Tuesday, February 17, 2009

For years the D.C. Department of Health’s HIV/AIDS Administration (HIVAA) has been the joke agency in a city filled with comedy and error. Speaking of the latter, the agency, in cooperation with the Centers for Disease Control, recently discovered it underreported AIDS-related deaths by 54 percent - 1,337 cases - between 2000 and 2005. The total AIDS deaths in the period was 2,460, not 1,123. How could the city lose 1,337 deaths from AIDS? Hey, in Washington anything is possible.

The city has underreported AIDS deaths each year for the past decade, sometimes intentionally, to keep the public from knowing how serious the epidemic really is. HIVAA, and for that matter the parent Health Department, had been plagued with deficiencies in leadership, constant director changes, and staffing problems throughout the administration of former Mayor Tony Williams. Former health director James Buford was under constant scrutiny by the D.C. Council, and the agency was sued during his tenure in 2003 by an HIVAA whistle-blower; at the time the office was understaffed and unable to tabulate and produce necessary epidemiology reports. For revealing the terrible truth about the woeful agency in testimony before the City Council, the employee, Michael Snoddy, was retaliated against with poor performance reports and downgraded job responsibilities, forcing the council to threaten the management staff with felony violations for their conduct.

Mr. Buford was fired by Mr. Williams in 2004 for, of all things, not quickly addressing issues of lead in the city’s drinking water. A year later, Lydia Watts was fired as director of HIVAA by the new director, Dr. Gregg Pane, for poor management and staffing problems. Dr. Pane, in turn, was fired by Mr. Fenty in 2007 soon after he took office, because the mayor wanted a “more aggressive public health strategy.” The D.C. health soap opera could rival “Days of Ours Lives” or “As the World Turns” (and be longer-running), extending for years even before Mr. Buford’s time, but you get the sorry picture.

Enter Dr. Shannon Hader, who became HIVAA director in 2007. “Shannon is the first person there who understands the need for electronic data and the first truly competent person who, with an aggressive approach, has worked to make the data real,” said Sharon Baskerville, head of the D.C. Primary Care Association. The absence of real data on HIV/AIDS deaths has led to untold millions of dollars wasted or devoted to supposedly targeted prevention and treatment programs with no bull’s-eye. When former Ward 7 council member Vincent Gray became chairman of the D.C. Council, he was astonished to learn that out of the millions of dollars HIVAA spent on AIDS prevention and treatment, not a single penny went to residents of his ward. That is just one of the effects of poor reporting - one whose consequences will bedevil Ward 7 residents for years to come. Another consequence is even more troubling. The entire District has been receiving millions less in federal funding and grants than it needed to attack this problem; while the AIDS rates continue to soar, and people who need treatment go un-served.

The HIV/AIDS Administration is issuing a new updated report this month with the new numbers. It’s a start, but this agency has a long way to go before it can gain the confidence of city residents.

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