Medicine: At Last, the Battle Is Joined

Washington fights AIDS with modest proposals -- and heated debate

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"AIDS is surreptitiously spreading throughout our population, and yet we have no accurate measure of its scope. It is time we knew exactly what we are facing."

With those words and after months of cautious deliberation and disagreement within his Administration, President Ronald Reagan finally unveiled a plan for combatting AIDS -- and further fueled the furious debate over how best to contain the virus. The question is fast becoming one of the most hotly contested issues both in Washington and on the international political agenda. As evidence of growing concern, 6,082 AIDS researchers and public health officials from 50 countries gathered in Washington for the largest conference ever devoted exclusively to the disease.

The President's remarks were one of several dramatic expressions in the capital last week of the intense national debate over a key issue involving AIDS control: mandatory testing. Reagan drew boos and hisses during a May 31 speech at a private AIDS fund-raising dinner when he urged "routine" testing of inmates in federal prisons and patients in Veterans Administration hospitals. He also asked that all foreigners seeking residence visas be screened for exposure to the virus and strongly encouraged states to test marriage-license applicants.

A day later, Vice President George Bush, echoing the themes stressed by the President, was roundly booed by an audience gathered at the Washington Hilton for the third International Conference on AIDS. In an aside that was picked up on an open television microphone, Bush, taken aback by the reaction, asked, "Who was that? Some gay group out there?" Before his speech, an estimated 350 protesters, some of them suffering from AIDS, had staged a noisy demonstration in front of the White House. District of Columbia police, wearing yellow rubber gloves to protect against possible AIDS-virus infection, arrested 64 of the protesters.

There were other signs of official preoccupation with AIDS. The threat of the disease is slated to come up when Reagan and six other leaders of major industrial democracies* meet at the economic summit in Venice this week. That the battle against AIDS will require international cooperation was a point repeatedly made by top AIDS researchers at the Washington conference. Speaker after speaker emphasized the lengthening reach of the AIDS virus around the globe -- and the potential magnitude of the problem for policymakers. Said U.S. Deputy Assistant Secretary for Health Lowell T. Harmison: "We are at war with a global disease."

Some American health officials welcomed the President's call for screening. At week's end Health and Human Services Secretary Otis Bowen announced plans to chart the dimensions of the disease by testing 45,000 randomly selected volunteers. There are now more than 36,000 cases of AIDS in the U.S., and as many as 1.5 million people, or about one in every 30 men between the ages of 20 and 50, may already carry the virus. "The President's statement was something I could agree with," said Surgeon General C. Everett Koop, who opposes mandatory testing because it might scare away those in high-risk groups who need both screening and counseling. Under the President's plan, Koop stressed, "individuals have a right to opt out."

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