Representative John Lewis: Sharing His Legacy

The Academy joins with our colleagues across the country in mourning the death of Representative John Lewis who died on July 17 at the age of 80. His life was one of courage and determination to fiercely fight for those who were unjustly marginalized in our country. He was a champion for healthcare for all Americans and combating health disparities. True to form, in this last year of his life, he introduced a bill that is critical to ending the HIV epidemic in the US – a bill the Academy continues to push forward in his honor.

Growing up in a family of sharecroppers in Alabama and inspired by the Supreme Court’s Brown vs. Board of Education decision in 1954, Rep. Lewis stepped up as a teenager to engage in civil disobedience to demand civil rights. He participated in the Freedom Rides of 1961, among other actions.

His national career started in his early 20s when he chaired the Student Nonviolence Coordinating Committee (SNCC), one of the six national organizations that orchestrated the 1963 March on Washington, where he was the youngest speaker on the podium. When voter suppression persisted even after passage of the 1964 Civil Act, Lewis and Hosea Williams organized a pivotal voting rights march from Selma to Montgomery, Alabama, during which the marchers were attacked viciously and Lewis was left with a fractured skull. Despite his injuries, 25-year-old Lewis testified on behalf of SNCC at a federal hearing less than a week later. The police violence at Selma appalled the country and public outrage sped up passage in Congress of the 1965 Voting Rights Act.

After SNCC, Lewis became director of the Voter Education Project, held a seat on the Atlanta City Council and, in 1986, was elected to the House of Representatives where he addressed a myriad of justice and equality issues impacting poor and disenfranchised communities both in his Georgia district and nation-wide.

HIV was already spreading in Georgia when Lewis went to Washington and continued throughout his 17 terms in office. By 2014, an appalling 64% of all people newly diagnosed nationally were Black/African American. At present, one third of Georgians with HIV are Black/African American – as are 42% of all people living with HIV in the US.

The growing prevalence in his district and state inspired Rep. Lewis to speak out, taking an HIV test on television in 2016, in an effort to show constituents that we “cannot allow fear or stigma to stand in the way of knowing your status.” On World AIDS Day in 2017, Lewis wrote that, “the medicine we have today is stopping the spread of HIV/AIDS and saving lives. Each and every person must get tested.” But still the rates in his district climbed.

Meanwhile, the Academy became acutely concerned about the growing HIV medical workforce shortage and, in 2008, was among the voices that requested that the federal Health Resources and Services Administration (HRSA) conduct an assessment. The Academy was the first to publish the HRSA workforce results in our HIV Specialist magazine showing that “the nation faces severe workforce capacity challenges to effectively treat people living with HIV. The demand for HIV and primary health care services, in particular, continue to increase.”

Twelve years later, the number of Americans with HIV is still increasing and the number of HIV-trained health care providers remains insufficient. As predicted, the new HIV incidence continues to increase and the number of health care providers trained in specialty HIV care is increasingly insufficient. Despite this, the Trump administration’s Ending the HIV Epidemic (EHE) initiative contains no provision to increase the HIV workforce.

Working in collaboration with the Academy and HIVMA, Rep. Lewis took action by introducing the “HIV Epidemic Loan-Repayment Program (HELP) Act” last February 7, on National Black HIV/AIDS Awareness Day. In his press release, he declared that “policy makers must ensure that there are enough qualified, dedicated health professionals to care, support, and provide guidance for them.”

With gratitude for his determination, the Academy and HIVMA will continue lobbying members of Congress to endorse this bill, designed specifically to correct this growing deficit of HIV health care providers. A few days before his death, Rep. Lewis approved a slight revision to the bill adding clinical pharmacists as eligible for support under the bill, along with physicians, nurse practitioners, physician assistants and dentists.

This HELP bill gives us a chance to ensure that dedicated HIV health care providers get the training they need without incurring insurmountable academic debt. This will bring more trained providers into the EHE areas and to areas relying on Ryan White program services. The determination demonstrated by Rep. Lewis’ life drives us to get this bill passed and enacted.

On March 24, 2017, when fierce debates were raging in Congress regarding the survival of the ACA, Rep Lewis said, “I will fight every single attempt to turn a deaf ear, a blind eye or a cold shoulder to the sick, to our seniors and to working families.”  His life-long determination to achieve justice fuels us now to get the HELP bill passed so that skilled HIV-specific care is available to all who need it.