Marching Orders on AIDS

In an emergency letter to the White House, the National Commission on Acquired Immune Deficiency Syndrome (AIDS) has opened a campaign to persuade American leaders “to match rhetoric with action” in containing the dreadful epidemic. The report is a most timely nudge for President Bush to provide national leadership on this critical problem.

“There is a dangerous, perhaps even growing, complacency in our country toward an epidemic that many people want to believe is over,” commissioners found. “Far from over, the epidemic is reaching crisis proportions among the young, the poor, women and many minority communities. In fact, the 1990s will be much worse that the 1980s.” Two urgent tasks for President Bush emerge from the report: Creating a national plan for responding to the epidemic and moving quickly to stem the alarming spread among intravenous drug users of the human immunodeficiency virus (HIV) that causes AIDS.

“There is no national plan for helping an already faltering health care system deal with the impact of the HIV epidemic,” according to the report. And the search for solutions has been made no easier by the fact that the President’s National Drug Control Strategy virtually ignores the rapid spread of HIV infection among intravenous drug users. Commissioners expressed understandable “surprise and disappointment” regarding those omissions.

The report, while directed to President Bush, makes clear that an effective campaign against AIDS will require the cooperation and work of leaders at all levels of government and within the private sector. Furthermore, the report realistically acknowledges that “the health care system itself requires urgent attention.” AIDS is not the cause of the unraveling of health services and, at worst, will not itself take more than about 4% of health-care funding. But no region is without problems as the epidemic spreads throughout the nation. Some areas, notably New York City, already are so heavily impacted that the health- care system itself is imperiled.

For us, there are two contrasting conclusions to be drawn from the report:

--The report underscores once again that there is a consensus among the professionals about what needs to be done. Like the report prepared 18 months ago by the Presidential Commission headed by Adm. James D. Watkins, this report identifies key areas of action and the increased funding necessary if the essential programs are to be implemented.

--But the report also reflects the inertia of too many leaders in implementing these clear and urgent recommendations. That is particularly evident regarding the call for mobilizing an adequate national drug rehabilitation program, something the Watkins panel cited as essential even before it wrote its final report in June of 1988. Education and on-demand drug rehabilitation are the only known means to respond to this growing problem which “imperils not only the drug users but also their sexual partners and children.”

No report was due from the commission until August, but members felt the need for “extraordinary measures” required an earlier response from them, a quicker mobilization of the nation. We agree. And we look now to President Bush, with confidence encouraged by his past statements on the epidemic, for vigorous leadership.