Ending the AIDS Epidemic Task ForceOctober 14, 2014

Opening Remarks by Task Force Co-Chair & Housing Works President & CEO Charles King

I dont know about you, but I woke up this morning with a thrill of excitement that we are officially
convening today to begin planning the end game for AIDS as an epidemic here in New York State,
an occasion for which many of us have yearned now some thirty years.
I also awoke with a heart full of gratitude. So many people have made this convening possible. Mark
Harrington first challenged me two years ago, sitting in a jail cell in Washington, DC, with the idea
that New York State could and rightly should be the first in the nation to show that we can end
AIDS as an epidemic. Other members of the community, including VOCAL and Harlem United
quickly caught the same vision. There have been people like Dan Tietz and Sheila Healy, who rallied
the larger AIDS and LGBT communities, organized community letters, and literally stalked the halls
of Albany, with so many of you responding to every call for action. Tim Horn wrangled drug
manufacturers, demanding that they become partners in ending the epidemic, and Patrick
McGovern first brought Gilead to the table to make ending AIDS something New York could not
afford not to do.
Having both argued with and partnered with the AIDS Institute for so many years, I have been
deeply moved at how forcefully Dan OConnell, Johanne Morne, Ira Feldman, Lynn Stevens, and so
many others have championed an End of AIDS. Elsewhere in the Department of Health we have
had key champions, including Gus Birkhead, Sue Kelly, former Commissioner Nirav Shah, who first
publicly committed New York State to ending the epidemic by 2020 last January, current acting
Commissioner Howard Zucker, and folk like Jason Helgerson and Greg Allen, who have strategized
and run interference for us at every turn. Rob Kent at OASAS has been stalwart in his commitment,
and more recently the vision of ending AIDS has been whole heartedly embraced by every person
with whom we have met in the de Blasio Administration in New York City. Finally, I want to
publicly express my gratitude to Courtney Burke, who from our first meeting, a year ago last August,
has been our stalwart champion in the Governors office, and Fran Reiter, who during her brief
tenure, weighed in to make ending AIDS a priority for the Governor. And, last but not least, I want
to acknowledge Governor Andrew Cuomo, first for his boldness as the first Governor in this nation
to commit to a definitive date to end the epidemic, and second, for courage in allowing the
appointment of a Task Force laden with so many trouble-making activists to develop the
recommendations to make his plan a reality.
I also awoke this morning feeling the heavy weight of the responsibility that we as a task force now
collectively bear. Gus, I feel as if there is, perhaps unseen, a balcony just behind us, with familiar
faces looking down to see how well we will carry out our task. Faces like those of Nick Rango, of
Dennis DeLeon, of Vito Russo and Bob Rafsky, of Phyllis Sharpe and Ilka Tanyan Payan, of Mark
Fisher, Tim Bailey, and Aldyn McKean, of Joe Bostic, Joe Capastany and Keith Cylar, and of many
others too numerous to name.
Some sitting in that balcony came to believe that for them there was no hope, but they fought with
every ounce of strength that they had on behalf of those who followed behind, some even urging us
to carry their ravaged and wasted bodies through the streets so that their voices would be heard even
after their deaths. Others were more circumspect. I remember a conversation with Nick Rango, after
a particularly bad bout of illness. I feel like I am on a conveyor belt in some giant factory, he said.
Every time someone else dies of AIDS, it lurches forward.It keeps moving faster and faster, and
there is nothing I can do to slow it down. And then we went back to our argument over what HIV
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prevention requirements to impose on long term care facilities.
Then there were those who refused to accept their fate, angry but always laughing, dancing until
their last breath, always turning us toward the light, always insisting on holding firm to hope even
when there was no hope. We who survived those years owe it to these our heroes to do their lives
justice here today.
But these are not the ones to whom we bear the greatest responsibility. Rather, it is to those among
us who are living with AIDS and HIV. Some of us are living quite well, albeit with a chronic
condition. Others, however, men and women, young and old, all too often poor and struggling with
other life-inhibiting conditions, remain afraid, ashamed, or all alone, still dying prematurely, or
leaving one form of prison or another with no place to turn.
And then there is our responsibility to those who are not yet infected but most at risk, that young
new immigrant who landed somewhere in the mid-Hudson Valley, the young transgender woman in
Buffalo, the young gay man, really still just a child, in East New York, just beginning to discover
them-selves and seeking to find their own way. We owe it to them to make the Governors words
about an End to AIDS a reality.
