Washington D.C. is the only capital city of a democratic country without self-governance or national representation. Congress can veto local spending and legislation, and the district's delegates at the Capitol do not have the right to vote there. D.C. has been fighting for proper representation in Congress for generations, and the slogan "Taxation Without Representation" is etched on the license plates and psyches of the city's residents. Federal meddling also limited local health spending, this has fueled the HIV epidemic in DC.
To promote D.C. self-rule and legislative representation, four Occupy DC activists began a hunger strike on December 8th. The original hunger strikers Kelly Mears, Adrian Parsons, and Sam Jewler have since been joined by Joe Gray. After many years of direct action protests, this is the first hunger strike for D.C. self-rule. The activists say they see this as an opportunity to empower Washingtonians to be active in their city and improve their communities.
"The fact this [lack of representation and self-rule] has been going on for 200 years is really a problem," said Jewler. "We are paying federal taxes, but are not being represented in the federal government. We are sending soldiers to war, but not being able to decide what wars they go into and why they fight." Lifelong Washingtonians have seen their city and country changed significantly with no representative voice of their own.
In the 1980s and '90s, when the HIV epidemic first hit D.C., the federal government banned the use of city funds for needle exchange. At the same time, the federal government was in denial of the rapid spread of the HIV epidemic and was deeply entrenched in the war on drugs, which further criminalized nonviolent marginalized populations across the country.
The New York City Harm Reduction Coalition, in a press release, said, "extensive research demonstrates that syringe exchange is a highly successful, cost-effective intervention that reduces HIV transmission among injection drug users." As the HIV epidemic expanded, needle exchanges and harm reduction centers in metropolitan areas around the country used private funds, allowing clients to trade dirty needles for clean ones and providing help to overcome addiction if they wanted it. According to Professor Karyn Pomerantz of the George Washington University School of Public Health, "intravenous drug use accounts for 19 percent of HIV infections, and needle exchange programs lower incidence rates by 80 percent."
The federal government eventually lifted the ban on funding for needle exchange, but is now considering reinstating both the federal and the local D.C. funding bans. D.C. has the worst AIDS case rate in the country and HIV prevalence above 3 percent. If D.C. were a country it would have one of the worst HIV/AIDS epidemics in the world. Yet, D.C. would not be allowed to control its own tax revenues and spend them to address the epidemic.
Dr. Randi Abramson, medical director of the D.C. social services nonprofit Bread for the City, said that government funding for needle exchange dramatically slowed the spread of HIV. According to Dr. Abramson, it "really tripled the number of clean needles on the streets," creating a culture of using clean needles and taking a concrete step forward towards ending AIDS. But if D.C. had full budget autonomy, this lifesaving program would have come to the District decades sooner.
This week the hunger strikers have been speaking to congressional leaders. On Tuesday they blocked the entrance to Speaker of the House Boehner's office when they were denied a meeting. They were shocked to learn that negotiations on an appropriations bill in the Senate have led to riders which currently include an end to needle exchange funding on the federal level. The Senate leadership is using peoples' lives and the HIV epidemic as a bargaining chip. It is not a healthy Democracy that plays games with the people's public health measures that are a matter of life and death.
On World AIDS Day, December 1st, President Obama renewed America's commitment to ending AIDS domestically as well as internationally. In July, the international AIDS Conference will be converging on Washington. With an international spotlight on the city, local activists have an opportunity to overcome the city's unique lack of self-governance. It would be an embarrassment to the whole country if we welcome the Global AIDS conference by legislating an increase in the rate of HIV in the nation's Capitol.