Response to AIDS

The letter to the editor (Dec. 31) by Robert C. Gates, director of the Los Angeles County Health Services, defending the county’s response to AIDS was deeply disturbing. It was disturbing because of its omissions and the many questions it left unanswered.

The letter stated that “on Oct. 22, the Board of Supervisors allocated $600,000 to create an AIDS Program Office in the Department of Health Services.” Surely, Gates has not forgotten that the $600,000 was allocated in 1985, over a year ago, following the announcement of actor Rock Hudson’s illness. The idea of an AIDS office evolved from a public hearing on the future impact of acquired immune deficiency syndrome on Los Angeles County in early 1985. The hearing was held by the Los Angeles City/County AIDS Task Force, which was convened by Supervisor Ed Edelman and Mayor Tom Bradley. The critical part of the recommendation for an AIDS Program Office was the calling for a 5-year plan to address AIDS in the county. More than a year later, is there any plan?

Gates mentioned 160 educational programs the county has participated in. The educational effort that is needed is tremendous and 160 programs is barely a drop in the bucket. The educational programs for gay men that Gates referred to in his letter took more than a year to get started. The county AIDS program continues to be too little, too slow.

Gates described the success of the county in obtaining federal funds. What he failed to note was the incredibly paltry response of the supervisors in terms of additional funds for all AIDS programs (other than the required patient care) in 1986. During the Board of Supervisors’ open budget hearing in June, 1986, I testified on behalf of the Task Force that at least $1.2 million additional county funds were needed. That request, based on another public hearing held by the Task Force, included $400,000 needed for programs for intravenous drug users, $300,000 for gay and bisexual men, $100,000 for heterosexuals and $50,000 for blacks and Hispanics. The unbelievable budget increase for 1986 was $60,000.

In New York and San Francisco, the health officers have taken leadership roles in the battle against AIDS. When has Gates proposed new programs? When has he asked for additional funds from the supervisors?

Instead, in his letter, he acknowledges that “action to deal with AIDS is needed on many fronts.” Why is he not providing that action? Whose responsibility is it if not his?

NEIL R. SCHRAM MD

Los Angeles

Schram is chair of the Los Angeles City/County AIDS Task Force.