Remarks by Ambassador Grenell World AIDS Day Conference Warsaw, Poland, November 27, 2018

November 27, 2018

(As delivered)

It is my pleasure to be here with you during your 25th anniversary conference. I am humbled to speak with you today, especially in light of the very important role which Res Humanae has played in fighting HIV and AIDS across this region.

We gather together today after having made tremendous progress in our fight. Today, someone who finds out they are HIV positive faces a much different and much better path than 10 years ago.

But the challenges we face in combating the stigmas associated with HIV are still vast. This isn’t just a public policy fight for more money or greater access to testing….it is also a moral battle. And one that is as old as time.

I discovered the writings of the British writer C.S. Lewis and the German pastor Dietrich Bonhoeffer many years ago. Their examples compelled me to face the questions of moral absolutes and real world truths – by living authentically and honestly in the image of God.

I am a believer in God. I am a Christian, and a gay man. I cannot hide or censor any part of myself if I want to honor the God who made me.

I talk about my faith today, not to be offensive or to make anyone uncomfortable who doesn’t believe the same way that I do – but to share my personal motivation in fighting moral fights. From my work to my home life, I strive – oh so imperfectly – to live out the message of love, justice, tolerance and fairness.

Bonhoeffer, especially, is a personal hero of mine. He stood boldly against the Nazis when the dark cloud of their hate threatened his home country of Germany. His crisis of faith – and what it means to live truthfully when faced with incredible opposition – has taught me much about courage and moral clarity.

Bonhoeffer was persecuted and murdered for trying to stop Hitler. And Bonhoeffer’s unshakable faith in standing up for the persecuted in the face of evil mirrors the life of Christ, who similarly held firm in the face of the Roman regime.

Christ stood in solidarity with outcasts whose illnesses kept them from fitting comfortably into their society. People who suffered from leprosy were a bit like people who suffer from AIDS today: feared, stigmatized, and greatly misunderstood. And yet when no one else would touch those with leprosy, there was Jesus Christ walking among them. Loving them just as they were. Giving of himself to heal them.

Along with C.S. Lewis, and Dietrich Bonhoeffer, these great men provide models for me, and for us, as we reach out with compassionate programs of healing towards all who are considered outcasts or in need. But this type of stereotyping and stigmatization pose serious challenges to the public policy issues we face today.

From the moment we start school we are asked to check boxes identifying our race, or our disabilities, or our family history. We have learned to categorize information, people, and ideas. These labels, however, have pushed many in the LGBT community away from seeking treatment, testing, acceptance, and even belief in God – and it has caused deep resentment instead of tolerance or love.

The fact is: labels increase stigmas for homosexuals. And stigmas have had serious consequences on our public health.

I believe we can do better – that we can resist society’s impulse to look at only one aspect of a person or an issue. Policymakers, especially, have a responsibility to understand the implications of their words and directives.

We must resist judging whole groups of people based on just one aspect of their lives.

Even if we disagree with one another on social or political issues, we must find ways to put those disagreements aside to meet the healthcare and other public policy challenges we face. Surely government officials, religious, and community leaders can work together to offer healing rather than condemnation or condescending labels.

This problem also transcends demographics and geography. People in the United States and around the world often think of AIDS as a “gay disease” or an “African epidemic,” when the fact is it is neither of those things.

HIV and AIDS are global human problems.

In fact, one of the first AIDS cases in the United States to get major media attention didn’t involve anyone from the LGBT community, or from Africa, it wasn’t a sex worker, or intravenous drug user. It involved a thirteen-year-old boy named Ryan White who had hemophilia.

Diseases do not discriminate or fit neatly into labeled boxes – and neither should our policies.

Ryan White didn’t fit into a preconceived notion of what someone with AIDS was. And it was clear that Ryan White couldn’t wear a political label. But Ryan White made Americans think differently about transmission and treatment.

In 1990, Congress passed the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, one of the first pieces of legislation in the U.S. that dealt with HIV and AIDS. The act – which had strong bipartisan support – originally provided funding that improved the availability of care for low-income, uninsured, and under-insured AIDS patients and their families. Since then, the law has been expanded to help pay for primary medical care providers and support services.

AIDS was never just an American problem, never just a European or an African problem either. AIDS has always been a global problem. In some places, it was becoming a human rights problem. In others, it was destabilizing countries, and even entire regions. And so it became apparent to U.S. policymakers that we could not ignore the AIDS epidemic that was raging in countries outside the United States and that we needed a comprehensive plan to ensure that we could effectively fight AIDS together.

And that brings me to the United States’ flagship program to fight HIV and AIDS on a global scale. PEPFAR, the U.S. President’s Emergency Plan for AIDS Relief, is the brainchild of Pres. George W. Bush. And President Trump proudly continues the program today.

The program was geared to work toward concrete goals through treatment, prevention, and care. And it focused on selected target countries. It included measurements of the outcomes. And the funds were to be used only to combat AIDS.

