Indians’ AIDS funds low
American Indians are losers in the battle for federal assistance to stanch the spread of AIDS in their communities.
That’s because the number of Indians afflicted with the deadly disease is small compared to other racial and ethnic groups in more populated areas.
Through 2003, the latest figures available, there have been 3,026 documented Native American cases, compared with more than 350,000 cases each for whites and blacks, about 173,000 Hispanic and just over 7,000 Asian.
With most money directed toward big cities with lots of documented cases, such as New York, Los Angeles or Oakland, Calif., little is left for reservations.
“In some ways, the Navajo AIDS Network needs the money more than Oakland,” said Marsha Martin, executive director of AIDS Action in Washington, D.C., which lobbies for HIV/AIDS programs and policy. “We might be able to prevent some things from happening on the reservation. We can only intervene in Oakland.”
The federal government spends about $16 billion on HIV/AIDS in the United States, including about $11 billion through Medicaid, Medicare and Social Security.
About $2 billion is allocated to the Ryan White CARE Act, designed to help care for people with AIDS who do not have adequate health insurance or other resources.
No one can say how much is spent directly on American Indians, but the money is focused on urban areas, not reservations. In 2004, the Indian Health Service received about $3 million for HIV assessment, prevention and treatment.
But the number of Indians afflicted is actually far greater. The undercount is due to racial misidentification, lack of testing in rural areas with few clinics, concerns about privacy in the Indian Health Service and denial in communities where religious stigma has replaced traditional acceptance, Native American leaders say.
“There hasn’t been enough money since the beginning,” Martin said. “Minorities are always on the short end of the budgeting.”
And Indians are the smallest of minorities in the United States.
They are also the sickest from other diseases, such as diabetes. And their health care, promised through treaties, is funded at less than half as much per person as that for federal prisoners. Policies are shortsighted, Indian leaders complain, because they focus on treatment rather than prevention. An onslaught of AIDS could wipe out whole communities, they add.
“I suspect that sooner or later we will start to see much higher rates (of AIDS),” said Dr. Jim Cheek, director of the Division of Epidemiology for the Indian Health Service.
“How are we going to detect when that happens? Are we going to be able to bring resources to bear?”