Applause for State AIDS Panel

The three-year strategic plan to deal with AIDS in California validates the wisdom of the Deukmejian Administration in establishing the State AIDS Leadership Commission. It is this commission which drew up the document that provides a summation of the best professional thinking for addressing the pandemic and making the most effective use of the funds and facilities available.

There are no surprises. The commission has drawn together programs already in operation and concepts already generally accepted among the professionals. The thoroughness of the 136-page report in bringing this material together is part of its value.

Only in its timing is it disappointing. The state Legislature had requested the report by April 1, so that it could be a more forceful part of this year’s legislative consideration of matters related to the epidemic of the human immunodeficiency virus (HIV) that causes AIDS. Some of the findings were brought out in March in legislative hearings, however; so the report’s impact can already be measured in some of the constructive bills already voted. What matters more is that the report will be in place to serve as a foundation for planning over the next three years.

Some people have been disappointed that there are no price tags attached. We think the commission was correct in resisting making this a budget document. Its usefulness is in establishing principles for the programs that each year will be adopted and adapted.

The single most important thought of the report, in terms of dollars and cents, is this: “The individual, social and economic costs of the HIV epidemic are already high, but the costs of not aggressively combating the epidemic now will be higher. The advantages of responding to this highly fatal, communicable disease now, instead of later, must be recognized and acted on.” That means that California, which is already spending more than any other state, will need to spend even more if it is to escape an even greater burden later.

Among the dozen priority recommendations are two that have not yet been implemented in the state. We share the belief of the commission that they should be acted on promptly. First, there is the need for legislation that would permit a controlled investigation of the effectiveness of exchanging clean needles for contaminated needles among intravenous drug users. The drug-addicted population now has the highest infection rate and, for Los Angeles County, is the group most at risk. We need look no further than New York City, where the public health system is overwhelmed with AIDS cases among intravenous drug users, to grasp the importance of contriving effective programs to reduce the spread of HIV in this group. The other area of weakness in existing programs is reaching minorities, now suffering an infection rate disproportionate to their population numbers. “Community-based and culturally sensitive HIV disease prevention programs should be implemented in racial and ethnic minority communities throughout the state,” according to the report. It urges a greater role by minorities in program development.

The report reaffirms the major policies in place. It supports voluntary testing, opposes mandatory HIV screening, advocates broad protection against discrimination, and, crucially important, it argues for strengthening AIDS education, the only way to curb the pandemic in the absence of any known cure.

The plan is not merely a state government proposal, but is intended to guide the response at every level in California, according to the preface by the commission co-chairmen, Dr. Kenneth W. Kizer, director of the state Department of Health Services, and Dr. Marcus A. Conant, a San Francisco physician and AIDS authority.

“To be effective, our approach to the HIV epidemic cannot separated from other modern-day epidemics such as drug abuse, sexually transmitted diseases, and teen-age pregnancy,” they argue. It is cogent advice. Indeed, the report’s breadth can usefully spur the state’s response to these other terrible problems, closely interwoven as they are.