Step in The Right Direction

By Christine Gorman

"We're not saying that AIDS is under control," said James Mason, director of the Atlanta-based Centers for Disease Control. "We are saying that it's not spreading like wildfire." That conclusion, the result of a CDC study released last week along with a preliminary report by President Reagan's AIDS commission, was little comfort to many Americans: AIDS has killed nearly 27,000 people in the past seven years, and is expected to infect a quarter of a million more by 1991. Nonetheless, the two reports met with cautious approval, even among critics, for the Administration's attempt to find some way out of the AIDS nightmare. Said Martin Delaney, a San Francisco AIDS activist: "They are moving in the right direction. The report doesn't contain any of the ideological nonsense we expected."

Few had thought that the commission would get so far so fast. Both the chairman and vice chairman of the original presidential panel resigned last October amid reports of internal bickering. The same month, in the largest gay-rights demonstration ever, 200,000 marchers in Washington protested the Administration's handling of the epidemic. Even so, the 13-member commission, now led by retired Admiral James Watkins, produced a 25-page report that decried the lack of resources and information needed to combat AIDS . "It is the firm belief of the commission that there is much to be done," the document concluded. "Too much time has elapsed and too many people have become afflicted while questions remain unanswered."

The commission singled out four critical areas for immediate investigation: the lack of low-cost hospices or home-based care for AIDS patients, the scarcity of drugs to fight the disease, the shortage of treatment programs for intravenous drug users, and the lack of hard figures on the extent of the epidemic.

"We're trying to recommend budget priorities and where dollars ought to be spent on education and health-care facilities," said Chairman Watkins. Those decisions, he asserted, depend on data that should have been established by now. Such information could not only help resolve the controversy over just how vulnerable heterosexuals are to the disease but also identify new risk factors.

The CDC, for its part, reported that the epidemic seems to have stabilized. As many as 1.5 million people are now infected, most of them in high-risk groups like homosexual men and intravenous drug users. But the rate of new infection among homosexuals has fallen dramatically. Moreover, there are no signs of the much feared "breakout" of AIDS into the heterosexual population. Still, infection among IV drug users has skyrocketed. "It's clear that we are dealing not with just one epidemic but a series of subepidemics," declared U.S. Secretary of Health and Human Services Otis Bowen.

Despite its encouraging intentions, the real test for the panel will come in the next six months, as it makes its final recommendations. Many wonder if the commission's plea for solid data about the extent of the epidemic conceals a resolve to broaden mandatory testing. Last week prospective immigrants to the $ U.S. joined military personnel, blood donors and other groups now required to submit to AIDS testing. The commission tabled discussion on AIDS education until February in spite of widespread agreement among health professionals that educational programs are the most effective way to combat the disease. The panel's recommendations will have to strike a balance between acceptable government-sponsored initiatives and what it has called "personal responsibility." Watkins and his team have made a credible beginning, but AIDS has had a considerable head start.

With reporting by Dick Thompson/Washington, with other bureaus