President Trump and HIV/AIDS

AIDS Rethinkers glimpsed a momentary ray of hope at the news that President Trump had fired the Presidential Advisory Council on HIV/AIDS; could it be that government policies on AIDS might become evidence-based?

I suppose that is not entirely impossible, but this presidential action is no indication of it. One possible reason for the firing is simply that a new administration chooses new sets of advisers; and Trump has shown that he wants to undo everything the previous administration had done.

Another possible reason is that 6 months earlier, half-a-dozen members of the Council had resigned in protest, stating that
“The Trump Administration has no strategy to address the on-going HIV/AIDS epidemic, seeks zero input from experts to formulate HIV policy, and — most concerning — pushes legislation that will harm people living with HIV and halt or reverse important gains made in the fight against this disease …
the final straw for us — more like a two-by-four than a straw — is President Trump’s handling of health care reform”.
It is well known that Trump is enraged over any criticism, and those statements alone, made publicly in Newsweek, would be enough to goad him to “clean out” that whole Council.

Further, it is also known that Trump is largely ignorant of details on any topic, so what happened re HIV/AIDS may reflect only the attitude of some aide in the White House who is perhaps actually opinionated about HIV/AIDS or is just following the current extremist wing of the Republicans to dismantle as much as possible of all government activities.

In any case, any genuine turning from present policies and actions about HIV/AIDS would require that the National Institutes of Health replace Anthony Fauci and make a wholesale change in the AIDS division of the National Institute of Allergy and Infectious Diseases. Such a move would be opposed by all the interests vested in present-day HIV/AIDS policies — all the bureaucratic niches involved, and most notably the drug companies, which presently are in effective control of Congress on all health-related matters. There is no actual sign in practice of any significant change in continuing policy about HIV/AIDS:

“Federal funding for HIV has increased significantly over the course of the epidemic, rising from just a few hundred thousand in FY 1982 to more than $32 billion in FY 2017”; the Trump budget request for FY 2018 has an estimated $32.0 billion for combined domestic and global HIV efforts. If enacted by Congress, it would mark a decrease in funding for HIV of $834 million, or 2.5% … compared to current levels ($32.9 billion). Most of this decline would be in the global portfolio (a $1.2 billion or 18% decline), although domestic discretionary programs would decline by $789 million or 10%; mandatory funding would continue to increase” (U.S. Federal Funding for HIV/AIDS: Trends Over Time, 9 November 2017.

Above all, the sad and bitter fact is that truth-seeking does not have a political constituency, be it about HIV, AIDS, or anything else.