include funding for Title X, the federal program that provides low-income people with family planning services, birth control, and other preventive reproductive health services. With the potentially life-changing outcomes that can result from contracting Zika, federal and state action is urgently needed to support prevention efforts and increase access to the full range of contraception available nationwide.

There’s no time to waste. More than 600 people in the continental United States, including at least 150 pregnant women, have already been infected with Zika. This month, a New Jersey infant exposed to Zika was born with the birth defect microcephaly, where a baby’s head is smaller than expected. Many more Americans have been affected in Puerto Rico and other U.S. territories. Local transmission is expected to spike as warmer weather approaches and climate conditions become more favorable to the virus’s primary vector, the Aedes aegypti mosquito.

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The Centers for Disease Control and Prevention (CDC) have reported significant evidence showing links between Zika and adverse pregnancy and birth outcomes, including miscarriage, stillbirth, and fetal abnormalities. Brain damage in Zika-infected babies is proving to be far worse than doctors initially thought. Zika has been found to attack lobes of the fetal brain that control thought, vision, and movement. Exposure to Zika was first considered to be a threat for women in the first trimester only, but there is growing concern about the possibility of maternal-fetal transmission throughout pregnancy.

It has also been discovered that men infected with Zika can transmit the virus to their sexual partners through semen, where the virus is stored much longer than in the blood.

As more individuals learn about the potential health risks linked to the virus, many will want and need services and information to help them effectively avoid or postpone pregnancy. Extensive research already shows the public health value and taxpayer savings associated with preventing unintended pregnancy.

Now with Zika, the stakes are even higher.

Congressional leaders must act without delay to pass a comprehensive Zika funding and preparedness package that includes additional resources for Title X to expand access to reliable birth control, related services, and counseling to low-income and uninsured people. Increased funding for these essential services is needed on the ground now, especially in regions expected to be disproportionately affected by the virus. The threat is particularly worrisome in areas that experience the warmer weather that’s conducive to Zika-carrying mosquitoes.

On the state level, elected leaders across the country should require public and commercial health plans to cover all—not just some—FDA-approved birth control. After the passage of the Affordable Care Act (ACA), California was one of the first states to approve a contraceptive-coverage equity law that codified the spirit of the ACA’s contraceptive mandate, also known as the birth control benefit, by requiring health plans to cover all methods of contraception without cost sharing or restrictions. Maryland recently enacted a similar measure that also requires coverage for vasectomies, and several other states are considering legislation with the same intent. The Zika threat makes passage of these kinds of laws across the country time-sensitive. State Medicaid programs must also adopt reimbursement and coverage policies that break down barriers enrollees may face in accessing the full range of effective contraceptive methods.

Patients must be able to get the method they can use safely and consistently. That means health-care professionals across the country, including those in primary-care settings, must offer all forms of available birth control. Providers need training to support their patients in accessing the contraceptive method that is best suited for their health and reproductive life goals. Even some OB-GYNs can use training on newer methods and updated best practices.

Many unknowns remain regarding the Zika virus, which has quickly become one of the world’s greatest public health challenges. But a concerted and proactive response—that includes improved access to contraception—must be implemented before Zika becomes a national public health crisis here in the United States.

News Abortion

The Forgotten History of Republicans’ (Failed) Attacks on Fetal Tissue Research

Christine Grimaldi

Today's congressional inquiry not only derides fetal tissue research, but attacks abortion care. The inaugural hearing in March 2016 gave Republicans a platform to compare fetal tissue research to Nazi experimentation. Republicans derided Democrats for exaggerating the importance of fetal tissue.

Republicans in Congress sixteen years ago were more vested in supporting life-saving fetal tissue research than they were in mischaracterizing such research to score political points.

The times, and the talking points, have changed.

In 2000, GOP lawmakers in the U.S. House of Representatives conducted an investigation into fetal tissue practices based on a deceptive Life Dynamics video featuring a disgruntled former tissue procurement company employee. Dean Alberty alleged that two of his employers, Anatomic Gift Foundation (AGF) and Opening Lines, which acquired and distributed human fetal tissue to researchers, trafficked fetuses for profit. He also claimed that abortion providers altered procedures to obtain better tissue specimens. 

Life Dynamics, which remains a prominent anti-choice group, paid Alberty thousands of dollars during and after the time he worked in the tissue procurement business. Republicans summoned Alberty to be their key witness, but he later admitted under oath that he had lied about business operations in the Life Dynamics video and in an interview with the then-prominent ABC television news program 20/20.

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Alberty’s reveal came as a surprise, and an embarrassment, to Republicans during a hearing on the allegations before the House Energy and Commerce Committee Subcommittee on Health and Environment.

“Your credibility, as far as this member is concerned, is shot,” said then-Rep. Richard Burr (R-NC), who now serves in the U.S. Senate.

Sixteen years later, credibility doesn’t seem to carry the same weight for anti-choice Republican lawmakers as a new set of videos alleging problems with fetal tissue donations have simultaneously been discredited but are still being used as the basis of hearings some have called a witch hunt.

