Lucy Bradley-Springer says she resigned, along with five others, from the Presidential Advisory Council on HIV/AIDS because the Trump administration has ignored the epidemic while backing policies that would hurt its patients
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AARON MATÉ: It’s the Real News, I’m Aaron Maté. Six members of the Presidential Advisory Council on HIV/AIDS have resigned in an act of protest. The council members say President Trump has ignored the HIV/AIDS epidemic since taking office. They also fault the Republican attempt to appeal the Affordable Care Act, and taking aim at Medicaid. They write, “We have dedicated our lives to combating this disease and no longer feel we can do effectively within the confines of an advisory body to a President who simply does not care.” Well, one of those who resigned from the Presidential Advisory Council on HIV/AIDS is Lucy Bradley-Springer, editor of the Journal of the Association of Nurses in AIDS Care. I spoke to her earlier today. Lucy, welcome. LUCY BRADLEY-SPRINGER: Thank you. AARON MATÉ: The statement that you signed along with five colleagues says that President Trump simply does not care about HIV/AIDS. What led you to draw that conclusion? LUCY BRADLEY-SPRINGER: Well, after the inauguration, the President’s Advisory Council on HIV/AIDS sent two letters to the administration to say, “Welcome. Here’s who we are, here’s what we do, here’s how we would like to help with making sure that policies related to HIV infection were in place that would be beneficial to people living with and at risk for HIV.” The letters we got back from the administration were from lower level officials and they were pretty much the kinds of letters you get back from your senator when you ask him to do something that he doesn’t want to do. They acknowledged that we had a point, but did not make any plans to move forward with working with PACHA. I’m not assuming that they would agree with everything that we did, but I wold expect them to want to work with us, and that did not seem to be forthcoming. AARON MATÉ: The push back that I’ve seen from the White House on this is that part of this was simply just part of the turmoil associated with transferring over to a new administration, that they were still getting their house in order. One administration official told Buzzfeed that you and your five colleagues didn’t bring your concerns to Katy Talento, who was tapped to lead health policy at the Domestic Policy Council. What’s your response to that? LUCY BRADLEY-SPRINGER: Well, I only learned about Katy Talento a few days ago. From what I can tell, she has done work in HIV and has done a good job in that. We are concerned, however, about some of her other policies which are not evidence-based, and her … The way that she is not in favor of the ACA or in making sure that if abortion is needed that it’s safe and available for women. AARON MATÉ: On that point, that has been a part of the Republican efforts around healthcare, since they took office, in seeking to repeal the Affordable Care Act, that was enacted under President Obama. Can you talk about how that push factored into your concerns? LUCY BRADLEY-SPRINGER: Well, that was probably the biggest piece of the pie. I am very concerned about what’s going on with healthcare. I am in favor of the ACA, I would like to see it continue, but I’m not stupid. I know that there are problems with the ACA. What I would hope would happen in Congress would be that they would look at the ACA, figure out where the problematic areas are, and work to fix those problems, rather than just throw the whole thing out. I am concerned about what came out of the House of Representatives. That bill was pretty devastating for people who need healthcare support the most. The second version, they did add some things back in, such as the preexisting condition issue where if you have a preexisting condition, that your health insurance still has to cover it, but they put it in in such a way that each state could make a decision to not do that if they wanted to. The states would have a lot of discretion in what they did or did not cover. The states that can’t afford to cover preexisting conditions are the states that are already having a lot of problems under the ACA, because they didn’t expand Medicaid. I’m concerned about decreasing the amount of funding available for healthcare by decreasing the money going to Medicaid, and I am especially concerned about how that will affect people living with HIV. All people … AARON MATÉ: How would it particularly affect people with HIV? LUCY BRADLEY-SPRINGER: Well, what we know about people living with HIV is that as the epidemic has progressed, this has more and more become a disease of people who live in poverty. People who don’t have the resources or the knowledge to prevent getting infected in the first place, and once they are infected, they don’t have the resources or the knowledge of where to go. There are also a lot of people out there who are infected and don’t know yet, so there have been some concerted efforts to get people tested, to do prevention with them if they aren’t infected, and if they are infected, to get them into care. The ACA supports all of those services. AHCA doesn’t really meet that standard that … AARON MATÉ: Just to clarify for people, that’s the Republican repeal bill. Sorry, go on. LUCY BRADLEY-SPRINGER: Right. The American Health Care Act is what the House of Representatives sent to the Senate. I don’t know if they will call it the same thing or not, but that’s the AHCA, that’s what it’s under. The ACA is the Patient Protection and Affordable Care Act, which is also known as Obamacare. Now, Obamacare covers a lot of things that have to do with prevention. As a matter of fact, most things having to do with prevention. People who … You don’t even have to be covered by the ACA. I recently needed a mammogram and there was no co-pay on that for me because of the ACA, even though I have separate insurance from the ACA. The concerns are huge on my part about prevention. The concerns are also huge on my part about getting people into care, keeping them in care, and making sure that they get the meds