The AIDS Political Machine

• Share

Good news rarely kicks up controversy, but this may be an exception. A report soon to be published by the national Centers for Disease Control estimates that the size of the AIDS epidemic is significantly smaller than originally projected. Since 1986, the Federal Government has claimed that as many as 1.5 million Americans were infected with the incurable virus. The number soon to be announced will be around 1 million, and some Government officials suggest that the count could be as low as 650,000. Also, the rate of new infections in New York City, Los Angeles and San Francisco is at last slowing. "In retrospect," says the CDC report, those earlier estimates, "based upon limited data available at the time, were too high."

Why the controversy? Because AIDS lobbyists insisted all along that the scope of the epidemic was being understated. By doing so, AIDS activists overcame conservative resistance and rightfully elevated the fight against the disease to the top of the nation's public-health agenda. Says June Osborn, chair of the National AIDS Commission: "We should not be content or comfortable. The national response to an out-of-control epidemic has been frighteningly modest."

But now that the picture is brightening statistically after a decade of gloom, many research scientists and health-policy analysts question whether the changes wrought by AIDS activists harm basic research, the public health and perhaps even those who are at risk of acquiring the virus. Says Joel Hay, a health economist and senior research fellow at the Hoover Institution: "Things are out of whack." Three areas merit special concern:

A swollen budget. After an initially sluggish response by the Reagan Administration, Washington has pumped current AIDS funding to a robust $1.6 billion. That is slightly more than the budget for cancer ($1.5 billion), which killed more than twelve times as many people last year (500,000, compared with 40,000 who died from AIDS). And it is far greater than the $610 million budget for heart disease, the nation's top killer. "It's wrong to spend more money on a disease that will never kill more than 35,000 to 40,000 people a year than on a disease that will kill a half-million every year," says Michael Fumento, author of the recently published Myth of Heterosexual AIDS.

Cures first, prevention second. The most effective means of controlling a contagious epidemic is through prevention. But the AIDS movement has emphasized the rapid development of treatments for AIDS victims. Says Michael Nesline of the activist group ACT UP: "We're fighting for people for whom the question of prevention is a moot point." In this regard, the movement found allies in conservative politicians who were unable to support "safe sex" education but saw AIDS research as politically neutral.

Consequently, spending on drug development has outpaced funding of prevention programs 2 to 1. Some public-health officials fear that the concentration on cures has been at the expense of educating Americans who remain at risk -- primarily blacks and Hispanics of the inner cities of the East. Thus the epidemic in those ghettos is likely to grow. Says Samuel Thier, president of the National Academy of Sciences' Institute of Medicine: "We should have known that focusing largely on treatment after infection would not be an adequate long-range strategy."