In June, Black Lives Matter Portland issued a set of demands, including the ousting of City Manager Jon Jennings. One aspect of Jennings’ track record that BLM pointed to was the closure of the India Street Positive Health Clinic. The clinic was one of three programs hosted at the India Street Public Health Center. A grassroots coalition succeeded in saving the needle exchange program and sexually transmitted infection clinic, but the Positive Health clinic for HIV patients was shuttered in late 2016.
Jennings is personally responsible for setting into motion the process that led to the closure of this nationally recognized HIV clinic. He wrote it into the first budget he presented after being hired, and later stated his desire to “start a community conversation about the core functions of government.”
I spent 2019 caring for my dear friend Mark while he was dying of cancer and AIDS-related illness. As a patient at Positive Health, Mark was outspoken against the closure. In the intervening years, I watched Mark’s fears about the closure become realized, as he went from seeing his infectious-disease doctor monthly to seeing this specialist about every six months. He went from having his needs met by trusted providers in one downtown facility, to having to take a bus or coordinate rides across the Portland area to see the various new doctors responsible for his care. He had three new primary care doctors in that time, and often lamented to me how emotionally difficult it was to share his complex health history over and over again.
In 2016, patients at Positive Health had a viral load suppression rate of 96 percent – a rate that nationally was almost unheard of. (Viral load suppression refers to when antiretroviral therapy successfully reduces the amount of HIV in a person’s blood to an undetectable level.) For comparison, in 2017 the Ryan White HIV/AIDS Program – a federal program serving uninsured and underinsured people living with HIV – celebrated having achieved a record 87.5 percent viral load suppression among their clients. The national viral suppression average that year was 59.8 percent.
The barriers Mark experienced after the closure were more than mere inconveniences, and it is unlikely that he was alone in experiencing them, but we may never know how deadly the impact of the closure was. Despite promises, the city utterly failed to track outcomes for former clinic patients.
The clinic’s closure disproportionately affected Black and Latinx Mainers. In 2016, Black Mainers were just 1.5 percent of the total population, but 15.6 percent of people living with HIV. Latinx Mainers made up 1.6 percent of the total population in 2016, but 6.5 percent of people living with HIV.
We have learned a lot about Jennings’ beliefs about “the core functions of government” in the five years he’s been city manager. Since then, police spending has gone up every year under his direction – a total of 24 percent, according to an analysis by progressive activist Joey Brunelle, while spending on public health fell by nearly 50 percent. Black Lives Matter Portland details more of Jennings’ track record, which includes moving the Oxford Street Shelter out of downtown; attempting to cap spending on homelessness and gut the Community Support Fund for immigrants, and opposing spending on schools. At the same time, Portland under Jennings has focused city investments on “(streamlining) its development regulatory process” and “(strengthening) city programs and services that support business development.”
Let’s take up Jennings’ invitation to discuss the core function of government. Why does an unelected, unaccountable city manager have so much power to decide budget priorities for our city? Disinvestment from public health is intimately linked to Maine’s racial health disparities, made more visible in the time of COVID-19. It is time for accountable leaders who prioritize human rights over the interests of developers and the police who enforce them.
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