Next January, a new president will be sworn in outside the U.S. Capitol and endowed with a mandate from the American people to run the country as he or she sees fit. As they are every four years, the fates of a multitude of government programs, advocacy groups and special interests will be suspended in the budgetary ether, waiting for policy decisions by whoever walks down the halls of Congress and works in the house at 1600 Pennsylvania Ave. For HIV/AIDS advocates, a President Clinton or a President Sanders brings with it the possibility of increased funding and a commitment to fighting the virus, while a President Trump portends a considerably less optimistic prospect. But, regardless of who becomes president, there will be an uphill battle to attract eyes and wallets to an issue that seems to fade farther from the national consciousness each year.
In 1987, as the AIDS epidemic was hitting full stride in the United States and public fear of the virus was at its height, a Gallup survey found that a staggering 68% of Americans said AIDS was the most urgent health problem facing the country. Fast forward through nearly three decades of scientific breakthroughs, public health initiatives and advocacy campaigns, and today only 1% of Americans cite AIDS as the country’s most urgent health problem.
On the one hand, this is tremendously positive. The precipitous decline in the general public’s urgent concern about AIDS is precisely because of all the advances that have been made since the 1980s and the fact that an HIV diagnosis has changed from a death sentence to a serious but manageable chronic illness that no longer prevents people from living full, healthy lives. On the other hand, the advent of ever more effective antiretroviral drugs and the sheer magnitude of positive people living well has turned HIV from the health crisis that defined a decade to one of many diseases fighting to differentiate themselves in the quest for media attention, political support and funding.