The Black AIDS Institute released a report July 29 titled Left Behind, Black America: A Neglected Priority in the Global AIDS Epidemic.  Funded by the Ford Foundation and the Elton John AIDS Foundation, the report praises the federal government's response to the global AIDS pandemic but criticizes its domestic response to the AIDS epidemic among African-American people. Phill Wilson, CEO of the Black AIDS Institute, spoke with POZ about the report and why leadership from the presidential candidates is crucial.

“When AIDS hit America, there used to be an emphasis but black people were not sufficiently addressed,” Wilson says. “Then the global epidemic hit and black people in the United States are still not getting the kind of attention that they deserve.”

More black people in the United States are infected with HIV than the total populations of people living with HIV in seven of the 15 countries served by PEPFAR, the $48 billion plan to fight global HIV/AIDS, tuberculosis and malaria (President Bush reauthorized the plan this week). Left Behind poses the following conundrum: “How can the United States lead a fight against AIDS around the world, when their own are dying here at home?”

Left Behind not only re-emphasizes familiar stats: In the United States black women are 23 times more likely than white women to be diagnosed with AIDS; and black people make up 70 percent of new HIV diagnoses among teenagers and 65 percent of HIV-infected newborns. But the new report also sheds a unique light on the issue. “This is the first time that we are framing the black epidemic in a global context,” Wilson added, “We have the first analysis of looking at black America through the lens as it being a free-standing country.”

And as a separate nation, its results are abysmal: While black America would constitute the world's 35th most populous nation, it would rank 16th in the world for people living with HIV, 105th worldwide in life expectancy and 88th in infant mortality. Black people in the United States have a lower life expectancy than the citizens of Algeria, the Dominican Republic or Sri Lanka.

Despite these stats, Wilson is clear that in no way are he and his co-authors Kai Wright and Michael T. Isbell trying to pit the U.S. epidemic against the global pandemic. Instead, they want to illuminate the desperate need for domestic-based complex approaches to solving the epidemic, especially since our government has no national AIDS strategy at this time.

“A more effective approach for black America would include a mix of targeted programs for high-risk populations, broad-based initiatives that mobilize entire communities, and efforts to address the role of concurrent partnerships and the rapid spread of HIV transmission in social networks,” Wilson says.

After releasing the Left Behind report to the press, Wilson held a press conference July 29 with Helene Gayle, MD, president and CEO of CARE; the Rev. Al Sharpton, president of the National Action Network; and Jacob Gayle, MD, deputy vice president of the Global HIV/AIDS Initiative at the Ford Foundation.

“The response has been fundamentally flawed with a ‘one size fits all' attitude'. We have to look at harm reduction, MSM [men who have sex with men] concerns incarceration and lack of access to health care to address the reason why too many blacks who test positive will develop AIDS within 12 months of diagnosis,” said Gayle at the press conference. “We need broader, more intense initiatives designed by and for blacks.”

Most experts agree that black community leaders, churches and longstanding organizations such as the NAACP must continue to mobilize in order to raise awareness and increase HIV testing. However, Wilson believes that having an “honest ally in office” is also crucial.

The Black AIDS Institute has not publicly endorsed a presidential candidate, but Wilson made it clear to POZ which one he believes is more committed to the fight against HIV/AIDS.

“The Obama campaign has endorsed a national response, and Obama himself has been publicly tested,” Wilson says. “McCain has not demonstrated leadership on this issue.”

That silence might change—on August 16 both Obama and McCain will attend the Rev. Rick Warren's Megachurch Forum in Lake Forest, California. One of the topics on the agenda is HIV/AIDS.

To read Left Behind, Black America: A Neglected Priority in the Global AIDS Epidemic, click here.