Why Hillary Clinton's HIV Promises May Not Be Enough

I knew my recent meeting with former Secretary of State Hillary Clinton was going to be a smashing success when I and 19 other representatives of more than 70 HIV organizations introduced ourselves as a bunch of policy wonks and Secretary Clinton replied, "Well, you know that's a term of endearment to me."

For nearly an hour, Secretary Clinton outlined her commitment to addressing the epidemic if elected president. She plans to invest more in HIV prevention and care services and programs, combat stigma and HIV criminalization laws, work to expand PrEP awareness and usage, and ensure full implementation of the Affordable Care Act by working to expand Medicaid in the South, where HIV infection rates mirror those of some countries in Africa. We also discussed limiting high out-of-pocket HIV medication costs due to discriminatory plan designs by insurance companies. Secretary Clinton promised to cap drug prices to no more than $250 per prescription and force the pharmaceutical companies to examine high costs.

While Secretary Clinton laid out her ambitious plan to tackle the epidemic through national leadership, all I could concentrate on was our state-level inability to live out her ambitious goals. I recognized at that moment that even if Clinton were elected president and made good on her promises, Illinois would be ill prepared to truly harness and embrace those advances in public health because of our 11-month budget crisis.

Since taking office in 2015, Gov. Bruce Rauner has decimated the HIV public health infrastructure in our state. His latest proposed budget contains a whopping $8 million slash to HIV funding line, representing a 28 percent cut from the fiscal year 2015 budget and a reduction in funding for the African-American HIV/AIDS Response Act (which funds many vital prevention services for communities most vulnerable to HIV) by 66 percent to $500,000. The governor's budget also proposes other devastating cuts to critical services that affect people living with HIV, including supportive housing, mental health, substance use, and child care.

These absent dollars represent real lives that are struggling to thrive. Consider these examples:

The Pediatric AIDS Chicago Prevention Initiative, which prevented a single baby from being born with HIV in 2015, is owed nearly $850,000. This program that is recognized as a successful model of prevention for mother-to-child HIV transmission by the Centers for Disease Control and Prevention is in danger of closing. Of the approximately 120 women the initiative served in 2015, no HIV-positive baby has yet been found.

Sisters and Brothers Helping Each Other provides syringe exchange, HIV prevention services, and harm reduction services across downstate Illinois. It has gotten only a fraction of promised funding from the state this year. Now all of it staff are working as volunteers, and it has been using their actual state funding for basic operating expenses.

Local health departments have suffered too. In Will County, for example, the health department announced that it will lay off 53 full-time staff due to a $2.1 million budget shortfall caused by the state's budget impasse.

I fear that Illinois's continued budget saga will hamper its ability to capitalize on the jolt of resources and supports that Secretary Clinton has promised if she becomes President. This story is playing out in other areas hard hit by HIV. We are jeopardizing and crippling our public health infrastructure beyond the point of repair, and lives will be its collateral damage.

It's time, Illinois. Pass a positive budget.

RAMON GARDENHIRE is the AIDS Foundation of Chicago's vice president of policy and advocacy.