The AIDS Epidemic:
How to Practice Safe Grantmaking

By Michael Fumento

Philanthropy, January-February 1990
Copyright 1992 by Philanthropy Magazine

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AIDS is a terrible disease, and one that will not go away any time soon. But it has also become something of a fad. It is not stylish to get, but it has become highly stylish to fund and work on projects for AIDS prevention and programs emphasizing the rights of AIDS victims. Because of this, and because there is so much confusion about how AIDS spreads, AIDS funding is probably among the most wasteful in the nation. This waste has not been documented in the press because the AIDS epidemic is considered a war from which there should be no dissent. But the waste is there and it is massive.

Grantmakers must be very careful to make sure that project applicants are seeking money for really deserve support. It is well known in the research community and presumably among others seeking funds that the golden key to obtaining grants is somehow to tie one’s work into AIDS. Right now, someone out there is probably preparing a grant application which will seek to link his interest of researching African swallows to the AIDS epidemic. Or something equally improbable. Grantmakers should take steps to avoid allowing their compassion for AIDS victims to lead them into supporting projects that do little or nothing to control or treat the disease.

Evaluating the Grantseeker

A grantmaker’s first line of defense should be to identify the past activities of the applicant, which may not always square with those given in the application. One group, which has received much media coverage for its activities, is the AIDS Coalition to Unleash Power (ACTUP). This organization accomplishes its ends through intimidation, picketing, death threats, and constant violation of the law. In addition, it often rallies for non-AIDS causes, as when it recently stormed St. Patrick’s Cathedral in New York to protest the Catholic Church’s teaching on homosexuality and abortion. Another group, Gay Men’s Health Crisis of New York, distributes literature that would make Robert Mapplethorpe blush. Grantmakers may not wish to be associated with such organizations bacause they are engaging inactivities that could prove embarassing to them or even conflict with their own moral codes. The best way to find out is to be sure to check the periodical file and the "grapevine" whenever an AIDS group applies for funds.

On the subject of morals, grantmakers should consider the policy of an organization towards condom distribution. Both the Pope and the Ameican Roman Catholic bishops have made it clear that even for AIDS prevention, church law prohibits the use of condoms. And many non-Catholics feel likewise. Nevertheless, from a purely health standpoint, condoms have been found effective in interdicting the AIDS virus both under laboratory and "field" conditions. When used properly, condoms provide nearly 100 percent safety.

There are, however, important qualifiers. Studies have shown that sexual contact between a non-infected person and an infected person in cases where condoms were used irregularly will often allow the virus to be transmitted. Further, if a person goes through the effort of purchasing a condon, that says he is willing to use it. Conversely, one knows nothing about a person who received a condom in a greeting card or caught one thrown at him during a "safe sex" rally. Indeed, limited studies have found that when condom are literally thrown at people, they will not be used.

Beware also that certain population control groups, such as Population Options and Planned Parenthood, are taking advantage of the AIDS crisis to promote their own agenda (that is, to promote a wider application of birth control). Those who do not wish to promote this agenda should not fund even those programs that seem to have a strong overlap with AIDS prevention.

What is Being Funded

"Safe sex" rallies, which are described in grant proposals in various euphemistic terms, are probably of limited use. Their basic purpose is not so much to instruct as it is to desensitize those who might have various objections to condom usage. Such rallies often involve the use of bananas, broomsticks, and vast numbers of prophylactics, and include such features as students dressed up as Trojans (not the ancient sort) or "Who can put the condom fastest on the broomstick" contests.

It is necessary to find out what age and demographic groups are being targeted for the education program. One organization has sought to teach the youngest of children about condom usage, relying on a cartoon figure called "Calvin Condom." It is far from clear why tots who can only be reached through cartoons should be instructed in condom usage.

One tactic used to elicit the greatest amount of philanthropic funds is to play up the white middle-class heterosexual angle. This is being done for the obvious reason that many grantmakers come from this group and can identify better with potential victims. Such a tactic can be misleading insofar as 13 years after the virus began showing up in New York City intravenous drug users (determined from a retroactive study), AIDS has shown consistent pattern of infecting primarily homosexuals and intravenous drug abusers, with Americans who don’t abuse drugs comprising only three percent of total AIDS cases. One of the largest and best-known organizations which has made exaggerating the scope of the epidemic its standard operating procedure is the American Foundation for AIDS Research (AmFAR), New York. It regularly targets its advertisements on those least at risk, referring to AIDS as an "equal opportunity destroyer." Of course, it’s possible that a group may solicit funds in the name of preventing white middle-class heterosexual AIDS and actually use it to combat AIDS where infections are occuring.

One controversial prevention technique consists of distributing new needles to addicts. While the efficacy of such programs is not yet determined, the areas of the country where high levels of intravenous drug abuse is associated with high HIV prevalence are usually those which have outlawed needle distribution. Thus, helping an organization to distribute needles may in fact be a violation the law. A similar program involves distributing bleach to clean the needles. Preliminary evidence indicates that this may be helpful. But even here, grantmakers need to be wary of what they are funding and ask whether under the aegis of preventing the spread of AIDS, these programs are actually encouraging intravenous drug use. In this case, grantmakers may want to consider funding programs that help get addicts off drugs, thus greatly reducing their risk of becoming infected.

AIDS is Not the Only Problem

Finally, grantmakers are far more aware of the limitations of their budgets than the AIDS activists and the general public, and must not forget that many other health problems exist besides AIDS. While the effect of the disease on the individual sufferer is just as cruel as the press makes it out to be, its future effect on the nation as a whole has been greatly exaggerated. While pundits have projected anywhere from tens of millions of American deaths to annihilation of the world’s population, AIDS cases (for the United States) in 1989 will in fact probably end up running only about 3,000 ahead of the previous year.

Each year, the rate of increase continues to slow and a peaking of the epidemic is imminent. Indeed, last summer the federal Centers for Disease Control announced that the number of cases among homosexuals (who comprise almost three-fourths of the total) had leveled off. This is the result of a leveling off of infections among homosexuals in 1981-1982 and has little or nothing to do with medicine, safe sex rallies, condoms on broomsticks, or cartoon prophylactics. Instead it reflects the natural pattern of any epidemic.

Grant money will not save the world. It may, however, if used wisely, prevent some infections and thus save lives, reduce some needless fears, and ease the suffering of those already afflicted.


Read Michael Fumento’s additional work on AIDS.