AIDS: Agenda for Action

The tragedy of the pandemic of AIDS has been brought home to Californians by the sad news that Paul Gann, who has had an extraordinary if disruptive influence on state government, is among the victims of the disease. Gov. George Deukmejian spoke for us when he extended his “deepest sympathy to not only Paul Gann but to everybody who has contracted this deadly disease.”

Gann reports that he was infected by blood received in a transfusion while undergoing surgery. That particular source of infection has been almost entirely eliminated in the years since Gann’s infection took place through the careful testing of blood donations.

The response of Gann, his family and numerous friends has understandably been one of anger accompanied by a new call for action. That concern can be helpful in awakening those in responsible positions who still resist the necessary commitment of resources.

There are also risks that the emotionalism, so widely shared when a public figure is infected, might encourage extreme measures that would be counterproductive rather than helpful. No nation can afford any diversion of resources from the priority tasks clearly identified by public-health professionals. But already there are calls for wider mandatory testing, for punitive action, for quarantining infected persons.

Public-health professionals oppose mandatory testing because it does not work. It serves no preventive purpose--a fact affirmed unanimously by the health ministers of the 12 nations of the European Economic Community. And it serves to drive underground the high-risk populations, notably the intravenous drug users, whose cooperation is critical to an effective prevention program.

Gann is right in urging more openness and more action. The most significant barrier to more openness is the refusal of governments, including the California state government, to enact guarantees of non-discrimination for those infected with AIDS. The absence of those guarantees invites secrecy and raises the risk of the uncontrolled spread of the disease.

The agenda for action is a long one.

There is a need for more widespread voluntary testing to help chart the spread of the disease and thereby better plan a strategy for control. More reliable tests are needed.

There is a need for better coordination. At the federal level, the White House is moving toward the appointment of a national commission that could be helpful, but until now the President is adamantly opposed to including a homosexual on the commission--an omission that would undermine support from the homosexual community, which in the United States is the most affected group. At the state level, Deukmejian continues to resist the creation of a state AIDS commission despite the support for such a commission from the chairman of his key advisory committee. At the regional level, Los Angeles County is now moving ahead with the creation of a commission emulating similar projects in San Francisco, Orange and San Diego counties.

As the search for vaccine and curative medicines continues, the only protection is a universal education program to teach the clear and simple ways to halt the disease. AIDS can be spread in only one of three ways: through sexual intercourse, through the exchange of blood--including transfusions and intravenous injections--and, finally, through an infected mother to a child in pregnancy or through lactation.

The terrible distress that is felt for victims of the disease, be they celebrities or unknowns, can encourage a new commitment to get on with the agenda that public-health professionals have laid before us.