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What Happened To The War On Aids?


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WHAT HAPPENED TO THE WAR ON AIDS?

AIDS activists once viewed President Clinton as their savior. "Fighting the AIDS epidemic will be a top priority," Clinton vowed on the campaign trail. He promised to launch major new prevention initiatives and boost funding for research, prevention, and care. And once in office, Clinton appointed an AIDS czar to lead an all-out war on HIV, the deadly virus that now infects more than 40,000 Americans a year.

All of this was a big change from the Bush Administration, which quashed even simple measures such as promoting condom use because of a perceived threat to "family values."

But on July 8, AIDS czar Kristine M. Gebbie, a former top Washington State health official, resigned--the latest sign, Administration critics now contend, of a weak and sadly disappointing AIDS policy. They blame the White House for not giving her the power or backing she needed to become a forceful advocate. "Gebbie is a scapegoat," declares Martin Delaney, founding director of Project Inform, an AIDS treatment and lobbying group in San Francisco.

Even members of the Clinton Administration admit they could do better. "A lot of the criticism is very legitimate," says Dr. Philip R. Lee, Assistant Secretary of Health & Human Services. "The process is improving. We're now getting cranked up."

Critics say examples abound of wobbly Administration support. When Gebbie tried to set up an advisory council to push a more aggressive AIDS agenda, the Administration failed to appoint any of the suggested members. Nor did the White House back the idea of providing addicts with clean needles, despite successful AIDS-prevention pilot programs in such cities as Tacoma, Wash., and Lund, Sweden. "The syringe-exchange issue is still bogged down at the federal level," complains Don C. Des Jarlais, research director of the Chemical Dependency Institute at Beth Israel Medical Center in New York.

To make matters worse, the White House hasn't been bold enough in promoting condoms, prevention experts believe. "Damn it, we've got a crisis," says Dr. David E. Rogers, professor of medicine at Cornell University and former vice-chairman of the National Commission on AIDS. "Here's a disease we absolutely know how to prevent, and we're not doing it."

Some wonder whether the White House's timidity stems from the same political concerns that hobbled the Bush Administration. Rogers speculates that after the furor over homosexuals in the military, Clinton is gun-shy about stirring up the Religious Right further--and alienating conservative Democrats. Rogers and others believe that the President may be worried about being blamed for encouraging moral depravity through aggressive condom promotions or needle exchanges. "Part of me suspects that somewhere in the Administration people are saying: `Let's do the minimum we can and just let this epidemic burn out,"' says Delaney.

HIGH MARKS. That's a bit too cynical for most Administration critics. "There are many people in the White House and public-health bureaucracy who are extremely committed to the fight against AIDS," says Lynora Williams of the AIDS Action Council, the lobbying group for service organizations. Dr. Lee at HHS gets high marks for starting to put together a comprehensive AIDS-prevention strategy. And the Administration has pushed through large increases in funding for AIDS research.

Administration insiders insist that Gebbie's resignation is a step toward fixing the problems. Her eventual replacement, promises a top White House official, will be more skilled at coordinating policy across the various agencies and boosting the overall AIDS agenda.

Still, until the Administration manages to deliver on more of its campaign promises, AIDS advocates aren't about to cast Clinton again as a hero.

CLINTON'S TARNISHED AIDS POLICY

The White House has increased funding for AIDS research and patients' care, but critics still accuse the Administration of falling short in key areas:

-- Boosting prevention efforts, such as needle-

exchange programs and sex education

-- Reassessing priorities for the nation's $1.3

billion research effort

-- Coordinating efforts of various agencies to end

duplication and save money

-- Putting AIDS at the top of the political agenda, as candidate Clinton pledgedJohn Carey, with Susan B. Garland, in Washington


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