The Associated Press; Saturday, December 6, 1997.
Laura Meckler, Associated Press Writer

"Progress in the federal response to AIDS has stalled in recent months, contributing to a sense of diminished priority for AIDS issues during the president's second term," said a draft of a progress report to be approved Sunday by the Presidential Council on HIV/AIDS.

The report cites the administration's failure to expand Medicaid to get AIDS- fighting drugs to people infected with the HIV virus and accuses Clinton of lacking "the courage and political will" to fund programs for drug addicts to exchange dirty syringes for clean ones.

It's the second progress report to be issued by Clinton's hand-picked AIDS advisers. The first, in July 1996, also criticized the administration's failure to fund needle exchange programs, but it emphasized that Clinton had done more than any of his predecessors to fight AIDS.

This report is harsher, said Dr. Scott Hitt, a Los Angeles physician who chairs the 30-member council.

"We believe progress on the battle against AIDS is losing momentum," he said Saturday in an interview while attending a meeting of the panel.

The report praises the Clinton administration for increased funding for AIDS, approval of new drugs and more efficient spending of AIDS research money. It also lauds Clinton's call for an AIDS vaccine.

"As history will undoubtedly record, President Clinton is the first American chief executive to take serious action to address the AIDS crisis," it says. "However, most of these important strides occurred during the president's first term."

Clinton's AIDS policy chief, Sandra Thurman, responded that the issues surrounding AIDS have become more complex as attention has turned from the basics of prevention and early funding to controversial and expensive policy proposals.

"I understand people's frustrations," she said Saturday in an interview. "We're grappling with some really hard stuff. Taking care of people in the short run and taking care of people in the long run are two different things."

On Medicaid expansion, the administration has concluded that it is too expensive to let people with HIV into the health program for the poor to access AIDS-fighting drugs. The drugs cost about $12,000 per person per year.

Officials had hoped the plan would pay for itself by keeping people healthy longer and saving on future hospital care but even modest proposals cost hundreds of millions of dollars over a few years, officials said.

Thurman, who attended the council's session Saturday, emphasized that the administration is still searching for ways to get AIDS drugs to people with HIV. But the AIDS council, in its draft report, says not enough has been done since April, when Vice President Al Gore announced the initiative.

"Many months have passed, no pilot project has been put in place, and the administration continues to send mixed and conflicting signals regarding its pursuit of this objective," it says.

Regarding prevention, the council report says the administration "has failed to lay out a coherent strategic plan of action," particularly its failure to fund needle exchange programs, criticized by some as promoting drug use.

The administration, the report says, has "failed to exhibit the courage and political will needed to pursue public health strategies that are politically difficult but that have been shown to save lives."

Still, council members backed off a threat to resign in protest over the needle exchange policy. Hitt said members were pleased that the administration fought to keep the authority to approve the programs, which some in Congress wanted to take away. Now, he said, they'll see if the administration takes advantage of it.

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