| As the decade wore on, it became increasingly evident
that a third stage, extending from the early to late 1990s, had evolved. This stage was marked
by the increased professionalization and expansion of minority
community-based AIDS organizations. The
strongest of the organizations created in the first and second phases
extended their reach among the populations they served, became more
polished in their public relations efforts, and, perhaps most
significantly, became adept at placing political pressure on government
officials at the local, state and federal levels.
Community
organizations that were created in earlier stages began to push for
legislative remedies addressing the challenges of providing education and
care services to the African American community.
The Black Leadership Commission on AIDS, the National Minority AIDS
Council, Balm in Gilead, and Gay Men of African Descent were just a few of
the organizations that came together to lobby members of Congress.
As active participants in the Congressional Black Caucus Health
Brain Trust, representatives from these organizations were also involved
in working with Congressional Black Caucus members to develop an AIDS plan
of action.
The
minority organizations and CBC members believed that AIDS dollars should
follow the course of the epidemic to reduce the incidence of HIV/AIDS and
provide quality services for those already infected.
Representatives from the African American CBOs eventually worked
with the CBC to formulate an initiative designed to circumvent their
funding difficulties by creating a new funding pool dedicated to capacity
building in minority communities. The
political response of the gay community in the 1980s demonstrated that
government resources were the key to saving lives because they were vital
to supporting and promoting AIDS research, treatment and prevention
measures. Thus, by pursuing
more resources, community activists, AIDS bureaucrats and politicians in
the black community were following a previous mobilization model that
directed critical resources to support and validate the lives of people
with AIDS and HIV infection.
For
years, Representative Louis Stokes of
Ohio
, serving as chair of the Congressional Black Caucus Health Brain Trust,
brought together experts, bureaucrats, and constituents from all over the
country to discuss health issues facing the community.
From diabetes to glaucoma and health insurance coverage, his Brain
Trust provided a forum to bring attention to pressing health matters in
need of a legislative remedy. AIDS
activists and professionals from many of the organizations discussed
previously participated in these Brain Trusts and in 1994, the CBC held
it’s first hearing on HIV/AIDS in the African American community.
Since that time, the CBC has dedicated a segment of its bi-annual
Health Brain Trust to the issue. The networking facilitated by the brain
trust helped set the stage for CBC political action on AIDS.
It
would not be until 1997 that AIDS was placed on the formal legislative
agenda of the CBC. Under the leadership of newly elected Chairwoman Maxine
Waters, the CBC issued a document called “The Agenda” that outlined
the organization’s legislative priorities for the 105th
Congress. Encompassing a host
of issues from drugs to education, computer literacy and employment, The
Agenda listed HIV/AIDS as a legislative priority for the first time in the
organization’s history. While
previous Brain Trusts and a special CBC hearing provided crucial
information and attention to the issue, its inclusion on the formal agenda
meant that HIV/AIDS was now a legislative priority that the organization
could officially pursue as a collective.
The
AIDS language in “The Agenda” reflected the no-nonsense style of the
new CBC chair. It acknowledged
that many African Americans considered HIV/AIDS to be “taboo” and
challenged the perception of AIDS as a “gay disease.”
The document’s frank approach marked a significant departure from
the largely conservative response of many in the community and directly
challenged the way the disease had been framed by black
leaders—particularly among faith-based leaders.
The document also underscored the serious nature of the epidemic
and assured that “immediate action” would be taken to reduce the
spread of the disease through the pursuit of additional resources for
education, research, treatment and prevention directed towards communities
of color “at risk” for HIV/AIDS.
The CBC began to act on the promises set forth in The Agenda the
following spring. On
Friday, April 24, 1998
, the CBC held its annual spring Health Brain Trust in a half-day forum
held in the
Rayburn
House
Office
Building
on Capitol Hill. In the
presence of Rep. Waters and others assembled, Dr. Beny Primm, Executive
Director of the Addiction Research and Treatment Corporation, outlined the
growing severity of AIDS in the African American community and urged the
CBC to ask the Clinton Administration to declare a “State of
Emergency” with the intent of stemming the spread of AIDS in the African
American community. CBC
Chairwoman Maxine Waters wasted no time springing into action.
One week after the Brain Trust meeting, the chairwoman issued a
memorandum to CBC members informing them that an emergency CBC meeting
would be held the following week with AIDS activists and professionals
from across the country and with representatives from the Department of
Health and Human Services in attendance.
The memo also announced a press conference following the meeting
“to release the findings of our discussion and a resolution to be
delivered to the President.”
On
Monday, May 11, 1998
CBC members met with AIDS activists from cities across the country—
San Francisco
,
Los Angeles
,
New York
,
Atlanta
—in a jam-packed room in the bowels of the U.S. Capitol.
