How About a Policy on AIDS? : Public health: The Administration’s response lacks a plan and a sense of urgency.

When Hillary Rodham Clinton accepts a Commitment to Life award from AIDS Project Los Angeles in January, it will focus attention on the important work APLA does for people with AIDS and will help APLA raise needed money. It is also an occasion to scrutinize the Clinton record on AIDS.

There are signs of movement. Secretary of Health and Human Services Donna Shalala has said that a new AIDS prevention initiative will be announced soon. The 1994 Clinton budget includes increases for AIDS services and research. And the Clinton health-care plan presents the possibility of more secure coverage for many people with AIDS.

Nevertheless, the Administration’s record on AIDS is disappointing. People with AIDS were not represented on the health-care task force, nor have they had much to do with planning the reform. The Administration continues to enforce discriminatory immigration procedures that bar people with HIV from entering the country.

The Democratic Convention made a point of showcasing people with AIDS--even the Republicans did that--as a signal that it would not continue the callous policies of the Reagan-Bush presidencies with the spread of HIV in America and the world. In his campaign, Bill Clinton promised that he would appoint an AIDS czar to direct, coordinate and energize national AIDS policy. But the Administration’s top AIDS appointee, Kristine Gebbie, advises lowered expectations and counsels Real-politik; if she is a czar, then so is the current Romanov.

To date, the Clinton Administration has failed in the two main areas an effective AIDS policy will require. The nation still has no battle plan, no specific goals and no coordinated strategy and timetable to reach them. The vaunted Clinton policy focus has not included AIDS and, whatever the press of other business, it is necessary to ask why. One can only hope that the failure to address AIDS at the policy level is not because of who it appears at this point primarily to attack: gay men, African American and Latino populations, drug abusers and their children--all relatively powerless members of the society.

The second indispensable requirement of a government AIDS policy is a sense of urgency, which the Administration has so far failed to inspire. The President brings formidable skills to his bully pulpit. He has already used them to highlight the urgency of women’s health-care issues. There is no need to choose between breast cancer and AIDS. Urgency is required in both cases.

The President took advantage of AIDS Awareness Day recently to talk about AIDS at last; time will tell whether this marks the beginning of his leadership in the fight against AIDS. When Mrs. Clinton comes to Los Angeles to accept her award, she will be justly praised for her efforts to reform health care. It is to be hoped that health-care reform will benefit the fight against AIDS, but the Administration’s record on AIDS is decidedly mixed. AIDS does not read between the lines. It spreads and it kills.