In July 2015, Rep. Trent Franks (R-AZ), sponsor of the so-called Prenatal Nondiscrimination Act of 2016, and some of his colleagues coordinated with the Center for Medical Progress (CMP), the anti-choice front group responsible for the widely discredited smear campaign alleging that Planned Parenthood profited from fetal tissue donations.

The House Energy and Commerce, Judiciary, and Oversight and Government Reform committees launched investigations upon the release of the first surreptitiously recorded videos and have continued to attack fetal tissue research, even though GOP officials in 12 states have since cleared Planned Parenthood of wrongdoing.

The first set of House hearings also failed to turn up any evidence that laws governing fetal tissue donation or research had been broken.

House Republicans nonetheless voted in October to form the Select Investigative Panel on Infant Lives, an Energy and Commerce panel relying on the CMP videos and other allegedly falsified evidence to prove their charges of “baby body parts” for sale.

Rep. Marsha Blackburn (R-TN), the panel’s chair, and other congressional committees have subpoenaed more than 2,000 pages of documents from tissue procurement company StemExpress. However, Blackburn has not brought in David Daleiden, the founder of CMP, to testify, although he now faces felony charges for his role in the original smear campaign.

Daleiden Testimony Could Undermine Republicans

Precedent doesn’t bode well for Republicans and their supposed whistleblowers.

Alberty, for example, expanded on his allegations of fetal tissue misconduct in the 20/20 interview with then-correspondent Chris Wallace, who now anchors Fox News Sunday. 20/20 separately targeted Opening Lines founder Dr. Miles Jones in an ostensibly damning undercover video included in the segment.

Alberty was unequivocal about wrongdoing. “This is purely for profit. Everything was about money,” he told Wallace. 

Wallace, for his part, narrated that Alberty had accepted thousands of dollars to act as an informant for Life Dynamics while continuing to work in the tissue procurement business. Why believe Alberty, then?

“I will stand behind my words until I die,” Alberty said. “I will go in front of Congress if I have to and testify under oath.”

Alberty appeared before the subcommittee the morning after the 20/20 segment aired. By that time, he had changed his story in an affidavit and a deposition that Democrats referenced to undermine his claims.

“When I was under oath I told the truth,” Alberty admitted during the hearing. “Anything I said on the video when I’m not under oath, that is a different story.”

Alberty’s name resurfaced at the select panel’s April 2016 hearing on fetal tissue “pricing,” which featured GOP exhibits reportedly taken from the CMP videos. Fay Clayton, a senior partner and founding shareholder of Robinson Curley & Clayton, P.C. and a witness for the Democrats, recalled her experience representing AGF. Alberty admitted to fabricating claims about AGF in the deposition with Clayton. 

Republicans did not know about the deposition until Democrats raised it during the 2000 hearing.

“Fetal tissue wasn’t ‘for sale’ at all,” Clayton said at the 2016 “pricing” hearing. “What was for sale was phony witness testimony, bought and paid for by opponents of abortion.”

An FBI investigation cleared Opening Lines and Jones of the trafficking charges. The U.S. Department of Justice (DOJ) also found no violations of federal statutes and closed an investigation in 2008, Robert Raben, a former DOJ official, said when he testified for the Democrats at the panel’s 2016 “pricing” hearing. 

Clayton called for members of the panel to get Daleiden under oath to tell the truth or face legal repercussions for perpetuating his claims. However, Republicans misrepresented Clayton’s testimony by saying she called for StemExpress to turn over accounting records. Blackburn soon subpoenaed those records and threatened “to pursue all means necessary” as the investigation proceeds.

Rep. Diana DeGette (D-CO), co-chair of the House Pro-Choice Caucus, has no doubts about why Republicans continue to rely on third-party witnesses rather than Daleiden.

“I don’t think they want to bring David Daleiden in because they know that he’s a shady character and an unreliable witness,” DeGette said in an interview with Rewire.

Anti-Choice Tactics Influence Current Inquiry

As the only lawmaker to serve on the past and present investigations, DeGette sometimes feels like she’s “in a real-life version of Groundhog Day.”

“We keep having these same kinds of hearings, over and over again,” DeGette said. “In my opinion, there’s continuing pressure on the Republican Party from the far-right anti-choice movement to have these hearings, even though the claim of sale of fetal tissue has been repeatedly disproved.”

Anti-choice tactics, if not the key players, behind what congressional Democrats have branded a “witch hunt” to undermine fetal tissue research are similar today.

Life Dynamics, the anti-choice group behind the Alberty video, receives the majority of its funding from fracking billionaires Dan and Farris Wilks—the main backers of Sen. Ted Cruz’s (R-TX) suspended presidential campaign. Providers told Rewire in March that a Life Dynamics document has been used to deceive and intimidate both patients and providers by threatening legal action should they go through with obtaining or providing abortion care.

