New Risk on AIDS

Petitions are now being circulated to qualify for next year’s ballots another initiative on AIDS, similar to Proposition 64 that was defeated in November, 1986. It is a mischievous move, once again risking the diversion of the energy and resources of the state from the serious business of controlling the pandemic. It is all the more dangerous as the crisis in public finance has placed extreme constraints on public-health programs, including those addressing AIDS.

But fear, as the number of cases of the fatal disease increases, also is enhancing the potential for political exploitation of the disease. That fear already has produced senseless discrimination against the victims of the disease--most recently in the refusal of scheduled airlines to fly an AIDS victim home from China, necessitating the dispatch of an Air Force ambulance plane. One airline had agreed finally to carry the AIDS victim, but only if he would buy a block of six seats, as if AIDS would crawl through his skin and contaminate others with whom he might rub shoulders aboard a crowded jetliner.

That same sort of irrational fear was a factor among the followers of Lyndon H. LaRouche Jr., who sponsored Proposition 64 in 1986 and are sponsoring the new initiative. LaRouche himself has seen AIDS as an issue that could carry him and his political extremism to the White House. He is not alone in sensing public anxiety and the hunger for easy answers. But the easy answers are counterproductive. That is why health-care providers and public-health officers, including Surgeon General C. Everett Koop, were virtually unanimous in their opposition to Proposition 64.

The new proposition is identical except for a broader definition of those to be affected by the law, going beyond the presence of the human immunodeficiency virus (HIV) to include also “other viral agents that may cause AIDS.” These persons would be declared as having an “infectious, contagious or communicable” and “reportable” disease under terms of the administrative code, and would specifically be made subject to quarantine and isolation laws. Furthermore, the law would affirm that public-health officers “shall fulfill” their legal functions--language that has been interpreted as mandating testing and quarantine programs. The uncertainty of the meaning is evident in the financial analysis accompanying the new proposition. State officials said that its cost implications could be minimal if it resulted in no substantial change in the existing discretionary authority, but, should it be interpreted as a mandatory program for massive testing, quarantine and isolation, the cost could run into the “hundreds of millions of dollars.”

It seems clear to us that the intention of the sponsors is not to support the existing discretionary authority of public-health officials, despite overwhelming evidence that it is adequate and is being used effectively. Rather, it seems to be their intention to launch a massive hunt for carriers of the AIDS virus and a program to isolate them from society. There are inescapable suggestions that the zeal for this mission for at least some of the sponsors of the initiative derives from the fact that most of the present victims are homosexuals or intravenous drug users.

Public-health officials oppose mandatory testing because it would serve only to drive the high-risk population underground, thus accelerating the spread of the disease. Mass quarantines and isolation of infected persons are as unnecessary as they are unworkable. There are adequate defenses already for the uninfected population. Even if it were useful, which it is not, quarantine would be unworkable because of the dimension of the infected population, estimated at 1.5 million nationally and at 345,000 in California.

In the absence of a cure, education remains the most effective control for AIDS. The key to control is winning a change in behavior from the highrisk population while teaching everyone the rules for protection, for minimizing the spread. It is those crucial programs that will be undermined y this initiative. That is something that each citizen must weigh when asked to sign these petitions. The sponsors have until Dec. 7. They need only 372,178 signatures.