No Place for Disarray

Resignation of the leadership of President Reagan’s national AIDS commission measures the disarray of both the commission and his Administration’s own policy. The President, like so many other public officials, has not engaged the problem with the commitment and determination that it urgently requires.

As constituted by the White House, the national commission was long on concessions to political forces that do not grasp the public health implications of the pandemic and short on the professionals that already understand the problem and are enlisted in finding solutions. It is far from clear that a couple of substitutes for the resigned members can resolve that.

More important than repairing the commission, however, is providing vigorous leadership. The President’s reluctance to be involved at all was a setback that cannot readily be overcome. What matters now is that no more time be lost. Reagan needs to pick up where he belatedly began on April 1 in Philadelphia, when he spoke authoritatively on the problem for the first time. He needs above all to take a central role in the education of the nation and in committing the federal government to providing adequate resources for research and for public health programs.

In education alone, the President could play a significant role. Education is the only defense against the deadly disease, with no vaccine or cure in sight. The President has every right to moralize, if he so chooses. But moralizing must be matched with the facts so that all Americans understand the risks of their sexual behavior, understand ways to reduce the risks and share that information with all potentially at risk.

Surgeon General C. Everett Koop has been the most effective spokesman in the Administration. He was the first to speak out, and he has consistently been the most candid. He has made clear that abstinence from high-risk sex is the only safe course. He has, however, felt free to advocate the use of condoms to reduce the risks. And, as research has shown the unreliability of condoms, particularly in the practice of anal intercourse, he has been willing to revise his counsel.

But none in the Administration has been candid enough about the inadequacy of funding. More is needed for research, including the search for a vaccine. More also is needed to serve existing institutions that are unable to expand services because of budget squeezes. One of these is the national drug-treatment program, the essential contact point for reaching the intravenous drug users who are second only to homosexuals as the population most impacted in the United States. In many areas, AIDS is having its most rapid spread among drug abusers, and from drug abusers into the heterosexual community. Yet in city after city there are no funds to expand drug-abuse services or even to offer adequate voluntary AIDS testing programs to trace the disease and help plan its containment.

Reagan is not the only leader who has failed to deal vigorously with AIDS. Gov. George Deukmejian has also failed to provide leadership and has allowed efforts to create a state commission to be sabotaged by a partisan political wrangle. In Los Angeles County, however, there are encouraging developments. The Los Angeles County Medical Assn., has launched a forthright billboard campaign, in both Spanish and English, to encourage the use of condoms by those at risk. An AIDS commission is now in place. The Board of Supervisors already has referred some critical issues to it for recommendation, with the likelihood that the commission can play an important role, the kind of role the federal commission could have played had the President been more respectful of balance and professional ability.