U.S. Panel Asks Fivefold Rise in AIDS Funds

A panel of prominent scientists and public health officials, urging that AIDS education be greatly expanded immediately, called Wednesday for a nearly fivefold increase in spending for AIDS education and research--rising to $2 billion annually by 1990.

In warning that the current AIDS epidemic “could become a catastrophe” if the spread of the virus is not curtailed, the committee said: “The situation demands both immediate action to stem the spread of infection and a long-term national commitment to produce a vaccine and therapeutic drugs.”

The report, believed to be the most comprehensive study of the epidemic to date, was compiled by the Institute of Medicine, an affiliate of the prestigious National Academy of Sciences.

Blueprint for Action

Many public health policy-makers, unhappy with the federal response to AIDS so far, hope it will impart a new sense of urgency and serve as a blueprint for a national strategy to combat the deadly disease.

“The potential at this moment for major spread of the infection is real,” Samuel O. Thier, president of the institute, said at a news conference Wednesday.

The institute released its report one week after Surgeon General C. Everett Koop issued a series of similar recommendations in his long-awaited report to the public on AIDS, which called for comprehensive acquired immune deficiency syndrome education at home and in school at the earliest possible age.

The institute report warned that “the $2-billion yearly expenditure proposed for responding to the epidemic is a small fraction of the billions of dollars for care that the epidemic is sure to cost, especially if it is not rapidly curbed.”

By the end of the decade, it said, education and research should be supported by $1 billion in federal funds “not taken from other health or research budgets.”

In addition, the report called for spending $1 billion on a new public health education program comparable to the current offensive against drug abuse. These funds should come from local and state governments and from private industry, as well as from Washington, it said.

$410 Million in U.S. Funds

Congress has appropriated about $410 million for research and other AIDS-related programs during the current fiscal year. The Public Health Service request for fiscal 1988, which begins next Oct. 1, includes $68.8 million for public health and education efforts within a total request of $471.1 million for all AIDS programs, the panel said.

The institute labeled the federal government’s educational efforts “woefully inadequate,” called Koop’s report “clearly a step in the right direction” and urged that future messages conveyed in media, public health and other educational campaigns be as direct as possible.

“We discovered that there is very little knowledge about sexual practices in the United States at all,” said panel co-chairman David Baltimore of the Whitehead Institute for Biomedical Research and the Massachusetts Institute of Technology. “It’s not just homophobia; there seems to be a phobia about the whole question.”

Explicit Warnings Urged

“Educators must be prepared to specify that intercourse--anal or vaginal--with an infected or possibly infected person and without the protection of a condom is very risky,” the report said. “They must be willing to use whatever vernacular is required for that message to be understood. Admonitions to avoid ‘intimate bodily contact’ and ‘the exchange of bodily fluid’ convey at best only a vague message.”

During a campaign trip last week, White House spokesman Larry Speakes, asked about the Koop report--which was approved by the White House--said President Reagan believes that sex education should be “a matter for parents, teachers and local school officials.” Speakes said the President believes that information on AIDS and other diseases should be made available but “generally opposes providing birth control methods and techniques to teen-agers.”

The Institute of Medicine panel acknowledged that governmental authorities may be reluctant to confront issues of sexual behavior. However, Baltimore said at the news conference, the AIDS threat in the United States “is of the magnitude that requires presidential leadership.”

The institute’s report recommended that a National Commission on AIDS be created to “monitor national AIDS efforts, assume an advisory role and periodically report to the American public.” In addition, it suggested that a new AIDS education office be established within the Department of Health and Human Services to implement educational programs.

Opposes Quarantine

The panel opposed mandatory blood screening for exposure to the AIDS virus and the quarantining of infected individuals, and it urged that infected children not be barred from the classroom.

The panel supported a controversial proposal that sterile needles and syringes be made available to intravenous drug users on an experimental basis to decrease transmission of the AIDS virus through the sharing of contaminated needles.

“Increasing the legal availability of hypodermic needles has received some support among public health officials but has generally been opposed by law enforcement officials, who predict that it would lead to greater (intravenous) drug use,” it said. “However, if drugs are available and clean needles and syringes are not . . . drug users will probably use available unsterile equipment.”

The director of the largest AIDS community service organization in Los Angeles praised the institute’s recommendations, saying the Administration has thus far provided inadequate leadership and funding.

Major educational and research programs--and the “moral leadership” of Reagan--are long overdue, said Paula Van Ness, executive director of AIDS Project Los Angeles.

‘Voices in Wilderness’

“To this point in time, there have certainly been some isolated efforts across the country that need to be encouraged to continue. . . . There have been lone voices in the wilderness saying we ought to do more, “ Van Ness said. “But, in terms of a national strategy and the kind of leadership we need, we’ve seen an inadequacy from our government.”

Van Ness said she “tries to be optimistic” that the institute’s report, coming on the heels of the Koop report, will persuade the Administration to change its course on AIDS.

“The Reagan White House has not been leading the effort against AIDS in the way we who are engaged in the fight feel he must lead it if we are to be successful . . . . It would give us great hope and pleasure if President Reagan came out as strongly on this as he has on drugs--even more strongly, in fact,” she said.