Perhaps the biggest difference between the past and present inquiries is Republicans’ attitudes toward fetal tissue research—and their ability to separate research from abortion.

The shift can be summed up in one word: politics.

“I think the difference is a structural one with a political origin,” Raben, the former DOJ official, told Rewire in an interview.

Republicans in 2000 investigated fetal tissue practices as part of a standing subcommittee. House Republicans today created the select panel, sought members to serve on it, and despite the lack of any evidence, continue to fund it through tax dollars that otherwise would not be diverted to sustained attacks on fetal tissue research.

“In the face of lousy evidence, they’re going to keep going,” Raben said.

Inquiries Diverge on Science

The current inquiry not only derides fetal tissue research, but also attacks abortion care. The inaugural hearing in March 2016 gave Republicans a platform to compare fetal tissue research to Nazi experimentation. Blackburn subsequently derided Democrats for exaggerating the importance of fetal tissue.

Democrats have warned that such rhetoric could slow scientific advances on dangerous diseases, including the Zika virus, which is linked to irreparable defects in the developing fetuses that Blackburn and her Republican counterparts have pledged to protect.

In 2000, even anti-choice Republicans repeatedly deferred to science on fetal tissue research.

“Today’s hearing is not about whether fetal tissue research is a good or bad thing, and it is definitely not about whether a woman should have a right to choose to have an abortion, which is the law of the land,” former Energy and Commerce Chair Tom Bliley (R-VA) said in 2000. “Whether we are pro life, pro choice, Republican, Democrat, or Independent, I think and hope that we can all agree that present federal law which allows for this research should be both respected and enforced.”

At that time, leading Republicans on the subcommittee also extolled, in the words of Rep. Fred Upton (R-MI), the “life-saving research” that their investigation aimed to protect.

Upton had worked in 1992 with former Rep. Henry Waxman (D-CA) to lift the ban on fetal tissue research. And he further expressed disappointment when President George H.W. Bush vetoed their effort.

“It’s really tragic,” Upton said then. “We tried to lift the substance over politics.”

President Bill Clinton signed legislation legalizing fetal tissue donations in 1993. “Being for fetal tissue transplantation is consistent with being for life,” Upton reportedly said during that era.

Republican Fetal Tissue Allies Disappear

Upton’s approach today does not reflect what happened the last time an anti-choice group manipulated evidence and fed it to congressional Republicans. The contents of CMP’s heavily edited smear videos “can’t help but make you weep for the innocents who were sacrificed in such a cavalier manner for alleged profit,” Upton wrote in a op-ed published in the weeks after the release of the first CMP recording.

Although Upton does not serve on the panel, he effectively sanctions the investigation as chair of the full House Energy and Commerce Committee. Under House rules, standing subcommittees draw funding from the budget of the full committee with jurisdiction. The full committee chair is in charge of managing additional funds from the House Administration Committee, which sets aside $500,000 per session of Congress to supplement operating budgets, according to a senior House Democratic aide with knowledge of the chamber’s rules.

The aide said the panel follows the same procedures, receiving an undisclosed amount from Energy and Commerce and an additional $300,000 from Administration.

Administration Democrats unsuccessfully protested the transfer at the end of last year. “Spending taxpayer money on this select panel is wasteful on substantive grounds and unnecessary on practical grounds,” they said.

The transfer followed the House’s informal two-thirds/one-third funding split between the majority and minority parties, with the Republicans receiving $200,000 and the Democrats $100,000, the aide said. Full committee leaders are charged with distributing the funds, meaning that Upton had to do so with the $200,000 for Blackburn, the aide said.

Rewire contacted Upton’s office with questions ranging from whether the chair approves of the panel’s approach to how much more financial resources he will direct from the full committee’s budget to the panel. Rewire asked for Upton’s views on fetal tissue research, including if he shares Blackburn’s derision for the research and if he considers fetal tissue and “baby body parts” to be separate.

In response, a committee spokesperson emailed a brief statement. “The efforts of the Select Panel have always been based on learning the facts,” the spokesperson said. “The panel has been given a one-year term to conduct that mission, and will continue their important work. Chairman Upton has been a supporter of the panel’s charge and their efforts to protect the unborn.”

Republican Leaders Disregard Appeals to Disband Panel

Although Upton’s office told Rewire that the panel was given one year, the resolution that created the panel suggested it could go longer. The resolution only specifies that the panel will come to an end 30 days after filing a final report.

Democrats have repeatedly called on House Speaker Paul Ryan (R-WI) to disband the panel, including in a letter to Ryan and Blackburn last month. The panel’s Democrats again appealed to Ryan after Blackburn subpoenaed a prominent abortion provider, shifting the target from fetal tissue procurement and research to later abortion care.

DeGette said some congressional Republicans have privately shared concerns about the panel with her, but won’t do so publicly, even as their counterparts on the panel have gone “rogue.”

“This is so out on the fringes that really, I think it’s beginning to reflect on Speaker Ryan and on the whole Republican leadership in the House,” she said.