Surgeon General Readying AIDS Report

President Reagan, vowing to keep the fight against AIDS one of the nation’s top public health priorities, announced Wednesday that he has directed the surgeon general to prepare a major federal report on the deadly disease.

“We are going to continue to develop and test vaccines and we’re going to focus also on prevention,” Reagan told employees of the Department of Health and Human Services at a rally to promote his budget initiatives.

White House and public health officials said that the President decided it was time to take “an authoritative look” at AIDS in an effort to reduce public fear and misconceptions about the disease. They said they hope the report, described as a “primer,” will prove to be a watershed event in public thinking about AIDS, much as the surgeon general’s report on smoking has defined that issue since the 1960s. The report is to be completed in two to three months.

“We want to give an update to the nation on where we stand on AIDS, where we are,” said Dr. Donald Ian MacDonald, acting assistant secretary for health.

Notes Need for Trust

MacDonald added: “We hope it will serve a purpose in allaying public concern. To people outside the Beltway (the highway that encircles Washington), the only doctors are Marcus Welby and the surgeon general--the surgeon general has a long history of being the doctor you can always count on.”

In his fiscal 1987 budget, Reagan asked for $203 million for AIDS research and education, to be consolidated for the first time within the office of the assistant secretary for health, and $10 million in the agriculture appropriations bill for AIDS-related activities in the Food and Drug Administration.

The consolidation was made “to highlight, plan and coordinate the total level of resources being devoted to this top public health priority,” the Department of Health and Human Services said, adding that “operational responsibility will continue to reside in the individual agencies involved.”

These agencies include the Centers for Disease Control, the National Institutes of Health and the Alcohol, Drug Abuse and Mental Health Administration.

Congress Allocated More

Although the Administration described the 1987 request as an increase over that of fiscal 1986, the figure, in fact, reflects a reduction from the $244 million Congress appropriated for 1986.

The level of the Administration’s 1986 AIDS spending was $193 million, $51 million less than the 1986 congressional appropriation. That $51 million includes an automatic cut of $10 million required under the Gramm-Rudman deficit-reduction law, and an additional $41 million in AIDS projects that the President has asked lawmakers to revoke.

The Department of Health and Human Services, in releasing its budget proposals on AIDS, said: “Extraordinary progress has been made in a relatively short period of time in understanding this new and devastating disease, including the identification of the causative HTLV-III virus, ensuring the protection of the blood supply and hemophiliacs, the initiation of clinical studies of promising therapeutic drugs and the development of public health guidelines for health care workers, schools and blood collection centers.”

Sees ‘Sleight of Hand’

But California Rep. Henry A. Waxman (D-Los Angeles), chairman of the House Energy and Commerce health subcommittee and a leader of the fight for increased AIDS funds, called the White House budget request “sleight of hand” for “trying to portray this as an increase.”

He added: “Congress has consistently appropriated more than the Administration has admitted it needs. Congress understands how urgently these funds are needed.”

The proposed surgeon general’s report on AIDS was announced in a 25-page legislative message transmitted to Congress on Wednesday. The message sets forth the Administration’s goals and priorities for the coming year.

The idea of having the surgeon general report to the public on AIDS was attributed to John A. Svahn, the Californian who heads Reagan’s domestic policy staff. A White House official said that Svahn thought it important for the study to have the imprimatur of someone widely respected by the public.

“This is an attempt to try to get a definitive look at AIDS,” the official said. He said the disease is “a topic that is on everybody’s mind.”

Federal health officials acknowledged privately, however, that Surgeon General C. Everett Koop thus far has had little direct involvement with AIDS activities.

AIDS Coordinator Named

Earlier in the year, the Office of Management and Budget proposed that all federal work on AIDS be transferred to the office of the surgeon general, an idea that was later dropped. Shortly thereafter, Walter Dowdle, director of CDC’s unit for infectious diseases, was appointed coordinator of all federal AIDS programs.

Reagan’s instructions to Koop, a White House official said, call for “a look at what we know, what we don’t know and some sense of where the research is headed.”

AIDS, or acquired immune deficiency syndrome, destroys the body’s immune system so that it cannot resist otherwise rare infections. It is transmitted by sexual contact--with the exchange of bodily fluids such as semen and blood--and through the sharing of unsterilized hypodermic needles. It also has been spread through transfusions of contaminated blood or blood products, although a blood-screening procedure begun last year has made that risk slight.

Those at highest risk are homosexual and bisexual males, intravenous drug users and their steady sexual partners. As of Monday, there were 17,001 reported cases of AIDS, and 8,801 deaths.