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Introduction: We Demand Accountability

December 2007

It was a watershed moment for presidential politics and the AIDS epidemic. PBS news anchor Gwen Ifill was moderating an October 5, 2004, debate between vice presidential candidates Dick Cheney and John Edwards when she asked both men what should have been an easy question. "I want to talk to you about AIDS," she began, first directing her query to Vice President Cheney. "And not about AIDS in China or Africa, but AIDS right here in this country, where Black women between the ages of 25 and 44 are 13 times more likely to die of the disease than their counterparts. What should the government's role be in helping to end the growth of this epidemic?"

Cheney's response gained instant infamy in the AIDS and public health worlds. He first spoke at length about the "great tragedy" of the global epidemic that Ifill had just said she was not asking about. Then, stunningly, he casually acknowledged he had no idea the domestic epidemic still existed -- let alone that it had anything to do with Black women.

"I had not heard those numbers with respect to African American women. I was not aware that it was that severe an epidemic there because we have made progress in terms of the overall rate of AIDS infection, and I think primarily through a combination of education and public awareness as well as the development as a result of research of drugs that allow people to live longer lives even though they are infected. Obviously, we need to do more of that."

Even the part of the answer Cheney professed to know -- that we had "made progress in terms of the overall rate of AIDS infection" -- was dead wrong. In fact, his own administration's Centers for Disease Control and Prevention (CDC) had been widely reporting the opposite since his first day in office -- and had churned out reams of data to make the point, including the statistic that Ifill cited in her question. Yet, Cheney seemed untroubled that he "had not heard" about it.

John Edwards did not do much better when Ifill next put the question to him. (Edwards was the first candidate in the current presidential race to release an AIDS platform.) Like Cheney, he ignored Ifill's framing and spoke about AIDS overseas rather than at home. When he turned finally to the U.S., rather than address Ifill's question about Black women and AIDS, he fumbled through remarks about the general need for Americans to have greater access to health care. "If kids and adults don't have access to preventative care," he said, "if they're not getting the health care that they need day after day after day, the possibility of not only developing AIDS and having a problem -- having a problem, a life-threatening problem, but the problem of developing other lifethreatening diseases, is there every day of their lives."

Ifill, perhaps seeing the futility, declared simply, "Ok, we'll move on."

But Black America did not move on. That 2004 exchange made it painfully clear that our elected officials are not paying attention. And it demonstrated that if we want political leaders to make ending AIDS in Black America a priority, we must insist upon that commitment before offering our support and our votes. It is with that fact in mind that the Black AIDS Institute has produced this campaign brief -- We Demand Accountability: The 2008 Presidential Elections and the Black AIDS Epidemic. The brief is the first in a series of publications that will help Black America hold elected officials at all levels of government accountable for ending the Black AIDS epidemic.

In publishing We Demand Accountability, we aim to meet three goals:

  • Help voters identify and understand the key questions that they should expect any candidate for elected office to answer;
  • Put campaigns and candidates on notice that Black America will expect them to not only be aware of the problem but have a plan for dealing with it; and
  • Educate voters on what the current presidential candidates have (and have not) contributed to the fight against AIDS in Black America.

What We Must Ask

In August 2006, a group of leading voices and organizers in the African American community came together to launch the Black AIDS Mobilization, led by Balm in Gilead, the National Black Leadership Commission on AIDS, and the Black AIDS Institute. The coalition has since set out to draft an overarching plan for coordinated action, dubbed the National Black AIDS Mobilization Plan. As the first step in that process, 16 of the coalition members are now drafting their own plans for folding AIDS into their organizational work. Each of their plans will work toward four common goals, and We Demand Accountability evaluates the candidates with those goals in mind.

The four goals of the National Black AIDS Mobilization Plan are:

  • Reduce infection rates. The plan seeks to slash HIV infection rates in our community by half over the next five years.
  • Get Blacks tested. The plan seeks to boost the number of Blacks who know their HIV status by 50 percent in the next five years.
  • Support appropriate care. The plan seeks to insure that African Americans who do test positive have access to appropriate care and are personally able to take the necessary steps to live healthily with HIV.
  • Eradicate stigma. The plan seeks to finally wipe out all of the needless, deadly stigmas associated with HIV/AIDS that have for too long blocked Black communities from saving themselves from this epidemic.

The Mobilization is rightly focused on spurring the community to act to save itself. For too long, we have waited for government entities, private funders and community allies to save us from this epidemic; today, we know that regardless of whether they act, we must -- both as individuals and as a community.

