Prevention at Risk

Nonprofit Claims CDC is Shortchanging Latino HIV/AIDS Prevention
by Larry Buhl

Every five years the CDC awards grants for HIV programs around the nation. In August the CDC had $143 million to allocate over the next five years of which they allocated $42 million for year one and funded 133 community-based organizations. Another $110 million was available to award over the next five years to organizations for “Capacity Building Assistance,” or CBA. For 2010–15, the CDC is dividing $143 million among 133 HIV/AIDS organizations for prevention programs and outreach, only seven of which are Latino. Only one of the Latino agencies funded is west of the Mississippi, where more than sixty-five percent of U.S. Latinos reside.

For capacity building assistance, according to the CDC’s Office of Information and Disclosure, they funded only one Latino agency out of fourteen to provide capacity building assistance to Latinos for the entire nation.

The CDC established that a top priority for funding would be Latino men who have sex with men (MSM), according to AGUILAS, but the government agency did not follow through on that priority, resulting in a severe lack of resources for preventing the spread of HIV/AIDS among Latino populations.

The CDC’s statements about Latinos as a priority don’t reflect their actions toward funding for Latinos, according to Eduardo Morales, PhD, executive director of San Francisco-based AGUILAS and distinguished professor of Alliant International University.
“Only one Latino program found west of the Mississippi, Bienestar, located in Los Angeles, will be funded directly by the CDC through 2015,” Morales told A&U. “That comes down to funding just a small fraction of a penny per Latino. This is not just a local risk, but a national health risk.”

Morales adds that although the CDC funds HIV programs through state allocations these funds are primarily designated for HIV testing. States and local health departments are not obligated to fund Latino-targeted programs and will model the funding patterns of the CDC, and therefore will not likely reach Latinos for prevention and intervention services.

Morales’ frustration results not only from being shut out of CDC funding, but also from bureaucratic foot dragging. Over the past twelve months Morales wrote letters with follow-up phone calls asking for the proper information about CDC funding programs targeted for Latino MSM. After more than a year CDC still had not responded.

“The CDC doesn’t disclose on their Web site who is granted funding in response to their RFPs [requests for proposals]. They force you to go through their Office of Information and Disclosure, and that can take over a year to receive a response for information that is typically posted by other federal agencies on their Web sites. It’s a problem of transparency and accountability.”

In April Nancy Pelosi, as Speaker of the House and Congressional representative of San Francisco, sent a letter to the CDC requesting the funding information requested by AGUILAS. Six months after the request her office still had not received answers, Morales told A&U. “When the Speaker of the House can’t get information from the CDC, who can?”

In October, AGUILAS held a town hall meeting in San Francisco to address the alleged discrepancy in HIV prevention funding for Latino-focused organizations. The forum stressed the need for action on the national level and the need to put Latino HIV prevention at the forefront. Local leaders responded to the lack of CDC funding with dismay. “To hear the news that there is a disproportion of funding for the Latino community is unfortunate,” said State Senator Mark Leno. District 9 Supervisor David Campos called CDC’s funding choices “nothing short of unethical.”

In November the CDC finally responded to Pelosi and AGUILAS. In a prepared statement the CDC said there are six organizations funded by the grant that serve Latinos in the western U.S., five of which are in California, and the grant initiative targets thirty-one Latino organizations, twenty-three percent of the 133 organizations funded nationwide. “While there will always be greater needs than there are resources, the CDC has taken extensive steps to ensure funding matches the epidemic,” said CDC spokesperson Elizabeth-Ann Chandler.

Chandler said funding for community-based organizations is based on an objective, scientific-based process that is highly competitive. “We know Latinos face a heavy burden of HIV,” Chandler said, adding that Latinos comprised twenty-one percent of AIDS diagnoses in 2008, the year with the most recent statistics.

Not satisfied with the response, Morales launched a letter-writing campaign to President Obama, asking the administration to pressure the CDC to increase funding for Latino organizations and launch an investigation into their budget details. “We want the CDC audited to find out how they’re spending their money,” Morales said. “It is interesting and suspicious that we receive information prior to the press conference that is very different than the information received in November.”

Other nonprofit groups say that the CDC is very particular about its allocation of money, and groups must meet all their criteria in order to receive funding. However, Morales says that CDC has had significant problems in the quality of the grant reviewers’ work, which it has cited as unprofessional and unethical. “In our case there is overwhelming evidence that the reviewers did not read our grant for HIV services for Latino MSMs. A detailed analysis of the evidence was sent to the HIV Prevention Director Dr. Mermin of the CDC,” says Dr. Morales.

“I’ve dealt with the CDC since the beginning of [the AIDS] epidemic. I’ve seen a lot of changing staff recently and as a result there is a loss of institutional history and a lot of repeated mistakes.”

Without the CDC funding AGUILAS and other organizations will have to rely on counties and local governments to pick up the slack. But that may not happen, Morales says. “Local governments get their money from the CDC, and they mirror what the CDC does.”

Morales is encouraged by the recent election that swept in Jerry Brown and Gavin Newsom (as governor and lieutenant governor) as well as the passage of a proposition that allows the state legislature to pass budgets with a simple majority of the vote versus the two-thirds that has been required in California. But he insists that even in the best-case scenario, the state and local governments can’t make up the shortfall left by the CDC. By 2014 and 2015 when RFPs open up again by CDC direct funding, we can expect Latino MSM to represent twenty-five percent or more of the HIV/AIDS cases in the U.S. based on a steady increase of one half percent each year for the past seven years for Latinos.

“We cannot allow the CDC to abdicate its responsibilities to Latino Americans to other entities,” Moraleas told A&U in conclusion.

Larry Buhl interviewed actress Lupe Ontiveros for the September cover story.

December 2010