Hoping for Another Dr. Koop : Clinton must rethink AIDS post before naming a successor to Gebbie

In addition to its many medical victims, AIDS has now claimed a major political one--Kristine M. Gebbie, appointed just 11 months ago as the nation’s first AIDS policy chief. Though well-intentioned and hard-working, she turned out to be a “czar” without armies, political clout or deep support. Under pressure from groups representing AIDS patients and people infected with the virus, Gebbie resigned Friday.

That leaves President Clinton with both a problem and an opportunity in recharting the war against AIDS, which has already claimed more than 220,000 American lives and threatens to kill thousands more over the next decade. As a candidate, he promised to intensify the war, and his Administration has indeed increased federal spending for research, prevention and education significantly.

Given its terrible toll, and the vast amounts of money being spent to halt it, AIDS has proved to be perhaps the most political of all diseases. The recently formed Office of AIDS Research, meant to direct all federal research on AIDS, is already embroiled in a congressional dispute over control of the money.

It is little wonder that Gebbie, a nurse and comparatively a political novice, ran aground in these treacherous shoals. She had no clearly defined mission apart from “coordinating” the work of different agencies, and from the outset she was resented by the AIDS Establishment and patient advocates.

Arguably, the nation does not need an AIDS czar. But AIDS is almost as much a matter of public relations as medicine. Given the reluctance even today to discuss the causes and prevention of AIDS, we need a strong public voice. What gave C. Everett Koop, the former surgeon general, such credibility on AIDS was that he was politically conservative and a deeply religious man who showed that homophobia, fear and moral hypocrisy had no place in the AIDS war.

The next AIDS czar should have similar stature and credibility. And the President should give him or her the tools, platform and bureaucratic clout to do the job, or just abolish it.