On March 19, the Centers for Disease Control and Prevention (CDC) awarded $115 million over five years to 21 organizations to provide technical assistance (TA) and capacity building to health departments, AIDS service organizations (ASOs) and community-based organizations (CBOs) implementing high-impact prevention and improving outcomes in the care continuum for people living with HIV/AIDS. Not one of the new CDC grantees 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.
It is obvious why this should be an issue of concern for Black people, for the public at large and for anyone who is sincerely interested in ending the AIDS epidemic in America. 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, the rate is 32 percent.
At a time when Black Americans are less likely to be linked to care, are less likely to be retained in care, are more likely to be diagnosed later in their disease, have poorer outcomes and die quicker than any other racial or ethnic group in the country, the decision by the CDC not to fund any Black organizations in this program further dismantles what little infrastructure exists in Black communities to address the HIV/AIDS epidemic. Health departments and organizations that desperately need assistance in building the capacity to respond to a rapidly changing health care environment will be unable to turn to a technical-assistance provider grounded in the experience of Black communities.
To exacerbate this problem, over the last few years, a number of Black AIDS organizations have had to close their doors because of lack of funding. Both CDC and Black AIDS service providers will offer various reasons that this happened. The CDC might maintain that the pool of Black organizations that applied was small, some did not demonstrate sufficient programmatic capacity, some had administrative challenges, while others were eliminated for technical reasons associated with the application. ASOs and capacity-building assistance (CBA) providers might counter by saying that the process completely disregards the value of cultural competency, denies Black organizations opportunities to focus on areas where they are strong, and inherently advantages larger organizations that can farm out their grant writing over smaller organizations that are better equipped to deliver the needed services but less equipped to prepare the grant applications.
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