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Op-Ed: Fight AIDS here at home-HIV health crisis among Africn-Americans (again I add HCV/HIV coinfection)
  By Dr. Nelson L. Adams and Dr. Mohammad N. Akhter
March 01, 2008 11:02:00 PM
President Bush's recent trip to Africa helped underscore his commitment to spend billions of dollars to fight the HIV/AIDS epidemic that has already killed some 17 million men, women and children. The president's five-year, $15 billion aid package for Africa is widely considered to be the most important and popular international program of his presidency. During the State of the Union address, the president called on Congress to double America's commitment to combat AIDS in Africa and approve an additional $30 billion over the next five years.
While the president should be applauded for his efforts overseas, we fear he is overlooking a growing public health crisis among African Americans here in the U.S. The statistics are truly shocking and show the grossly disproportionate impact that HIV/AIDS has on the African American community. While African Americans represent about 13 percent of the U.S. population, they account for half of the more than one million people living with HIV in the nation.
In 2005, the rate of HIV among black men was nearly seven times higher than that of white men. African-American women's rate of infection was more than 20 times that of white women. Needless to say, HIV/AIDS has by far the greatest impact on African Americans than any other group, and is among the leading causes of death.
To get a firsthand look at this deplorable situation, the president need only to travel outside the White House gates. Nowhere is the HIV crisis more widespread than in Washington, D.C. African Americans account for more than 80 percent of recent HIV/AIDS cases in a city where they make up only 57 percent of the population. One in 20 is infected with the virus, and one in 50 has AIDS.
Just as the president's additional spending request will extend treatment to 2.5 million people and prevent 12 million new infections in Africa, similar progress is needed in this country. The president has a long way to go before his final term ends in January, but he can gain a significant head start by taking three basic steps:
· Develop a national plan. Despite the fact that this scourge is decimating minority communities in this country, the U.S. has no national plan to deal with the AIDS epidemic.
· Appoint a leader. Not only does the U.S. not have a plan, but no one is in charge of the problem. Once a leader is named, community groups, churches, medical groups and others should work together to resolve the most pressing issues.
· Focus on resources. While funds are scattered around the country to fight HIV/AIDS in many little pockets across the U.S., the bulk of the money should instead be devoted to African American communities with the highest rates of HIV/AIDS.
The president and Congress should take action now to get a handle on the problem before treatment costs increase to astronomical levels. A recent study estimated that direct and indirect costs of HIV/AIDS in this country is $36.4 billion, of which more than 80 percent is related to productivity losses. This price tag will only increase the longer we wait.
Nearly 26 years into the AIDS epidemic, federal government agencies have tried unsuccessfully to solve the problem. The president has an opportunity to add one final milestone to his presidency when the history books are written. If the president acts immediately and decisively, he can also forge a lasting legacy with African Americans.
Dr. Nelson L. Adams and Dr. Mohammad Akhter are president and executive director, respectively, of the National Medical Association, representing more than 30,000 African-American physicians and their patients.
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