U.S. AIDS Response Held Too Small, Uncoordinated

WASHINGTON — Experts believe 1988 federal funding for AIDS prevention programs is too low and that the government’s response to the crisis has become tangled in red tape, a congressional report said Wednesday.

The report, released by Sen. Lawton Chiles (D-Fla.), found that the experts agreed with the government’s prevention priorities but said at least $365 million more is needed in 1988 for AIDS education, testing and methadone treatment for intravenous drug users, a key high-risk group.

“Many told us that the perceived lack of federal leadership is at least as troublesome as estimated shortfalls in the budget,” said the report by the General Accounting Office, the investigative arm of Congress. “These researchers concluded that the federal response to AIDS appears uncoordinated and insufficient.”

Officials Are Frustrated

The report said state and local health department officials in New York City and San Francisco, both major AIDS flash points, were frustrated by having to spend an inordinate amount of time filling out funding applications instead of educating the community about acquired immune deficiency syndrome.

“The (officials) told us that the patchwork of federal and state funding available for AIDS prevention programs and the lengthy and cumbersome application processes for grants have prevented a quick response to the AIDS epidemic in many instances,” the GAO report said.

The Centers for Disease Control in Atlanta said that almost 40,000 cases of AIDS have been reported in the United States as of July 29, resulting in 22,548 deaths. The Public Health Service predicts there will be 270,000 cases by 1991.

The report noted that federal funding for AIDS research and prevention has increased dramatically since the disease was identified in 1981. The Public Health Service budget for AIDS has gone from $200,000 in 1981 to a projected $790 million in fiscal year 1988, including $247 million for prevention activities.

Consensus Cites Fund Lack

But in interviewing more than 20 AIDS experts nationwide, the GAO found a consensus that projected 1988 federal funding for certain high-priority AIDS prevention programs was not adequate.

The experts suggested spending be increased by at least:

--$250 million for expanded capacity at voluntary AIDS testing and counseling centers.

--$65 million for educational campaigns targeted at both high-risk groups and the general population.

--$50 million for methadone treatment to hold down the spread of AIDS among intravenous drug users, who account for 16% of all AIDS cases nationwide through the sharing of infected needles.

No Regard for Priorities

The GAO noted the experts’ funding recommendations were made without regard to competing health priorities or federal budget constraints.

The report said experts were particularly alarmed about the epidemic among intravenous drug users because they are the main source of transmission to heterosexuals and newborns of the deadly disease that destroys the body’s ability to fight infection. Drug users account for 60% of heterosexual cases and 73% of cases in newborns.