that they need and take the meds. HIV infection is a chronic disease. We don’t have a cure for it yet. It would be nice, we hope we’ll get one, but we don’t have one. We don’t have a vaccine for it, so we’re dependent upon people who are infected getting the treatment that they need. If they get the treatment that they need, they can live a regular lifespan and be pretty healthy throughout that whole lifespan. They also will have the number of viruses in their body go down. The fewer viruses in their body, the less risk that they have of transmitting the infection to other people. Getting people who are infected treated has a double effect. One is the personal effect of keeping you healthy and alive, and the other is the public health effect which is keeping you from infecting other people as you move through your life. AARON MATÉ: You mentioned earlier the links between HIV/AIDS and poverty. I’m wondering, as someone who works in health policy, did you see a big shift in the attitude towards this very important framework for understanding disease, in terms of it being closely tied to poverty, from the Obama administration to then the Trump administration, and the people that he’s put in place? LUCY BRADLEY-SPRINGER: I have seen a huge shift in policies from the Obama administration to the current administration. I don’t know if it’s related to the fact that poverty … I have a saying. Money isn’t the root of all evil, poverty is. Poverty creates situations where people do things just to survive that are not healthy. People get diseases, and it’s not just infectious diseases. People who live in poverty have higher rates of cardiovascular disease and lung disease, and lots of other problems. What it has done is that in the early days, we saw a lot of middle class gay white men who were infected, who were taking up the mantle and becoming advocates for themselves. Now we have a lot of people who live in poverty who don’t have those skills. They didn’t learn those skills all along, they don’t have the economic background to be able to take time off from work, to spend time doing advocacy. A lot of these folks can’t advocate for themselves. They need to have access to healthcare as much as we all do, but they don’t have the ability to stand up and say, “Wait, this isn’t right.” With poverty being an issue, we’re seeing a shift in the demographics of the epidemic to shifting towards people who don’t speak up as much as they should. The shifts that I have seen from the Obama administration to the current administration that we saw during the campaign, during the post-election period between the election and the inauguration were a lot of voices coming out, especially from appointees of this president that have clearly demonstrated that they have problems with women, with women’s healthcare, with not caring as much about people who live in poverty. I have seen some stories where people are saying that the reason the Republicans want to get healthcare taken care of is that they’re hoping it will free up some money so that they can do tax reform. That to my mind is not the best way to approach the needs of healthcare in this country. AARON MATÉ: Lucy, given all that, given this picture that you’ve just laid out where a large segment of the patients who have HIV/AIDS don’t have the economic freedom as you said, to be able to advocate for themselves in a forcible enough way, simply because as you said, it takes time, it takes resources to be able to be an activist and to raise awareness of your plight. Can you talk about the struggle, I imagine you faced, in terms of deciding whether or not to stay within the system and do what you can as a member of the Presidential Advisory Council on HIV/AIDS or do as you did, which is resign in protest in the hopes that that might raise awareness and draw attention? LUCY BRADLEY-SPRINGER: It absolutely was difficult. I’m a nurse and there haven’t been very many nurses on the Advisory Council. I really felt honored when I was appointed by the Obama administration to serve, and I felt like nursing needs to have a voice at that table. Nurses are the largest group of healthcare providers in the world, and we often don’t get asked for our opinions. It was an honor, but I also felt it was a big responsibility, and I took that to heart. I felt like the things that we were doing during the last two years have been very beneficial. We have made good suggestions about how to take care of some of the problems that people living with and at risk for HIV were having. I do feel like I was able to contribute to that, so I was feeling very pleased with the council for including nursing and for making sure that we had a voice. Leaving the council where nursing is at risk of having even less of a voice was the crux of my problem, with deciding to stay or go. As we move forward and as people started talking in the council, and when Scott Schoettes sent an email around and said, “You know, I don’t think that staying on this council is the right thing for me to do. What about the rest of you?” That pushed me a little more to think about what would be the appropriate response. As I thought about it harder and harder, not only did I think that I personally wouldn’t be making a huge difference by staying on the council, I also felt that I personally needed to protest what was going on, and it seemed like leaving with this group of my five colleagues and me would be the best way to make a statement that might be heard more than if I stayed on the council. Because I think some of the things that are going on are happening out of ignorance, and we need to stop people who are working from ignorance and help them understand why this is so important. AARON MATÉ: Well, Lucy, I’m sure that the act that you and your colleagues took in resigning from the Presidential Advisory Council on HIV/AIDS will help towards that goal of combating ignorance on the issue. Lucy Bradley-Springer, former member of the Presidential Advisory Council on HIV/AIDS, and Editor of the Journal of the Association of Nurses and AIDS Care. Lucy, thank you. LUCY BRADLEY-SPRINGER: Thank you, Aaron. AARON MATÉ: And thank you for joining us on The Real News.