July 13, 2010 | Read Time: 5 minutes
President Obama on Tuesday issued the first national AIDS plan, a strategy outline that may well be the most influential national document in the history of the AIDS epidemic in America. Now it is up to philanthropy to join forces with government to make it work.
For a quarter of a century, our government used a broken business model to fight HIV/AIDS in the United States, spending far too little money to prevent the spread of infection. Severe state budget shortfalls are now adding to the problem. In California, programs to prevent the spread of HIV have been cut to pay for medications for poor people who already have the infection.
The results of bad policy making in the past presented a big challenge for President Obama. For instance, HIV rates among adults in Washington, D.C., now exceed 1 in 30—a statistic that is higher than the reported rates in Ethiopia, Nigeria or Rwanda. At a time when we struggle to care for all the people who have the disease, it is heartening that the president’s National HIV/AIDS Strategy gives high priority to financing and spreading effective local programs that prevent infection. AIDS is a disease that can be entirely prevented if we teach people how to avoid behavior that puts them at risk. However, it is not a disease that is entirely curable, and it is far more vicious a foe than many drug ads would have us believe. Too often the shame and stigma surrounding sexual activity and drug use—behaviors that lead to HIV transmission—have caused the United States and far too many countries around the world to shy away from critically important and effective programs that prevent HIV, what has now become the leading cause of death among American black women of childbearing age. Although the AIDS epidemic in the U.S. is not widespread throughout the country, it is still concentrated in specific geographic communities as well as among certain population groups, including black women and men who have sex with men. To wipe out these serious mini-epidemics, we need a well-coordinated, well-financed strategy that focuses on results.
President Obama’s HIV/AIDS plan recognizes that problem and urges nonprofit organizations, businesses, and philanthropies to work more closely with local governments to learn from one another and to use donor dollars to support and evaluate prevention programs. The goal is to learn what approaches work best in the rural south, for example, and which ones will do the most good in New York City, recognizing that sometimes very different efforts work best in different regions.
The question for grant makers and governments now is how do we best forge such partnerships, given the complex financing and epidemiological landscape?
At the MAC AIDS Fund, we have spent 20 years financing projects to treat and fight AIDS. We have collaborated with many government agencies in the United States and around the globe and can offer some important lessons from these partnerships.
Since March, for example, we have been working in Washington, D.C., with the Department of Health, Washington AIDS Partnership, the CDC Foundation and several corporate grant makers on a project that has already demonstrated strong results.
Several government and private organizations have come together to distribute 500,000 female condoms in the neighborhoods of Washington that have been hardest hit by HIV and AIDS. The program, the first in the United States to involve so many types of organizations, is seeking to empower women to protect themselves from HIV and other sexually transmitted diseases. In just four months, more than 11,400 female condoms have been distributed free and more than 2,325 women have been educated about how to prevent HIV and how to use the female condom. The MAC AIDS Fund paid for community groups to distribute the condoms to needy women; CVS drugstores agreed to sell the condoms so women could also obtain them at nearby stores.
From this partnership, we have learned that flexibility and creativity in defining roles are critically important to the success of partnerships between government and philanthropy. This experience has also taught us how crucial it is for grant makers and other private organizations to work in close collaboration with both local and federal government from the outset of a program. It is also vital for grant makers to stay open to what would normally be considered government responsibilities in the short term to ensure that new and innovative approaches have the money and support they need to take root.
While it can seem daunting to some grant makes to consider combining nonprofit and for-profit approaches within the same program, we have learned there are times when it is exactly this type of innovative hybrid approach that can make a difference when strictly for-profit or nonprofit ventures might fail.
Health care is essentially the business of government, but projects like the one in Washington show that corporate America’s skills can be put to work in making programs efficient and effective.
As states begin to put President Obama’s AIDS plan into effect, government leaders, corporate influencers, and citizens everywhere must hold hands and work together. Otherwise the AIDS plan will remain what all of the previous, less prestigious, and less courageous presidential commission plans became — unfinanced and unsupported mandates. People living with HIV/AIDS and those at risk of becoming infected as well as their families deserve better.
Nancy Mahon is executive director of the MAC AIDS Fund, a corporate grant maker in New York.
