Some AIDS groups are openly calling for Mayor Bill de Blasio to replace Thomas Farley, the commissioner of the city’s Department of Health and Mental Hygiene (DOHMH), with someone who is willing to use current technologies and tools to respond to the AIDS epidemic.
“I don’t think that Commissioner Farley has been effective on HIV/ AIDS,” said Charles King, president of Housing Works, an AIDS services organization.
“I think the curve of the epidemic has happened without his policies being what has shaped it in a good direction,” he added, “and I would certainly hold him accountable for the intractable continued spread of HIV among young men of color who have sex with other men.”
In 2009, Farley replaced Thomas Frieden, who now heads the federal Centers for Disease Control and Prevention (CDC), and adopted a far lower profile than his predecessor. While Frieden had ardent detractors and fans, Farley has inspired neither. He has not implemented any significant programs to respond to AIDS. Some of the Frieden initiatives that he kept, such as expanded HIV testing, have produced good results.
The state’s redesign of its Medicaid program and the federal Affordable Care Act, better known as Obamacare, were opportunities for the city to increase funding for programs or insurance coverage for people with HIV that New York City has not taken advantage of.
Additionally, the DOHMH has lagged in encouraging post-exposure prophylaxis (PEP), in which anti-HIV drugs are used to prevent infection in someone who has recently been exposed to the virus, and has done nothing to promote pre-exposure prophylaxis (PrEP), in which daily doses of an anti-HIV drug are given to people to prevent them from becoming infected.
At a December 2 World AIDS Day event, a Farley speech was seen as uninspired. It mentioned only HIV testing and condoms as the primary tools in HIV prevention.
“Many of us were actually fairly taken aback that the one initiative that was announced by Commissioner Farley was a new social media campaign,” said Gina Quattrochi, the chief executive officer at Bailey House, an AIDS housing group. “We all kind of looked at each other and went, ‘What?’ We need somebody who is dynamic and has vision and I don’t think Farley fills that bill.”
ACT UP, the AIDS activist group, protested outside of de Blasio’s January 1 inauguration, which was held at City Hall, demanding that New York City roll out HIV prevention campaigns that include PEP and PrEP, among other tools.
“Remarks by current City Health Commissioner Tom Farley at a World AIDS Day breakfast, more appropriate to last decade’s epidemic than today’s, disheartened a wide swath of the HIV community,” wrote Jim Eigo, an ACT UP member, in an email. “After 12 years of the Bloomberg administration’s indifference to HIV, Mayor de Blasio will have to recommit New York City — in official focus and in funding — to HIV testing, care, treatment, and prevention. This real, hard work will require smart, unorthodox leadership, as passionate and informed about HIV as the communities a health commissioner is appointed to serve. That person is not Tom Farley.”
AIDS groups are currently working with the Cuomo administration to develop a plan to end AIDS in New York. At a December 9 meeting of the groups and state officials, Daniel Tietz, the executive director at ACRIA, an AIDS services group, said that Farley had to be replaced. There was no dissent, according to people who attended the meeting.
Asked about Farley at a January 6 press conference, de Blasio said he would not comment on personnel matters, a posture he maintained throughout his transition, and added, “I have a lot of respect for Commissioner Farley and asked him to stay on transitionally. We have not yet gotten deep into the process about making decisions about the future of the Department of Health.”
Asked to respond to that quote, Tietz said, “I’m gratified to hear that Mayor de Blasio and his team are carefully vetting the next commissioner of the [DOHMH]. We certainly hope that it’s someone with a good grasp of HIV and related conditions and who is fully committed to ending the epidemic with the tools and resources we have now.”
King said that the community must educate and pressure de Blasio if it hopes to have a health commissioner who will respond to its demands.
“I think it’s fair to say that de Blasio has not made health a priority and I think it’s fair to say that he hasn’t focused on HIV/ AIDS at all,” King said. “So far as I know, no one in the AIDS community has had an opportunity to meet with him, with his transition team, and with his key staff... I think the community needs to hold his feet to the fire.”