CDC Locks Out Black Providers in New AIDS Technical Assistance Announcement, Says the Black AIDS Institute

LOS ANGELES, April 2, 2014 /PRNewswire-USNewswire/ -- On March 19 the Centers for Disease Control and Prevention (CDC) awarded $115 million over five years to 21 organizations to provide technical assistance to health departments and organizations implementing CDC's new prevention strategies and improving health outcomes for people living with HIV/AIDS. Not one of these organizations is a Black organization. The effect of this decision is that Black organizations have been locked out of leading technical assistance and capacity building in this country for the next five years.

This should be an issue of concern for Black people, the public at large and anyone who is interested in ending America's AIDS epidemic. Let's look at the numbers: There are about 1.2 million Americans living with HIV today. Nearly 50 percent of them are Black. Of women living with HIV in the U.S., nearly 64 percent are Black; among gay and bisexual men, 32 percent are Black.

At a time when Black Americans are more likely to be diagnosed late in their disease, less likely to be in care, have poorer clinical outcomes and die quicker than any other racial or ethnic group, the decision not to fund any Black organizations in this program further dismantles what little infrastructure exists in Black communities to address HIV/AIDS. Health departments and organizations that desperately need technical assistance to respond to a rapidly changing health-care environment will be unable to turn to an organization grounded in the experience of Black communities.

And over the last few years, a number of Black AIDS organizations have had to close because of lack of funding. Both CDC and Black AIDS Service Organizations (ASOs) will offer various reasons. The CDC might maintain that the pool of Black applicants was small and that some did not demonstrate sufficient programmatic capacity, had administrative challenges or were eliminated for technical reasons.

The Black organizations might counter by saying that the process completely disregards the value of cultural competency, denies Black organizations opportunities to focus on their strengths, and inherently advantages larger organizations that can farm out their grant writing over smaller organizations that are better equipped to deliver services.

The CDC appears to be more obsessed with having a pristine grant-making process than with making sure the outcomes of that process reflect the communities most at risk for HIV. Many Black AIDS organizations have prioritized cultural competency and resisted retooling themselves in order to respond to the changing HIV/AIDS landscape.

There is plenty of blame and finger-pointing to go around, but it all misses the point.  We are failing in our fight to end the AIDS epidemic in Black America.  Indeed, in some areas we are losing ground.

Nearly 64 percent of newly diagnosed women, nearly 67 percent of newly diagnosed youth (ages 13-19) and 36 percent of newly diagnosed gay bisexual men in America are Black.

Here's the question: Is it in the interest of ending the AIDS epidemic—and particularly of ending the epidemic in Black communities—to have a service delivery network that is void of Black providers?

The CDC's decision basically creates a technical assistance elite that perpetuates a notion that outside technical assistance providers can parachute in to rescue communities, and violates the notion that (properly supported) communities have both the responsibility and the capacity to save themselves. As Calvin Rolark, the founder of the United Black Fund, said, "Nobody can save us . . . but us."

Whatever the reasons, it's imperative that communities, AIDS organizations and government agencies like the CDC work together to make sure that we have a geographically and racially diverse HIV service-delivery system.—And that all HIV service providers have both the cultural and subject-matter competency and the administrative bandwidth to deliver the services that our communities need and deserve.

Both the message and the messenger matter. Unless we are explicitly included, we are implicitly excluded. In order to end the AIDS epidemic in Black communities, the AIDS service-delivery system must reflect the communities most at risk. Unless Black people see themselves at every level of the care-delivery system and every point of the treatment cascade, we will continue to see the unacceptable outcomes that currently exist in Black communities.

In the interest of disclosure, the Black AIDS Institute is a small subcontractor to one of the CDC grantees.

SOURCE Black AIDS Institute



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