People with AIDS are under attack! The culprit? U.S. House Majority Leader and top Republican snake-oil salesman Eric Cantor. When Cantor slithered into the John F. Kennedy Jr. Forum at Harvard recently, we could not pass up this opportunity to let him know how damaging his neglect for people with AIDS and other infectious diseases has been. Cantor, one of the most powerful legislators and one of the men most responsible for ravaging an infrastructure of government services and support, has continually failed to support programs that would prevent millions from becoming infected with HIV, HCV, and other diseases and provide treatment to those already infected. Given Cantor’s supposed commitment to ending disease, which he addressed in his speech at Harvard, and his supposed valuing of human life, this neglect is inexcusable. Nearly forty activists from the Harvard College Global Health & AIDS Coalition, Harvard Medical School, ACT UP Boston, Boston University, and others came out to oppose Cantor’s shameful policies.
We asked Representative Cantor’s support for two initiatives, different in their strategies, but similar in their overall missions of ending the burden of disease both domestically and abroad. The first of these two asks is for expanded funding for AIDS treatment and prevention globally through the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and domestically through the Ryan White Care Act. These programs are vital for ensuring that people living with HIV and AIDS around the world get the care and support they need.
In the past few years, funding for all of these programs has stayed steady or declined. With the recent budget sequestration, funding levels to these programs have been slashed even further. When more than half of the 34 million people around the world infected with HIV do not have access to the treatment they need, this failure to act is unacceptable. As we are finally developing the tools we need to treat this epidemic, effectively prevent its spread, and ensure that those living with the disease can have prosperous lives, now is not the time to ignore our commitments. We realize there are trade-offs to be made in responding to budget shortfalls, but this is not a necessary trade-off. AIDS programs – both domestically and abroad – form a tiny percentage of the overall budget, less than one third of one percent. Letting AIDS patients die for the sake of a balanced budget is not worth the costs.
An important component of AIDS funding is prevention – to ensure that the disease stops spreading we must think of creative ways to prevent transmission. Nearly one in five people that are exposed to HIV in the US are exposed through the sharing of unclean syringes. This number is multiplied more than three-fold in the case of hepatitis C, another infectious disease that can lead to liver failure and death and currently affects more than 3 million people in the US. Given the salient role that dirty needles play in perpetuating the transmission of blood-borne illnesses like HIV, hepatitis C, and other diseases, syringe exchange programs (SEP) are a smart and effective way to prevent transmission. These programs provide free, sterile syringes to injection drug users, an approach that reduces the likelihood of users sharing injecting equipment. Such programs also implement safe disposal of used syringes and a range of other health and supportive services, including on-site medical care; screening and counseling for HIV, hepatitis C, and sexually transmitted infections; distribution of condoms, food, and clothing; and referrals to substance abuse treatment.
But the federal government refuses to fund these life-saving programs. In 2009, President Obama signed legislation ending a 21-year ban on federal SEP funding. Just two years later, Congress reinstated the federal ban; Cantor was instrumental in the revival of this ban. Numerous studies report that syringe exchange programs do not increase drug use or encourage people to start using drugs. They have wide support in the medical and public health fields.
In the two years since Representative Cantor last visited the JFK Jr. Forum, approximately two million people have died from AIDS related causes due to lack of treatment. Roughly 5 million people became newly infected. When Mr. Cantor was last here, the Harvard College Global Health & AIDS Coalition asked him to restore AIDS funding. He responded that it’s all about trade-offs – and the federal government does not have the money to fully fund AIDS programs. Whether pinching pennies to deny treatment to those most in need or opposing smart and effective ways to prevent the spread of AIDS, we cannot stand idly by as Mr. Cantor launches these attacks. So we took a stand in an institution that hails itself as a “premier arena for political speech, discussion and debate,” an institution we believe should encourage direct political action. Cantor himself recognized the significance of this venue and responded to the very chants that got us escorted out of the Forum by saying, “I applaud you in your advocacy for your cause.” We were given access to one of the most powerful members of Congress and we took a bold stand to instill in Mr. Cantor’s memory the need to commit himself to this fight.
Mr. Cantor’s response to the issues at hand signaled his stubbornness and continued neglect. Despite focusing his speech on the need to advance scientifically, stating that “there should be no higher priority than curing disease,” Mr. Cantor was intransigent on AIDS funding and syringe exchange. He simply reiterated the worn-out excuse of budget troubles and trade-offs. We understand the difficult decisions facing Congress, but programs like Ryan White, PEPFAR and the Global Fund carry a unique moral imperative by providing life-saving treatment to individuals across the globe. Lifting the SEP ban will cost the federal government nothing – it will simply allow states to divide up their prevention dollars differently – and it saves the government money long-term.
Rather than committing to protect these initiatives, Cantor once again reiterated his willingness to invest in research and development and ignore the very real burdens being currently felt by these diseases. While scientific research is unquestionably important in the fight against AIDS and other diseases, we believe that the ultimate goal of these research endeavors is to inform policy decisions. Recent landmark studies like HPTN 052 have decisively shown that providing treatment can stop the spread of the HIV virus by 96% among certain populations – demonstrating that the path to eradicating this epidemic lies in expanding access to life-saving treatment. With this new knowledge, recent investment frameworks have concluded that we could see the end of the AIDS epidemic within our lifetimes if we properly invest in treatment expansion now.
What we need is the political will from leaders like Cantor to actually realize these goals rather than simply putting forth recycled rhetoric. When Cantor defended his position from two years ago and said the trade-offs we have seen in AIDS policy are to be expected, he ignored the incredible progress we have made thus far and the need to sustain momentum. We hope our angry, outraged voices will still be ringing in his ears the next time he has a chance to overturn the syringe exchange ban.
Graphs: T.Q. Nguyen, B.W. Weir, S.D. Pinkerton, D.C. Des Jarlais, D. Holtgrave.. Increasing investment in syringe exchange is cost-saving HIV prevention: modeling hypothetical syringe coverage levels in the United States. MOAE0204 – Oral Abstract, 2012 International AIDS Conference.