Mayor Martin O'Malley declared a "state of emergency" yesterday in Baltimore's battle against AIDS, calling for a coordinated assault by public and private interests on an illness that disproportionately afflicts the black community.
His declaration - which promised little new money and few initiatives - came after intense lobbying by an organization of black ministers and an AIDS commission spearheaded by City Council President Sheila Dixon, who lost her brother and sister-in-law to the disease.
Since June, both groups had called on the mayor to dedicate more resources to prevention, treatment and education - saying the city's efforts have been woefully inadequate. Yesterday, Dixon said she had been frustrated by the delay but was grateful he acted.
Joined by city Health Commissioner Dr. Peter L. Beilenson, O'Malley made the announcement at a hastily called news conference that apparently was meant to capture the momentum of World AIDS Day, which was observed Sunday.
"I'm declaring a public health emergency with respect to HIV and AIDS," O'Malley said. "I'm urging all citizens ... to step up efforts so this scourge can be conquered in the city, this country and this globe."
Similar declarations of a public health crisis were made two years ago in Houston, and four years ago in Oakland.
Although his concrete plans were few, O'Malley said he intends to create a standing commission consisting of public officials and experts from the private sector to monitor the epidemic and the quality of city programs to address it.
Though acquired immune deficiency syndrome remains the second-leading cause of death among city residents between the ages of 25 and 44, trailing only homicide, some of the statistical trends are encouraging.
The rate of new AIDS cases and HIV infections per year has been declining in the city and across the nation for several years. The number of people dying each year of AIDS has dropped steeply - from 959 in 1993 to 105 last year - largely because of new medicines and novel ways of combining them.
Even so, the disease continues to take a heavy toll on Baltimore, which has one of the highest per-capita caseloads in the country. In 2000, some 12,000 city residents were living with the AIDS virus. Today, about 85 percent of the caseload is African-American, a figure that far exceeds the percentage of blacks in the general population.
Beilenson said the "emergency" declaration would help counter the growing perception that the epidemic has ceased to be a problem.
"Yes, there have been a lot of successes," he said. "But it's still a major problem. Why was this not declared in 1993? My answer is that we probably should have."
Last year, the City Council convened an expert panel to assess the city's response to the epidemic. In its report, issued in June, the group said the city was blessed with medical institutions that are national leaders in research and treatment
But it also said that public health officials have not paid enough attention to prevention and education, and have not done enough to coordinate public, private and church-based groups attacking the disease on different fronts. The report also criticized the business community for not helping out with money and leadership.
The creation of a standing commission was a key proposal of the report.
Beilenson said the city would go along with another report recommendation, devoting money from the city treasury to fight AIDS, though he did not give a figure.
The city's investment is unlikely to add much to the federal and outside funding Baltimore gets for AIDS treatment and prevention. Beilenson noted that the nearly $25 million obtained this year is far more than in the past. Also, he said that $63 million for drug treatment also goes to fight AIDS, since the virus is spread largely through drug use and sexual contact with infected addicts.
Dixon said she was caught off guard by the mayor's announcement, after several months of what she perceived as inaction and delay. "I'm glad we're starting it now," she said.
Much of the pressure came from clergy on the National Black Leadership Commission on AIDS, which formed a Baltimore affiliate earlier this year.
The Rev. Raphael Warnock, chairman of the local chapter and pastor of the Douglas Memorial Community Church, said the group is planning to create a "state of emergency preaching institute" to help pastors address the crisis from the pulpit.