Minorities and HIV: Calling a State of Emergency

African American Cases Still Rising

...wherever African Americans dominate a community, they exist in Third-World health conditions... A history of limited access to quality healthcare, disease prevention, and health promotion has compounded a state of emergency in public health of these communities.

Debra Fraser-Howe, President, BLCA

While African Americans make up 12%13% of the American population, they are disproportionately represented in cases of devastating diseasetuberculosis, hypertension, sexually transmitted diseases, infant mortality, cancers, bronchial disease, violence, and childhood diseases believed to be eradicated long ago. They are very disproportionately represented in cases of AIDS, a disease that is destroying African American communities. According to the Centers for Disease Control (CDC), between 1981, when HIV/AIDS first appeared on our healthcare system's radar screen, to 1987, blacks represented 25% of AIDS cases. By 1995, the proportion had increased to 38%. More recent estimates place it at 39%.

The mission of the National Black Leadership Commission on AIDS (BLCA) is to organize local black leaders to respond to this emergency in their own communities by raising awareness and advocating for critical public health services and education programs to fight HIV/AIDS. A typical local board may bring together local clergy, physicians and other medical professionals, attorneys, teachers, and many other professionals. The Commission began working in New York City, expanded to other African American communities in New York state, and is now building organizations in 17 cities across the country.

BLCA Takes Emergency Action

During a meeting of black community leaders and the CDC in 1998, data were reported that shocked the delegation. The interview that follows gives a close up and personal account of that meeting, which galvanized community leaders and resulted in action by the President. BLCA will continue to be a leader in pushing for a State of Emergency to be declared at the highest levels of government.

March 3 1998

At the March 3rd meeting between African American leaders and the CDC, we were at a point of political showdown instead of the more traditional negotiation to get needed funding for African Americans with AIDS. We saw the data for the first time, and the response was that the leaders shut the meeting down. When the 33 African American leaders discovered the extent of the AIDS epidemicÑthat it was destroying their communitiesÑthey demanded that the then CDC head meet with them immediately. The leaders looked at these statistics the same way as we look at civil rights. BLCA pulled together a smaller group of leaders, The Palm Sunday Group, to directly approach the President to issue a State of Emergency with reference to this issue.

Can You Hear the Alarm Going Off?

Out of the seven people newly infected by the HIV virus every hour in this country, three are African Americans. This means that 72 black Americans are being infected every day.

BLCA focuses on more than HIV/AIDS

HIV/AIDS is like a locomotive out of control in the African American community. Still, you can't talk about HIV/AIDS in a vacuum. You have to put it into the context of the other pressing epidemics affecting African Americans: TB, diabetes, prostate and breast cancer, substance abuse, violence, stroke, hypertension, and sickle cell disease. BLCA continues to push forward on every one of these diseases in our communities. We work toward seeing that the money goes where the need is greatest.

BLCA teaches communities to fight AIDS

If you are going to survive, you learn to swim against the tide. To ignore the public issues that affect African Americans is to insure our extinction. BLACA has tried for the last 13 years to help develop the infrastructures to respond to both current and future health crises. What we know is that it is necessary to educate our leadership to advocate for this issue in order to ensure success. BLACA is now the special adviser for the Black Caucus in Congress. We have targeted cities across the US where communities of color have been disproportionately affected by HIV/AIDS and other devastating diseases. For example, Baltimore has 18 times the national average of syphilis. Atlanta has the fifth highest rate of syphilitic infection. Of all newly reported HIV infection in women, African American women account for nearly 70%.

Who are some of the heroes in this battle?

Senator Arlen Spector, who was able to recognize this epidemic for what it was, provided the kind of leadership that was needed on the Senate side to make it possible to make the program fly on the House side. Congresswomen Barbara Lee of Oakland, CA, helped peers in Oakland to declare an Oakland State of Emergency. Donna Christian Christianson, Chair of the health brain trust of the Black Caucus has identified the scope of the epidemic in the US Virgin Islands. There are many more.

Goals for the year 2000

We are going to try to increase the technical assistance to local organizations to assist in creating an atmosphere of cultural competency. People absolutely need to have their needs addressed in such an atmosphere. Also, we want to help caregiving and support organizations with grant-writing skills and to cultivate relationships with funders. All of these infrastructural needs are built into the Fiscal Year 2000 enhanced funding stream.

BLCA's efforts have resulted in new funding of $156 million. Their Year 2000 funding is 245.4 million. And 2001 will see $349 million as the base, which was the original amount they had requested for 2000.