Funder Spotlight: AIDS Funding Collaborative

Melissa Federman is the Treuhaft Chair for Health Planning and Director of the AIDS Funding Collaborative (AFC), housed at The Center for Community Solutions. In these roles she oversees the organization’s reproductive health projects, and the grantmaking, advocacy and convening work of the AFC. Melissa is also a relatively new member of the FCAA board who has already made invaluable contributions including — but certainly not limited to — participating as a panelist in our spring convening, Managing the Maelstrom: Navigating Politics, HIV, HCV and Opioids. It was that topic, in fact, that we wanted to further unpack. So we asked Melissa to talk to us about her organization’s focus on HIV/AIDS and how it intersects not only with FCAA’s work, but with efforts to address the impacts of the opioid crisis. Here is what she had to say:

Q: Tell us about your organization and its mission.
The AIDS Funding Collaborative’s origins are in the late 1980s, when there was little if any public funding for the HIV/AIDS epidemic. At the time, the Cleveland Community AIDS Partnership (CCAP) was established as one of the original eight funding partnerships of the National AIDS Fund. As CCAP shifted to focus more on systemic and policy approaches in the 1990s, it also sought to identify a way to allocate and distribute local funding, a recommendation from a local Citizens Committee on HIV/AIDS. As a result, the AFC was created.

The AFC is a public/private partnership that includes the Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County, the Cleveland Department of Public Health, the Cleveland Foundation, Cuyahoga County, the George Gund Foundation, Mt. Sinai Health Care Foundation, and our United Way. Our mission is to strengthen the community’s response to HIV/AIDS providing coordination leadership, advocacy and funding. The resources we mobilize are targeted to Cuyahoga County, which is the greater Cleveland metropolitan area.

Q: When and why did the organization determine that fighting HIV/AIDS was an important part of that mission?
In the 1980s, health philanthropy program officers in Cleveland recognized the need for a local response, and leadership to support both the infrastructure serving Clevelanders with HIV as well as prevention efforts. They supported the establishment of the National AIDS Fund, as well as our local Community AIDS Partnership.

The AFC functioned as a less formal, annual coordinated grantmaking body until 2005 when it adopted a strategic plan that prioritized an expanded community leadership role, a formalized structure to support growth, and more targeted grantmaking. That year, the AFC formed a partnership for fiscal sponsorship with The Center for Community Solutions, a now 104-year-old health and human services think tank, which had been involved in HIV/AIDS as a convener since the early days of the epidemic.

Q: What makes your organization unique as an HIV/AIDS funder?
Funders are attracted to AFC because we are nimble and responsive to the local epidemic. We sit at state and local HIV program planning tables and not only advocate for sound health programming and policy but also gain an understanding of the gaps in the community, and where AFC dollars will most effectively be directed. For several of our funding partners, the informed HIV grantmaking is what brings them to the table; for others it is our advocacy role. Across our funding partners, local resources are leveraged to create something more impactful than a single grant.

Q: What does your organization view as the biggest challenges in the HIV/AIDS fight at the moment?
The biggest challenge continues to be reaching the populations most impacted. Locally, we have done a lot of work around pre-exposure prophylaxis (PrEP) awareness. But, for a variety of reasons, it is not accessible to the young black men who have sex with men who are at greatest risk of acquiring HIV in Cleveland. Even if they are insured — which is not always the case — disclosure and privacy concerns related to insurance are barriers.

And, there is the intersection with the opioid epidemic. In Ohio, what were known as “pill mills” were shut down to combat illegal prescribing of opioids. But there wasn’t a coordinated public health response, including harm reduction, outreach for treatment and recovery services, etc. Many of the individuals who were dependent on that source of opiates lost access and moved to heroin. We have seen an increase in heroin use and a huge increase in overdose death due to fentanyl and its analogs in the drug supply.

We have also seen a slight uptick in HIV infections attributed to injection drug use. That slight increase would undoubtedly be far worse if not for local organizations like Circle Health Services, an AFC grantee. Circle Health provides clean syringes, and drug testing and overdose prevention supplies to clients. We have been so grateful to have those resources in place, and to be able to scale them up in order to address the current need.

Q: You have been a member of FCAA for many years. What do you view as the greatest value from this community?
The AFC has been a member for a long time. In fact, AFC funding partners may have been represented on FCAA’s first Board of Directors.

The sharing of learning and resources has been an enormous benefit of FCAA. The Summit is a go-to meeting when we have new staff or board members. It’s important for them to understand the world of funding and what best practices look like ― the Summit is a one-stop shop for that.  Inevitably, there is a group of funders who end up meeting at a FCAA program and begin collaborating thereafter to address an issue together – this year it is the domestic opiate response.

Q: Why do you believe it is so important to contribute data to the resource tracking report? Why do you think the data itself is so valuable?

It is important to follow the trends of HIV funding. It’s hard to advocate for additional dollars or different priorities if we don’t know where and to what extent we’re spending. The report is also a way to identify regional philanthropic allies to better coordinate funding. And every year, FCAA finds a new way to look at the data and, as a result, we learn something that changes the way we work. Beyond that, I also thing it’s important to recognize those who are funding this work.

Q: What message would you share with other funders?
There are so many ways to engage in the movement. Housing is healthcare. We have marginalized communities that are not receiving the care and treatment they need – continued advocacy for safety net healthcare coverage is tremendous. There is more need for harm reduction services than ever. PrEP and PEP services are not scaled in most Midwest communities. Investing in LGBTQ communities is crucial, and protective. Choose your priority – and then let FCAA know where you invested!