Finally, there are the others for whom words like AIDS Free Generation, The Three Zeros, and
A World Without AIDS remain nothing more than feel-good slogans. Whether in Mississippi or
Malawi, they are depending on us. If we succeed in making a coherent set of recommendations that
bring about an end to AIDS as an epidemic here in New York, we will have laid out a path for other
states and even other nations to follow. And if we fail...
Well, I would like to briefly offer a few suggestions that will ensure that we not fail. The first is to
keep our eye on the prize. Governor Cuomo has laid out three solid pillars around which to
construct a plan to end the epidemic:
identifying those who are unaware that they are positive and getting them tested and into care
complete viral suppression for everyone already living with HIV
and scale-up of prevention technologies such as PrEP for those who are most at risk.
We know that if we are successful in doing these things, we can end the epidemic. But we also know
that these are all hard things to accomplish and that they require multi-layered approaches that treat
people with respect and dignity. As part of keeping our eye on the prize, we should start by coming
up with a common set of definitions and metrics that will tell us and the rest of the world that we
have succeeded in our task.
The second is to stick with what we know works. Fourteen months ago, we in this ad hoc
community coalition provided the State with what we believe are the five key elements of a
successful plan to end AIDS. These include:
1) scale-up of 21
st
-century surveillance tools
2) evidence-based combination HIV prevention for both HIV-negative and HIV-positive persons
3) broad implementation of validated services and interventions to fill the gaps in the HIV
continuum of care
4) ensuring the availability of housing and essential support services for all New Yorkers,
whether HIV-negative or HIV-positive
5) continuing commitment by political leaders and all New York communities to ownership of
the NYS Plan to End AIDS.
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We have already achieved victories in many of these areas, including changes in our HIV
surveillance law, increased rebates from key drug manufacturers to allow expanded access to ARVs,
expanded housing affordability in New York City, and even the appointment of this task force. We
must build on these successes.
Third, if we are to be successful, we must leverage the work that has already been done in New York
State, including Medicaid redesign and the way in which we have adopted the Affordable Care Act.
We cannot end the epidemic, I would suggest, unless we are fully able to maximize the use of
DSRIP, health home, the HARPs, and other such initiatives for this purpose.
Fourth, we need to be honest, transparent, and follow the science, including solid implementation
science. We should be rigorous with our debate, but we also need to be rigorous with our data. We
should be open to any ideas, however foreign, and then evaluate them against what we know and are
learning each day. Then we should set out metrics for measuring the success of each one of our
recommendations. I have no doubt that some of the recommendations we will consider at this table
will be challenging for our Governor and other key stakeholders to adopt. But I am equally
confident that if we allow the data to lead us, we will be able to assemble a set of recommendations
that work to End AIDS as an epidemic by 2020.
One final thought and then I will be done. The End of AIDS is what has brought us all to this table.
But what we are about is much bigger than just AIDS. After all, as Ebola is teaching us even today,
there will always be another virus ready to take advantage of our own inhumanity. If we do our job
well, we will have not only ended AIDS, but we will have helped to make New York a better place, a
place where those cast to the margins will find themselves at the center of our care and concern.
Thirty years ago, AIDS forced me out of the closet as a young gay Baptist minister, standing at the
bedside of our minister of music, who believed God was punishing him because of his sexual
orientation. After leaving my position at Immanuel Baptist Church, I, like so many others, eventually
found myself in the LGBT community center in the West Village of Manhattan on a Monday night
at a meeting of ACT UP New York.
Sometime later, in October of 1988, I joined some of the people who are in this room on a trip to
the Federal Drug Administration that changed the course of the epidemic. The day before that now-
famous demonstration, we gathered for a not-so-well remembered rally in front of the headquarters
of the United States Department of Health and Human Services. It was there that I heard Vito
Russo articulate a vision that I have held onto as my personal calling ever since:
Someday, the AIDS crisis will be over. Remember that. And when that day comes when
that day has come and gone, therell be people alive on this earth gay people and straight
people, men and women, black and white, who will hear the story that once there was a
terrible disease in this country and all over the world, and that a brave group of people stood
up and fought and, in some cases, gave their lives, so that other people might live and be
free.And then, after we kick the shit out of this disease, were all going to be alive to kick
the shit out of this system, so that this never happens again.
It is the fulfillment of that vision, I would suggest, that brings us together here today.