Panel Says U.S. Apathy Harms Fight on AIDS

WASHINGTON —  Warning that the United States has reached a crossroads in the AIDS epidemic, the National Commission on AIDS on Wednesday predicted “relentless, expanding tragedy in the decades ahead” if concerted action is not taken soon to curb the burgeoning crisis.

The commission, which released its final comprehensive report after two years of work, blamed societal and governmental apathy for the nation’s failure to develop an AIDS strategy or to devote sufficient resources to combat the disease.

“There is so much that we can do . . . and so much that we must do . . . “ the report said. “But there are two destructive attitudes within our borders that hamper these actions. They are a thinly veiled feeling that those who acquire the virus are getting what they deserve, and a collective indifference to their fate.”

The commission condemned federal policy-makers for not doing more to address the epidemic. AIDS has claimed the lives of 120,000 Americans over the last decade, the panel said, and the toll is expected to grow to 350,000 by the end of 1993. An estimated 1 million Americans are believed to be infected with the human immunodeficiency virus.

“Our nation’s leaders have not done well,” the report said. The White House “has rarely broken its silence” on AIDS during the last decade, it said, and Congress, while developing important AIDS legislation, “has often failed to provide adequate funding for AIDS programs.”

White House Press Secretary Marlin Fitzwater, however, took issue with the panel’s criticism of the Bush Administration’s efforts to deal with AIDS. “We believe that the government has been aggressive in responding to the AIDS crisis,” he said.

Fitzwater said the Administration agrees that AIDS “is a major health problem that this nation has to deal with.” But, he added: “This is a new problem in an historic sense. We’ve been trying to deal with AIDS for probably less than a decade. Enormous resources are being put into it, and we will take this report and try to improve the system as best we can.”

The commission made more than two dozen recommendations for fighting the epidemic, including development of a federal AIDS prevention initiative and adoption of universal health-care coverage for everyone living in the United States.

As a starting point, it called on the White House to develop a national plan to identify priorities and resources needed to prevent HIV transmission and to treat AIDS. “The United States, which has more people with AIDS than any country in the world, is one of the few developed nations with no national plan,” the panel said.

Since universal health insurance is expected to be a long time in coming, the commission proposed taking other, more immediate steps in the interim. It recommended making all low-income persons with the HIV disease eligible for Medicaid coverage, and increasing Medicaid payment rates to providers to encourage greater participation in the program.

The report charged national leaders with adopting a “false calm” about the epidemic and with fostering a belief that “enough has been done about AIDS since it is just one disease” and that attention should be directed to other diseases that currently kill more people.

“I often have the urge to find the tallest point in the land or the highest building, and get to the top and scream: ‘Hey, listen to what we know, and use it,’ ” said Dr. June Osborn, who heads the commission. “ . . . This is forever. We’re not going to get rid of the virus. For the longest time, there’s been a sense that this will go away some day. It won’t. Even if we stopped every new infection tomorrow, we’ve got a decade of trouble coming.”

AIDS organizations and policy-makers praised the report.

It “reminds us again that the AIDS epidemic is far from over,” said Sen. Edward M. Kennedy (D-Mass.), chairman of the Senate Labor and Human Resources Committee. “The conclusion that public ‘blame, fear and indifference’ are now as deadly as the virus itself is a devastating indictment of the nation’s inability to deal effectively with this critical public health issue.”

Daniel T. Bross, executive director of the Washington-based AIDS Action Council, urged that elected officials “take to heart” the report’s message. “It is now up to the President and the Congress--especially the President--to move from occasional symbolic gestures to true compassion,” he said.

The 15-member commission was created by federal statute to advise Congress and the White House on the development of a “consistent” national AIDS policy. It includes members appointed by Congress and the White House. One of President Bush’s appointees, Belinda Mason, recently died from AIDS.

Osborn said that the commission, which has been renewed for a third year, will use the next 12 months to “try and find ways to watchdog and push our recommendations--which is a luxury most commissions don’t have.”

Meanwhile, on Capitol Hill, the parents of a dying 23-year-old Florida woman who apparently was infected with the AIDS virus by her dentist, appealed for support for legislation that would require AIDS testing for health-care workers who perform invasive medical procedures.

The woman, Kimberly Bergalis, is scheduled to testify today during a hearing before the health and environment subcommittee of the House Committee on Energy and Commerce.

“Her journey here, whatever happens, may be her last,” her father, George Bergalis, told a roomful of reporters and television crews. “Her dying wish . . . is that every member of Congress have an opportunity to vote on this issue.”

The legislation is opposed by the American Medical Assn. and numerous public health officials who have argued that the risk of HIV transmission from health-care professionals is extremely remote.

Bergalis and his wife, Anna, and the bill’s sponsor, Rep. William E. Dannemeyer (R-Fullerton), accused public health officials of failing to treat AIDS as they would other infectious diseases because of the political strength of the homosexual community. Dannemeyer has said repeatedly that the public health community, in dealing with the AIDS epidemic, “has placed the civil rights of the infected above those of the uninfected.”