Representatives from the Department of Health and Human Services
participated as “silent observers.”
Led by Waters, the session allowed AIDS activists and
representatives from minority AIDS CBO’s to share their experiences from
the field. Many of the
participants spoke out about issues related to the dearth of funding
opportunities, the difficulties encountered treating persons with
substance abuse problems, the need for more prevention efforts, and the
stigma associated with AIDS—particularly the need to address the issue
of homophobia in the black community.
The activities of May 11th became the springboard for
subsequent political action. Merging
Primm’s blueprint for action with the recommendations resulting from the
meeting with grassroots activists, CBC leaders, particularly Reps. Maxine
Waters, Donna Christian Christensen, and Louis Stokes, worked with CBO
representatives and Clinton Administration officials to create the
foundation of what would become known as the CBC AIDS Initiative.
Later that
year, the Clinton Administration announced its support for an AIDS state
of emergency in minority communities.
The Administration framed the situation as a threat to national
security and dispatched the National Security Agency (NSA) to look into
the matter. The involvement of
the NSA was a curious response to a matter that had been traditionally
viewed as falling solely within the jurisdiction of the Department of
Health and Human Services. The
Administration’s response demonstrated, however, the severity of the
epidemic and the power of the CBC Chair who had established a close
working relationship with a receptive White House weakened by political
scandals. In addition to
declaring a state of emergency, framing the crisis as a threat to national
security served to provide the administration with a justification for
dedicating additional federal resources toward the CBC AIDS Initiative.
Ironically,
the success of the initiative was ultimately furthered by the actions of
House Speaker Newt Gingrich (R-GA). This
highly ideological and controversial leader of the Republican majority and
author of its Contract With America was at the helm of a rocky House
budget process during the 105th Congress.
After stalling on spending measures for much of the year for
political purposes, Gingrich was forced to negotiate with Administration
officials to complete an omnibus spending bill containing all of the
spending measures for the next fiscal year.
Completed behind closed doors with only a few players from the
White House and Congress, the Omnibus Appropriations Bill of 1998 stood 16
inches tall and contained over 4,000 pages.
In the chaotic atmosphere surrounding its completion,
Clinton
negotiators were able to insert an authorization for $165.7 million in new
AIDS dollars to be dedicated to the CBC AIDS initiative in fiscal year
1999.
The CBC AIDS initiative broke new ground for minority communities
in their fight against AIDS. It
directed critical resources toward minority populations severely impacted
by the epidemic. It also
ensured that funds would go toward minority AIDS CBO’s who had been
previously left out of the funding process, by stipulating that
organizations eligible for the funds had to have a governing board
comprised of a majority of its members representative of racial and ethnic
minority groups. This
controversial measure had the effect of excluding traditional AIDS service
organizations based in the white gay community.
The
substance of the initiative was a conglomeration of new and expanded
grants and programs spanning the various HHS agencies including the
National Institutes of Health, the Substance Abuse and Mental Health
Agency, the Centers for Disease Control, the Office of Minority Health,
the Health Services and Resources Administration, and the Agency for
Health Care Policy and Research. These
“targeted investments” sought to provide more technical assistance and
infrastructure support for minority community-based organizations, better
access to prevention and care for communities of color, and stronger
linkages between government resources and local systems of care.
Examples of new or expanded programs targeting minorities included
research on prevention interventions for gay men of color, support for
faith-based initiatives that focused on integrated HIV and substance abuse
prevention, grants for increasing access to bilingual HIV/AIDS and
prevention services, new pilot programs in prisons to promote effective
treatment and prevention methods, and special grants to directly fund
programs in minority community based organizations.
Working with grassroots activists and organizations, the CBC
directly confronted issues of stigma and access in its effort to prevent
the spread of the epidemic in the African American community.
The end result was a community initiated policy effort that
utilized input from individuals and organizations close to the epidemic to
shape the final product. By
working with informed activists, the CBC pursued policy goals that
represented a realistic response to the challenges of AIDS in the black
community. Inclusive of
populations traditionally referred to as deviant, the CBC initiative spoke
to AIDS issues involving gays, women, prisoners, and substance abusers and
demonstrated that the African American political leaders were indeed
capable of prioritizing the needs of all within the community.
Much of the
information in this section is synthesized from primary data that the
author collected first-hand while studying the CBC as a Congressional
Black Caucus Fellow in the 105th Congress.
The results of her study are documented in:
Maya Rockeymoore. The
African American Political Response to HIV and AIDS:
A Study of the Congressional Black Caucus in the 105th
Congress. Dissertation,
Purdue
University
, 2000.
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