Lift for AIDS Efforts

A massive expansion of rehabilitation programs for intravenous drug users is high on the agenda of President Reagan’s AIDS Commission. It is a wise way to get Washington solidly behind lagging efforts to control the disease.

Adm. James D. Watkins, the retired chief of naval operations and the chairman of the commission, gave a preview of the proposals that will come before the full commission Monday for action. The scope and depth of his recommendations suggested that the commission may at last be moving ahead constructively. Watkins had been named chairman only last October after the original chairman and vice chairman resigned in frustration over the failure of the commission to work coherently.

Watkins’ focus on intravenous drug users is correct, for it is that group that poses the greatest threat of spreading the disease--including the risk of broader infection among heterosexuals. Until now, a majority of the cases of AIDS--70% nationally, 90% in Los Angeles County--have been among homosexual and bisexual men. But the most rapid spread is occurring among intravenous drug users, who now represent about 17% of the AIDS cases in the nation.

Efforts to control the spread of AIDS among drug users have been frustrated by the shortage of funds for rehabilitation programs, many of which have waits as long as six months. Only 15% of the intravenous drug users are thought to be in therapy at the present time. Now Watkins has proposed a flow of $2 billion in new funds for each of the next 10 years, made of federal appropriations matched by state and local governments. That, for the first time, offers a realistic response to an agonizing national problem.

The proposals recognize two stark realities about the AIDS pandemic:

--There is no alternative to prevention, because no cure is known and none is likely in the foreseeable future.

--There is no cheap solution to the problems. Slogans like “Just say no,” especially when twinned with reduced federal spending, have not curtailed drug abuse, and now the urgency of drug-abuse control is even more evident as the role of intravenous drug users in the spread of AIDS is fully understood.

The 60-page interim report also makes specific proposals (1) to improve care for those with the AIDS virus and (2) to accelerate basic research, including drug and vaccine development. Each of these is treated with extraordinary detail against a background of useful data gathered in the commission’s extended and continuing public hearings.

In a climate of budget politics driven by complaints that “we cannot afford it,” Watkins has presented with candor and reality the needs that the nation cannot afford to ignore. It is obvious that the cost of failing to respond to these proposals would be far greater than the funds that he has called for in new programs.

Much lies ahead for the commission before it completes its work June 24. Some of the most sensitive subjects--including testing, confidentiality, education and discrimination--have been reserved for the final commission report. But confidence in the ability of the commission to provide a forth-right and effective final report was enhanced by this first interim report from the chairman.

Watkins described the urgent problems with AIDS that the nation faces and said: “So let’s move it.” Let’s move it indeed.