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Gordon Nary
The International Association of Physicians in AIDS Care

April, 1997

Although Dr. Eric Goosby has been recently named as interim National AIDS Policy Advisor to replace Patsy Fleming, the media have been floating a gaggle of names of possible nominees for permanent AIDS Czar. Along with the roll of leading AIDS activists, there is a growing list of out-of-work politicos such as former Housing and Urban Development Secretary Henry Cisneros and former Texas Governor Ann Richards.

According to our Washington sources, nine people have already turned down the job. And the adminstration is currently negotiating with David H. Mulligan, commissioner of the Massachusetts Department of Public Health, who has asked for significant changes in the job description.

The office of National AIDS Advisor has a full-time staff of two and an annual budget of less than the cost of maintaining the public washrooms at the Willard Hotel in Washington DC. And while the office has attracted well-meaning people, it has essentially been a charade-an agency in name only with no meaningful budget, no authority, no moral voice, and no significant impact on AIDS policy. The career of anyone who seriously considers a nomination to this position will either be destroyed or, at best, compromised.

There has also been a call to strengthen the position of National AIDS Policy Advisor by elevating it to cabinet status. That might have been a reasonable strategy four years ago when the position was created, but not now. AIDS has become another disease of the poor. Since the poor are disenfranchised in our society, we will never see an advocate for the poor given cabinet status.

We don't need a National AIDS Policy Advisor to tell the White House what needs to be done. The issues essentially have been the same for the past 10 years when the first presidential AIDS Commission issued its recommendations to President Reagan. We all know what needs to be done. We need to lift government restrictions on needle exchange programs. We need to legalize pharmacy sites of sterile injection equipment. We need more federal funding of drug treatment programs. We need funding of vaccine research coupled with an ethical method of testing the vaccines. We need to provide sexually explicit HIV educational material to young people. We need to run condom ads on the major networks during prime time. We need to provide AIDS drugs and related technologies to all those who will die without them.

AIDS policy is essentially an ethical challenge. We have allowed political considerations to undermine effective AIDS prevention and treatment policies. Winning elections has always been more important than saving lives. The discipline of ethics is concerned with the consequences of our acts or of our failure to act when we have the obligation to do so. Our political leaders have failed to create effective AIDS prevention and treatment policies. As a result, hundreds of thousands of lives are unnecessarily compromised by HIV. We don't need a National AIDS Policy Advisor. What we need is a National Ethics Advisor.

©1997, Medical Publications Corporation

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