U.N. Aid for AIDS

The creation of a Global Commission on AIDS by the United Nations will serve as a reminder to the leaders of every nation that the pandemic of acquired immune deficiency syndrome is everyone’s problem and that control will be effective only if there is international cooperation.

The commission emerged from an extraordinary debate on the disease in the U.N. General Assembly--the first time in the organization’s history that a public-health issue has been the center of discussion. But such a debate was consistent with the history of U.N. debates that have addressed, over the years, not only the issues of war and peace but also the social and economic problems that affect all lives.

The educational value of the U.N. intervention is important. Many nations, notably in Latin America and Africa, continue to try to conceal the toll of the disease to avoid discouraging tourism. Arab nations have refused to give country-by-country figures, but provide the World Health Organization with a single total ostensibly encompassing all of the Arab states. As a result, the official figures provided by 126 governments to the World Health Organization, which now add up to 62,438 cases, bear no resemblance to reality. This kind of deception can only deter the kind of aggressive programs required to begin to contain the disease.

There is another value that is generated by this sort of international commitment. It may help raise the level of resources that are required. WHO needs $45 million through 1988 for its program as the designated coordinator of the global campaign. The United States, through the Agency for International Development, has promised substantial support, but the promises of the American and other governments have not, for the most part, been translated as yet into cash. The United States, alone among all major countries, is $85 million in arrears for its assessed share of regular WHO operations. The extraordinary General Assembly session may at least accelerate payments for the AIDS program.

Two Americans were at the center of the U.N. discussion--Dr. Jonathan Mann, the director of the WHO program on AIDS, and Dr. C. Everett Koop, the U.S. surgeon general. They have both given singular leadership. Unfortunately, the U.S. government has yet to respond with adequate resources.

Congress, which is now debating funds for AIDS education, reflects the irrelevance and prejudice that haunt the AIDS effort in the United States. Because most American AIDS victims are homosexual males, and because the second-largest infected population is made up of intravenous drug users, disdain and moral posturing have clouded efforts to raise enough money and to provide adequate education. This has been demonstrated again in the congressional debate, with sweeping amendments commanding that education must promote sexual abstinence and must not promote homosexuality and drug abuse. That only discourages the most effective forms of education, which, while obviously not intended to promote any particular sexual practice or illegal drug use, must deal openly with these subjects to reach high-risk groups. There is no dispute about abstinence being the most effective protection. But in a nation that is demonstrably highly active sexually, abstinence cannot be relied on as an effective means of controlling AIDS.