Op-Ed Articles

Fighting an Epidemic in the Absence of Leadership
September 4, 1985

The Washington Post

By Henry A. Waxman

We are losing the war against AIDS. The Reagan administration´s lack of leadership and commitment against this horrible disease is allowing us to lose. The president can´t even bring himself to say the name of the enemy. He has yet to make any public statement on the issue, and his administration acts as if the whole problem will magically disappear.

Today there have been almost 13,000 cases of AIDS in the United States. There are 20 new ones each day. The total doubles every 10 months.

At this rate, by the next presidential election, more Americans will have died of AIDS than died in Vietnam.

This disease is defeating us. We are losing not just because the enemy is new and unknown and deadly, but also because of politics–the politics of the budget and the politics of sex.

The most easily identified problem is money. The administration has cut research budgets by millions of dollars, while the nation´s treatment costs have already run into the billions. Respected government health officials have come to the Congress, defending the administration line that everything that needs to be done is being done. But at the same time, these officials are writing desperate memos to budget officers, warning of urgent needs and catastrophic possibilities.

The Public Health Service has done astonishing work under these circumstances. Committed public health and research personnel continue to work overtime at AIDS control. But overtime cannot substitute for technical staff. Extra hours are not the same as extra labs or extra clinical trials of drugs.

Another problem for the administration is those who get AIDS. This is the administration whose White House director of communications, Patrick Buchanan, once argued in print that AIDS is nature´s revenge on gay men. One cannot help but wonder if the administration´s approach to the epidemic comes from such open disdain for the victims. Surely the administration would not have reacted in the same way if the first victims of the disease had been identified as members of the Chamber of Commerce.

It is surprising that the president could remain silent as 6,000 Americans died, that he could fail to acknowledge the epidemic´s existence. Perhaps his staff felt he had to, since many of his New Right supporters have raised money by campaigning against homosexuals.

Can he remain silent during the rest of the year, as the death toll rises to 10,000? Or next year, when it will reach 20,000 and more and more of the victims are children or non-gay adults?

As an administration uncomfortable with most of the people who have AIDS, an aggressive program of AIDS education has been even more politically unappealing. The AIDS virus is elusive and difficult to stop. Cures for AIDS infections are unknown. A vaccine is still years away, if ever possible. The only current hope that the epidemic can be slowed is education of those at risk–education about exposure, about body fluids, about sex. Such educational campaigns can succeed: In cities in which the gay community has worked intensively to educate and warn its members, gay venereal disease rates are sharply down.

But this is the administration that does not even condone telling heterosexuals about birth control. It will be difficult for it to tell everyone–both gay and straight–about condoms and safe sex. For years now, the Department of Health and Human Services has left such educational efforts to others, fearing that it would appear to be condoning homosexual acts or promiscuous behavior. The VD studies suggest that if the administration had been able to overcome its squeamishness about sex and put expertise and resources into education, many of the epidemic´s victims might have been saved.

Such political difficulties as these must be overcome. We cannot afford to be priggish when lives are at stake. We cannot afford to cut corners in studying an epidemic.

It is clear, however, that the urgency of the situation has not moved the White House. Even when it reluctantly requested increases in AIDS funding, it did so only when the Congress threatened to subpoena the administration´s own scientists´ proposals. Even when researchers can name the scientific work that should proceed, the administration budget-makers send them back to whittle at the dollars to support it.

What will it take for us to deal with AIDS not as a political disease but as a public health catastrophe? What will it take for the administration to respond to the epidemic with the concern, compassion, and immediacy that it deserves?

Perhaps if the president were to say the word.