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What's Your Game Plan? More Musings From Paul Kawata

By Paul A. Kawata

August 30, 2011

This article was provided by the National Minority AIDS Council; Paul Kawata is the organization's executive director.

The take home messages from the National HIV Prevention Conference (NHPC) were:

  1. Funding is Shrinking
  2. Prevention Is Changing

The question is "Are You Ready?"

The Federal Budget for 2012 has not been finalized. However, we do know that Congress and the Obama administration have agreed to more then $2 trillion in cuts to federal spending. As one federal official let me know, in terms of the 2012 reductions, "all cards are on the table, there are no sacred cows."

As you've probably read, Congress has created a 12 member deficit reduction committee, also known as a "Super Committee." This committee is responsible for identifying/negotiating federal budget cuts. If they can't reach an agreement, then there will be automatic tax increases and across the board budget cuts that neither party wants. It is not clear whether the members of the Super Committee will call for broad, general cuts or specific program-level cuts. Either way, the HIV community needs an advocacy strategy targeting members of the Super Committee and the Obama Administration.

NHPC clearly sent the message that U.S. prevention initiatives are changing. It's called "High Impact Prevention (HIP)." Priority will be given to:

  1. Prevention for Positives
  2. Linkages to Care
  3. HIV Testing

Your HIV prevention programs need to address one of these issues to be fundable. For some organizations, this may mean big changes.

I have also challenged you to add Treatment as Prevention (TasP) -- linking those who test positive for HIV to early treatment and bringing their viral load to undetectable -- as a critical component to your initiatives. It's a potential game changer, but we now need to find real-life applications for what was proven in a scientific study.


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Are You Ready? Do You Have a Game Plan?

If there was ever a time to talk with your colleagues and stakeholders, the time is now. We need to come together as a community and talk about how we are individually and collectively going to protect existing funding for programs we feel are vital to fighting HIV/AIDS. We also need to fight against any cuts that may be directed at our programs.

I mean fight back. How can we implement the National HIV/AIDS Strategy (NHAS) without more money? How can we balance potentially devastating cuts in a prevention and treatment landscape that is rapidly changing? How can we justify over 9,000 Americans languishing on ADAP waiting lists? How can we accept over 50,000 more Americans to become infected with HIV next year? I've also been hearing from the field. I've heard concerns over the late notice of grant awards for programs such as Ryan White from HRSA. I've heard your concerns about changing your prevention programs, even though you understand it's necessary.

Change is coming. We must be ready.

One place to talk, strategize, and get ready is this year's United States Conference on AIDS (USCA) in Chicago. I've always thought USCA was a great place to network and learn, but now I think it's essential. It's essential for our movement to come together to discuss the impacts of $2.5 trillion cuts in federal spending, the change to HIP, the over 9,000 people on ADAP waiting lists, and the role of the NHAS in an environment with this much uncertainty. Priorities and strategies need to be discussed. We may not agree on away to proceed, but we need to at least start the conversation. If nothing else, we can be learn what others are doing and how we can support each other.

This is our moment to hopefully end the AIDS epidemic. But given our economy, our politics, and the mood of the country, it's also an extremely difficult time. Remember, you don't get to choose your moment. The moment chooses you! I look forward to seeing all of you at USCA and planning how best to ensure this moment doesn't pass us by.

Yours in the struggle,

Paul Kawata
Executive Director

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