But that reality does not mean we can or will ignore the fact that AIDS is as much a political challenge as it is a medical and social one. The history of this epidemic is littered with political failures that, rather than helping solve the problem, have made it worse. Those shortcomings have cut across party lines.

By the time President Ronald Reagan uttered the word AIDS in 1986 (he didn't give a speech about it until 1987) the reported epidemic was five years old and more than 16,000 Americans were known to have been killed in it. President George H.W. Bush sat and watched as the U.S.'s annual death toll from AIDS grew by more than six fold. By the end of 1992, the year he left office, 190,687 Americans were dead from AIDS, according to the CDC, nearly a third of them Black.

President Bill Clinton did far more than his predecessors, but his own record remains tarnished by political failures as well. In a baldly political decision, he ignored the advice of his own secretary of Health and Human Services and refused to use his congressionally granted power to lift the ban on federal funding for needle exchange -- this, despite overwhelming scientific consensus both inside and out of government that such programs are remarkably successful in reducing infection rates, are among the least costly tools available, and do nothing to encourage drug use.

President George W. Bush has slashed domestic spending on a range of AIDS services, creating devastating holes in our safety net that have resulted in Americans dying while awaiting access to AIDS drugs. Here and abroad, he has promulgated ideologically rigid ideas about prevention and presided over a resurgence in new HIV infections.

So, just as we must take personal responsibility for ending AIDS, we must demand our elected officials and policymakers take responsibility as well. With that in mind, the first section of this campaign brief educates Black voters on what issues they must expect 2008 presidential candidates to address, and explains how those issues relate to each of the Black AIDS Mobilization's four goals.

Putting Candidates on Notice: Our Methodology

We Demand Accountability has an advocacy purpose as well: Informing every candidate that Vice President Cheney's shoulder-shrugging I dunno reply to questions about the epidemic is no longer acceptable. Elected officials are notoriously reactive -- if no one's asking, they're rarely telling. Gwen Ifill began a new tradition of our community asking about AIDS, and we will continue to do so until the epidemic is over.

The Black AIDS Institute sent written surveys to each of the 16 candidates with declared campaigns as of October 2007. For some campaigns, AIDS- or health-policy advisors had already publicly engaged the broader AIDS community; we sent surveys directly to those specialists. For others, we contacted the campaign press office and directed the survey to the staffers each identified. The 15-question survey focused on the four goals of the Black AIDS Mobilization and a fifth goal of the broader AIDS community: developing a national AIDS strategy for the U.S. A copy of the survey appears at the end of this brief.

Other AIDS organizations and media outlets have already published surveys of the campaigns. In particular, -- a voter-education initiative led by the advocacy coalition Campaign to End AIDS -- and Gay Men's Health Crisis (GMHC) have published an impressively exhaustive review of the candidates drawn from its own survey, the candidates' public statements, and congressional voting records dating back to the epidemic's start. Such existing surveys and reviews are crucial resources for voters, and we draw heavily on them in this brief, particularly that of

However, previously published candidate reviews neither explain how the issues are relevant to African Americans in particular nor ask the candidates to speak specifically to the Black epidemic. We Demand Accountability seeks to fill both gaps. African Americans account for more than half of the U.S. epidemic today, though only 13 percent of the overall population. It is crucially important that candidates know that our community in particular is watching, and that we want to know how they are going to stop the carnage.

Where the Candidates Stand

The second section of this brief reviews both the Democratic and Republican crop of 2008 presidential candidates, examining their records through the lens of the Black AIDS Mobilization's four goals and the broader community's call for a national AIDS strategy. We draw on our survey and interviews, on public information such as the campaigns' platforms and on previous studies. We focus special attention on the top contenders in each party and, given the reality of party-driven policymaking in Washington, D.C., also review the broader records and perspectives of each party on AIDS.

It is crucially important that Black voters make this the first, rather than the last set of questions they ask the campaigns about AIDS. Within weeks after this brief's publication, the newly compressed party primaries will have swung into high gear and, in all likelihood, will have severely narrowed the field. As scrutiny heightens on those still standing and, ultimately, on each party's nominee, so must our questions become more pointed.

Throughout the year, the Black AIDS Institute will continue to report on the campaign and ask the important questions. Follow the news by subscribing to the Weekly AIDS Update at, or watch for reports from our Black Press partners -- the NNPA News Service and your local Black newspapers, AOL Black Voices (blackvoices. com/blogs/category/aids-25-years-and-copunting) and American Urban Radio Networks, among others.

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This article was provided by The Black AIDS Institute. It is a part of the publication We Demand Accountability. Visit Black AIDS Institute's website to find out more about their activities and publications.