The AIDS Message Bush Must Give

President Bush on Thursday will become the first American President to speak on AIDS to an AIDS conference, raising extraordinary expectations at a critical time in the spread of the human immunodeficiency virus (HIV) that causes AIDS.

As the President prepares to address the conference, we urge him to consider two timely and pressing issues:

--The sixth International Conference on AIDS, scheduled in June in San Francisco, faces a global boycott to protest the U.S. law that requires foreign visitors infected with HIV to obtain a special entry permit. The rule is unnecessary because it serves no public-health purpose and unfair because it is discriminatory. Yet there is widespread agreement that only strong leadership by the President can effect changes in it in time to assure success of the meeting.

--Funding for AIDS is dangerously depleted, giving new urgency to bipartisan legislation introduced by Sen. Edward M. Kennedy (D-Mass.) and Sen. Orrin G. Hatch (R-Utah). Their bill properly treats AIDS as a disaster and provides greatly increased funding to provide the expanded services required. Half of the funds are to go to the 13 most severely impacted cities, led by New York, Los Angeles and San Francisco. The remainder would go to the states for distribution to other areas with large HIV-infected populations. Again, without strong leadership from the White House, the legislation is not likely to survive the budget- cutting fever that predominates in Washington.

At Thursday’s gathering, the President will address the National Leadership Coalition on AIDS, which includes business and labor leaders concerned about the epidemic and its impact on the workplace, including fair employment practices.

There is strong support for changing the rule that requires a special permit for HIV-infected visitors to enter the States. The National Commission on AIDS has led opposition to the rule. But giving leadership may be difficult at a time when Bush seems anxious to placate the radical right in his party. The rule’s author was Sen. Jesse Helms (R-N.C.).

The Kennedy-Hatch legislation also has won endorsement from leaders of the National AIDS Commission. Under its provisions, $600 million would be provided in each of the next three years. Congressional leaders have not yet set budget priorities, however. So it is not clear how the expanded program would be funded within the budget limits accepted by Congress.

An expanded level of funding would recognize a fact that is sometimes forgotten at a time of confusing statistics: The epidemic is not over. A leveling out of new case loads in some areas only presages what will be record numbers of living AIDS patients in already-impacted urban areas, while in some states, such as California, the majority of new cases will occur outside impacted areas such as Los Angeles and San Francisco.

Statistics have proven unreliable as well as confusing. There is evidence that doctors are careless about reporting AIDS cases. One thing remains clear, however: An already burdened health-care system faces an increasing load of HIV-related cases for many years to come. The Kennedy-Hatch legislation recognizes the reality of the cost. The President should do no less.

Statewide Number of reported AIDS cases per year, from 1986 to 1989, in California and its local areas. Southern urban area is comprised by San Diego, Orange, Riverside and San Bernardino counties. Source: California Department of Health Services