At the start of last week, the Presidential Advisory Council on HIV/AIDS (PACHA) comprised its full roster of 21 members, and no one outside the HIV advocacy community was paying them any mind. By the end of the week, PACHA's numbers had dwindled to 15, and the abrupt resignation of six members arguably generated more media interest in the Council than had been seen since that body's creation back in 1995.
First, Newsweek published an opinion piece by recently departed PACHA member Scott Schoettes, in which the HIV project director/senior attorney for Lambda Legal stated flatly that he and the other five exiting council members "do not believe the Trump Administration is listening to -- or cares -- about the communities we serve." Soon after, a slew of prominent media outlets covered the story.
In a matter of days, the Trump administration's non-response to the HIV epidemic went from being largely ignored by the mainstream media to getting coverage in everything from Time and NBC News to The Boston Globe and The Washington Post. The story even made it to late night TV, with the host of CBS's The Late Late Show with James Corden devoting nearly six minutes of his broadcast to the Trump administration's failure to act on HIV and the resignation of the six PACHA members:
Where Do We Go From Here?
All of the attention being paid to this PACHA story is wonderful -- particularly at a time when a vote on the Senate's vile version of the American Health Care Act (AHCA) appears to be on the horizon -- but it most certainly will not last. By the time you read this, several news cycles and perhaps more scandals and ethical abominations from the Trump administration will have passed, and HIV's proverbial moment in the sun may have passed.
This begs the question: Where do we go from here? What do these six HIV advocates do after their act of protest, and what do the 15 PACHA members who chose to remain do in the wake of their colleagues' departure? The answers HIV advocates provide to these questions reflect what they believe is the best way to fight the Trump administration's and the Congressional Republican majority's efforts to take quality, affordable, accessible health care away from people living with and affected by HIV.
In his Newsweek piece, Schoettes said the rationale behind the six members' departure lay in their belief that it was ineffectual to participate in the Council under an administration that had no interest in listening to them. He said they thought they could do far more to help the HIV community by advocating from the outside.
In contrast, public statements from members of PACHA who have chosen to stay reflect the hope that the Trump White House's neglect of the Office of National AIDS Policy (ONAP) will be only temporary and they will be able to use their seats at the executive council table catch the ear of administration officials at some point in the future.
It is all well and good to play armchair quarterback and broach our opinions on whether the inside or outside game is the best way to approach this administration, but the fact of the matter is that there is no "right" choice in the unenviable and disadvantageous position these 21 current and former PACHA members find themselves.
If the Trump administration just came out and said it was dismantling the National HIV/AIDS Strategy or appointing a homophobic abstinence warrior to head the ONAP, then the 15 remaining PACHA members' decisions to stay or go would become much easier. But, so long as the Trump administration simply does nothing, it leaves the door open to future actions affecting the implementation of the National HIV/AIDS Strategy. And that means having inside advocates to provide guidance could prove vital.
Similarly, Congressional Republicans could make the remaining members' decisions to stay on or leave PACHA much simpler if they weren't dead set on embracing the abomination that is the AHCA. If Republicans in Congress mirrored the behavior of GOP governors such as John Kasich (R-OH) and Brian Sandoval (R-NV) -- who recently signed on to a bipartisan letter rejecting the AHCA, calling for open, inclusive discussions on health care and advocating for improvements in the Affordable Care Act rather than tearing it down -- PACHA members could resign safe in the knowledge that they had Congressional Republican partners to work with. Instead, anyone leaving PACHA does so knowing that future interactions with Congressional Republicans will come from a place of opposition and not collaboration.
Every Ounce of Advocacy
With hindsight, we will eventually be able to determine whether the departure of the six HIV advocates from PACHA was prescient or premature -- but right now, it is important that members of the HIV community provide support both to those who left and those who stayed. We need every ounce of advocacy we can get right now.
The AHCA is currently on the cusp of becoming the law of the land. Should it pass, the AHCA would provide nothing but suffering and pain for people living with or affected by HIV. We cannot let that happen -- and the surest way to make certain it doesn't is by embracing all HIV advocates, both those who use the inside game and those who fight from the outside. We don't have the luxury to spend our time debating the merits of PACHA members' decisions to stay or go. We can only support them and fight on together.