When news hit that another Wall Street financial institution was on the verge of collapse, the response from rivals Sen. John McCain and Sen. Barack Obama was swift.  Both candidates issued statements touting their respective economic plans.  What kind of impact could our presidential candidates make if they responded as quickly to the domestic and global HIV/AIDS crisis?

News that blacks, who make up just 12 percent of the total population, account for 46 percent of new HIV incidences was certainly cause for alarm in my world.  It's clear that we should add HIV/AIDS policy to the list of things in need of change.  So as the presidential campaign moves into the final stretch, I decided to take a look at the two major political parties and what their nominees offer to address the global and domestic HIV/AIDS crisis.

Sen. McCain has not issued a formal HIV/AIDS plan or a strategy to address HIV/AIDS domestically or globally. Sen. McCain does have a domestic health reform plan to expand access to healthcare coverage - a plan that would use tax rebates to shift Americans from employer-based coverage into the individual insurance market - but he does not support policies that would prohibit insurers from denying coverage based on pre-existing conditions, so HIV positive people seeking insurance on the private market may not be able to secure coverage.  On the issue of global HIV/AIDS, Sen. McCain supports the President's Emergency Plan for AIDS Relief (PEPFAR), with ideologically-based restrictions intact.  McCain has suggested that contraception has no part in an HIV prevention program and supports abstinence-only programming. If elected, McCain says he would call for the creation of a new international organization to link democratic nations together to address challenges including HIV/AIDS and the eradication of malaria in Africa.

Domestic and global policy development to address HIV/AIDS was largely ignored during the Republican National Convention.  There was no mention made of the domestic HIV/AIDS crisis and only passing references made to the global epidemic. Neither Republican Presidential nominee Senator John McCain nor Vice Presidential nominee Governor Sarah Palin mentioned HIV/AIDS in their speeches before delegates at the Republican National Convention.  When First Lady Laura Bush spoke of AIDS in her address she noted the number of Africans receiving AIDS treatment through PEPFAR, a program spearheaded by her husband President George Bush. Yet no speakers at the Republican National Convention addressed the HIV/AIDS epidemic in the United States and the 2008 Republican platform offers no direct plan to address it.

In contrast, Democratic Presidential nominee Sen. Barack Obama introduced a plan to address HIV/AIDS in 2007.  That plan supports the creation of a National HIV/AIDS Strategy, a coordinated plan to address HIV domestically, set targets for decreases in infection rates and respond to health disparities. He supports expanding Medicaid coverage to all low-income people living with HIV/AIDS and he supports the Ryan White CARE Act, the US's largest federally-funded program for people living with HIV and AIDS. Obama's plan would focus on eliminating disparate impact of HIV/AIDS, particularly in minority communities. On the issue of prevention, Obama supports age appropriate comprehensive sex education and federal funding for needle-exchange programs.  Obama's broader healthcare proposal would promote universal healthcare coverage by building on the existing public and employer-based system and by creating new coverage options for the uninsured.  Insurers would be prohibited from denying coverage based on individuals pre-existing health conditions or from charging higher premiums based on health status. Low and moderate-income individuals would be provided premium subsidies to ensure that coverage is both available and affordable for people living with health conditions such as HIV/AIDS.

To address the global issue of HIV/AIDS, Obama proposes providing $50 billion by 2013 to go towards the United States' global AIDS efforts through PEPFAR.  That proposal includes an increase in our commitment to the Global Fund to Fight AIDS, Tuberculosis and Malaria. Obama would double foreign assistance to $50 billion by 2012 through his global development plan and coordinate the consolidation of foreign assistance initiatives into a restructured aid program. Obama supports increasing our national investment in the healthcare infrastructures of developing countries so those countries can better address public health challenges and he supports the cancellation of debt for those countries.

The domestic and global challenge of HIV/AIDS was addressed at the 2008 Democratic National Convention where the 2008 Platform specifically calls for a National AIDS Strategy.  When speaking at the DNC, former President Bill Clinton praised Senator Obama saying, "He will continue and enhance our nation's commendable global leadership in an area in which I am deeply involved: the fight against AIDS, tuberculosis, and malaria, including -- and this is very important -- a renewal of the battle against HIV and AIDS here at home."   In addition to President Clinton's call for a renewed focus, Representative Barbara Lee and Representative Maxine Waters also called for a National AIDS Strategy.

The Centers for Disease Control and Prevention (CDC) recently released an analysis of their 2006 HIV/AIDS data.  The analysis looks at the number of new HIV infections in 2006 and who is represented in that number.  The CDC found that 53 percent of the estimated 56,000 cases of new HIV infections in 2006 were among gay and bisexual men.  Forty-six percent of the infections occurred among blacks. Within the gay and bisexual group, young black men between the ages of 13 and 29 years old were roughly twice as likely to get infected as young white and young Hispanic men within that same group. Among women, black women were almost 15 times more likely to get HIV than white women and are almost four times more likely than Hispanic women.

The revised CDC HIV/AIDS figures and the analysis of those figures further highlight the urgency of the HIV/AIDS crisis in the United States.  Yet, although the United States requires that PEPFAR-funded countries have national coordinating strategies on HIV, we continue to try to operate without one.  Voters must add a candidate's HIV/AIDS policy to our evaluation of a candidate, because trying to address the global and domestic challenge of HIV/AIDS without a National AIDS Strategy makes about as much sense as trying to govern without a budget.