Through three presidential administrations and changing majorities in Congress, PEPFAR and its mission have enjoyed strong bipartisan support. Fifteen years ago, HIV was a death sentence in many parts of the world. But U.S. leadership has brought the pandemic from crisis toward control; replacing death and despair with hope and life, including for vulnerable populations.

PEPFAR has saved more than 17 million lives, prevented millions of HIV infections, and – community by community, country by country – brought the world closer than ever to controlling the HIV pandemic. In fact, AIDS-related deaths around the world have been cut in half since their peak in 2005.

Through PEPFAR, we have invested more than 80 billion dollars into global HIV and AIDS programs. I’m proud to say that this is the largest commitment ever made by any nation to address a single disease.

Last year, we invested nearly $600 million to strengthen health systems, including nearly $100 million for laboratory systems.

By the end of 2017, PEPFAR supported around 12.9 million children, pregnant women, and adults on life-saving treatment. 8.5 million were directly supported by PEPFAR funds. The remaining 4.4 million were supported through technical assistance, jointly with partner countries.

The people of the United States are very proud of what they have accomplished through PEPFAR.

However, government cannot – and should not – take on the entire burden of HIV/AIDS programs. Over the years, we have developed some very effective partnerships that help us expand our impact. Our strategic partnerships take advantage of the private sector’s unique strengths to drive innovation and deliver results. Private partners can also help us better tailor programs to meet local needs.

When we work with the private sector, we are often better able to reach key populations, who, along with their sexual partners, account for 45 percent of new HIV infections. This reach helps better control the transmission of HIV and meet our ultimate goal of attaining sustainable control of the HIV/AIDS epidemic and elimination of the disease.

For example, we work with the Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson, Gilead Sciences, and ViiV Healthcare on a program called DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe). This program aims to reduce new HIV infections among adolescent girls and young women – who account for 74 percent of new HIV infections in adolescents – in sub-Saharan African countries. DREAMS goes beyond the health sector and digs into the social and cultural issues that can increase girls’ HIV risk, including poverty, gender inequality, sexual violence, and a lack of education.

This summer, the United States and other partners launched the MenStar Coalition. This effort brings together more than 1.2 billion dollars from coalition partners to expand the diagnosis and treatment of HIV infections in men, particularly those in sub-Saharan Africa. MenStar will support innovative approaches that help break the cycle of HIV transmission and enable us to meet our goal of ending the AIDS epidemic as a public health threat by 2030.

Some of our other partnerships focus on providing treatment to and preventing HIV transmission in other vulnerable populations including children.

All of our programs together – both government and private – have saved millions of lives, prevented millions of HIV infections, and brought the world closer than ever to controlling the pandemic.

I know many of you work with people who are HIV positive or who have AIDS. So you are aware that, while the clinical processes of controlling HIV and AIDS are vitally important, we must also consider what people – those who live with the infection every day – need beyond the physical.

First, we need to work hard to eliminate discrimination on the part of health care workers and community leaders. The fear of being exposed – of being shunned – often deters members of vulnerable groups from seeking and obtaining health services. When that happens, transmission becomes more likely and the disease spreads. The protection of human rights and non-discriminatory access to HIV services are essential.

Second, when we develop laws, regulations, and policies related to HIV, we should bear in mind how those laws will affect the target populations and consider the possibility of unintended consequences. We need, in other words, not to rely on our mental “boxes” when approaching policy. If our laws are discriminatory, if they spread false narratives about those living with HIV/AIDS, if they increase the stigma associated with the disease, then we should abandon them and find a better way to achieve our goals.

As we have seen in Ukraine, evidence-based investments means annual new HIV infections have fallen by 30% since PEPFAR began its support there. Poland should also provide greater access to new, safe, and internationally recommended regimes – because they work!

On the other hand, problems such as insufficient access to sterile injecting equipment and scarcity of opioid substitution therapies are stymying efforts to prevent new HIV infections among drug users in Russia – home to 70% of those living with HIV in the region.

But we also need to think about creative ways to prevent transmission in our communities by helping to raise awareness, especially among young people.

These kinds of projects don’t necessarily have to be expensive or complicated. Earlier this year, Embassy Berlin put together a social media campaign urging everyone to get tested for blood cancers.

As I discovered through personal experience, blood cancer is easily detected with a simple test. I firmly believe that getting tested for AIDS should be as free of stigma as getting tested for a blood cancer.

I’m hopeful that all of us will stop using stereotypes and embrace everyone, especially the young LGBT people around us. Rather than shunning them or forcing them into the labeled boxes of the past, these young men and women need to be publicly supported, and loved.

Dietrich Bonhoeffer said it best: “God does not love some ideal person, but rather human beings just as we are, not some ideal world, but rather the real world.” The Gospel of Matthew challenges us not to recoil from poverty or disease. It tells us that God does not condemn people for their past mistakes or demand that they smooth out their rough edges before he loves them or meets their physical needs. Instead God instructions us to: ‘Heal the sick . . . cure those with leprosy . . . and Give as freely as you have received!’ (Matthew 10:8).
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